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The Senior Care Dictionary: 128 Words and Acronyms You Need to Know

The Senior Care Dictionary: 128 Words and Acronyms You Need to Know

According to the U.S. Census Bureau, there were 47.8 million people age 65 and older in the United States in 2015. This means that approximately 16 million families now find themselves sandwiched between caring for their children and their parents. That number will only continue to grow, given that seniors account for at least 14.5 percent of the U.S. population.

Whether you’re currently caring for an aging loved one or not, it’s crucial that you begin to familiarize yourself with all the aspects of senior care. From insurance policies to medical situations, there are a lot of terms that come with aging—along with an even longer list of acronyms that could make anyone’s head spin. Here’s a list of the 128 most commonly used senior care terms and acronyms that you should know as you help your loved one on their care journey.

1. Activities of Daily Living (ADL): “Activities of daily living” are basic tasks that people complete each day and are needed in order for basic functioning. This includes bathing, dressing, eating, toileting, and continence.

2. Acute: Severe or sudden.

3. Acute Care: “Acute care” is a type of care that is provided to a senior for a short-term medical condition from which they are expected to recover. Once they are fully recovered, seniors who needed short-term care typically don’t require daily attention in order to resume their normal routines and lifestyle.

4. Adult Day Care: “Adult day care” is a program in which adults are supervised and provided care during the day; Elders can typically attend one to two days per week up to five days per week. Some programs are open on the weekends.

5. Adult Protective Services: “Adult Protective Services” is a publicly funded investigative unit that works to review reports of abuse and neglect of seniors. The agency works with local law enforcement officials to handle abuse claims and connects seniors with support resources. To report an abuse claim, contact your local police station. If there is an emergency, call 911.

6. Aging Life Care Manager: An aging life care manager (formerly known as a “geriatric care manager” or GCM) is a type of health care professional who generally has more local connections and can assist an elder and/or their family with the process of deciding what care is needed, finding the providers of that care, and coordinating the administration of that care.

7. Alzheimer’s Disease (AD): The most common type of dementia, Alzheimer’s Disease is a degenerative disease in which the brain’s function gradually declines and eventually results in death. This disease starts with short-term memory loss.

8. Ambulatory: “Ambulatory” is a term used to refer to someone who is capable of moving. In other words, someone who is not confined to a bed or wheelchair.

9. Americans With Disabilities Act (ADA): The Americans With Disabilities Act is a law passed in 1990 that is intended to prevent discrimination based on mental or physical disability. This includes regulations on the design and accessibility of public buildings and modes of transportation, as well as business practices.

10. Amyotrophic Lateral Sclerosis (ALS): ALS (also known as “Lou Gehrig’s disease”) is a progressive disease in which a person’s brain degenerates and causes muscle weakness and eventually death. Generally, the patient’s cognitive functioning is unaffected.

11. Area Agency on Aging (AAA): “Area Agency on Aging” is a publicly funded agency that provides elders with programs and resources to assist in their care and to ensure their rights are protected. The agency has local chapters that are located throughout the U.S.

12. Arthritis: Arthritis is a joint disorder in which the joints become swollen and cause pain.

13. Assignment of Benefits: An Assignment of Benefits is the arrangement a patient has with their insurance company that details who will receive payments from their health benefit plan. Payments can go to the patient or a doctor, hospital, or medical facility.

14. Assisted Devices: Equipment that provides minor care and allows seniors to perform their activities of daily living. Some—but not all—of those devices include motorized wheelchairs, walkers, walking sticks, and guard rails.

15. Assisted Living Facility (ALF): “Assisted living facilities” provide a lower level of care than do nursing homes. They generally allow the residents more freedom and the residents require less skilled care and supervision than those in nursing homes do. A higher percentage, if not all, of the residents are private pay. These facilities may also be referred to as “assisted living” (AL), “assisted living communities” (ALC), or “assisted living residences” (ALR).

16. Asymptomatic: Without any symptoms (or effects of a disease or illness).

17. Beneficiary: The individual who receives the benefits of a will, trust, insurance policy, or other contract. A person covered by Medicare is also referred to as a “beneficiary.”

18. Benefits: “Benefits” is the money paid under an insurance policy. An insured senior can also assign their benefits to a family member or a health care provider.

19. Benefit Period: A “benefit period” is the amount of time during which an insurance policy provides a senior with benefits. Typical options for benefit periods include three years, five years, or lifetime.

20. Benefit Trigger: A “benefit trigger” is a specific condition that must be satisfied in order for an individual to be deemed eligible to use their benefit. occur to start a “benefit period.” A “benefit trigger” is part of a long-term care insurance policy.

21. Blood Pressure (BP): The pressure created by the blood circulating in the human body; it is one of the basic vital signs used.

22. Carcinoma: Cancer.

23. Caregivers: Caregivers provide non-medical care for seniors who need assistance with activities of daily living. This care can be provided in the home, or in a senior living community. Although a caregiver is generally not a skilled medical professional, some may have specialized certifications or training.

24. Cataract: A condition in which the lens of the eye becomes clouded. Surgery can be performed that usually restores much of the eyesight.

25. Centers for Medicare and Medicaid Services (CMS): The “Centers for Medicare and Medicaid Services” is a federal agency that is in control of the Medicare and Medicaid programs. It is also in charge of many regulations and certifications.

26. Certified: Medicare and Medicaid outline a set of requirements that a long-term care facility, home health agency, or hospice agency must meet to be considered certified. Medicare and Medicaid will only cover the costs of care if an establishment is certified. Some long-term care insurance policies also have this same provision.

27. Certified Nursing Assistant (CNA): A certified nursing assistant is a health care worker who works under the supervision of a nurse. They are required to go through training and generally work in nursing homes or hospitals. They provide patients with non-medical support, such as help with eating, getting dressed, or cleaning their living space.

28. Chronic: Ongoing.

29. Chronic Obstructive Pulmonary Disease (COPD): A disease in which the air pathways in the lungs narrow and limit the ability to get air to the lungs. The disease progresses over time and can result in death.

30. Community Health Center (CHC): A “community health center” is a provider of basic medical care. They typically exist in “medically underserved” areas and charge people on a sliding-scale basis.

31. Community Meal Program: A “community meal program” is a program typically offered by community centers that serves healthy, balanced, nutritious meals to seniors.

32. Companions: “Companions” are people who provide in-home care and companionship for seniors. While companions do not provide medical care or hands-on care, they may perform household chores like cooking, cleaning, transportation, and errand-running. Individuals who need less assistance would hire companions for caregiving roles.

33. Computerized Axial Tomography (CAT/CT): A scan of head and/or body that produces a cross-sectional image.

34. Congestive Heart Failure (CHF): The inability of the heart to provide sufficient blood to the rest of the body which can lead to shortness of breath, swelling of legs, and inability to exercise. Contrary to popular belief, it is not a heart attack.

35. Conservator: A “conservator” is a person who handles the financial affairs of someone who is no longer able to do so themselves. A court will appoint a conservator when necessary.

36. Copay/Copayment: A “copay” or “copayment” is the amount of money a person has to pay before their insurance covers costs.

37. Cueing: “Cueing” is when a caregiver helps a senior complete a task using prompts. The caregiver will provide the senior with specific visual or verbal actions that remind them to perform tasks and other daily activities like eating, taking medicine, or getting dressed.

38. Dementia: “Dementia” is a symptom that refers to memory difficulties and other cognitive problems which interfere in daily life. The deterioration of intellectual abilities can include a reduction in vocabulary, abstract thinking, judgment, memory, and physical coordination. Alzheimer’s Disease is the most common form of  dementia. There is no cure for dementia, but there are treatments that can address some of the symptoms associated with dementia.  

39. Department of Health and Human Services (DHHA): The Department of Health and Human Services is a cabinet department of the U.S. government which aims to improve the health and well-being of all Americans. It is in control of many regulations relating to health care provisions related activities.

40. Diabetes: A disease in which the body either doesn’t make enough insulin–a hormone the body needs to convert sugar to energy — or doesn’t use it properly. The result is that the person suffers from high blood sugar levels. The disease is treatable, but requires constant maintenance. Poor maintenance can lead to deteriorating eyesight, cardiovascular disease, and, in extreme situations, gangrene that requires amputation.

41. Discharge Planner: A discharge planner is a health care professional who provides support to seniors and their families following a hospital or rehabilitation stay. They are tasked with working with the senior to develop and coordinate a plan for post-recovery care.

42. Do Not Resuscitate Order (DNR): A “Do Not Resuscitate” order is a legal document—written by a doctor or lawyer—that informs medical staff that they do not wish machines or “drastic measures” (often including CPR) to be used in order to prolong their life. A DNR may also be referred to as a “No Code” or an “Allow Natural Death” order as well. 

43. Durable Medical Equipment (DME): “Durable medical equipment” is medical equipment that’s used in a home to improve a senior’s quality of life; examples include wheelchairs (electric or not), hospital beds, and catheters.

44. Durable Power of Attorney (DPOA): “Durable power of attorney” is a written authorization that enables a person to be in charge of addressing the legal issues of another. It may also be referred to simply as the “power of attorney” (POA).

45. Durable Power of Attorney for Finances: A “Durable Power of Attorney for Finances” is a legal document that allows a person to transfer authority over their financial decisions to a trusted individual. In this context, the term “durable” means that the order will go into effect if the person is unable to manage their own financial decisions.

46. Durable Power of Attorney for Health Care: A “durable power of attorney for health care” is a person who has been designated in advance by an elderly person to make health care decisions when he/she is unable to make those decisions about their own care. This is also known as a health care proxy.

47. Electronic Health/Medical Record (EHR/EMR): An “electronic health/medical record” is an electronic system which maintains patients’ health records. This makes it easier to transfer information across institutions and doctors’ offices.

48. Emergency Medical Services (EMS): “Emergency medical services” generally means an ambulance with EMTs.

49. Emergency Medical Technician (EMT): An “emergency medical technician” is a health care worker who responds to emergency medical situations. Generally, they are the workers that staff an ambulance. They have training, but not as much as a nurse or doctor.

50. Emergency Room/Department (ER/ED): An “emergency room” or “emergency department” is the part of a hospital that treats patients who have immediate and emergency medical conditions.

51. Emphysema: A progressive disease in which the lungs lose their ability to maintain their shape and can lead to the collapse of the lungs and inability to breathe.

52. Employee Assistance Program: An employee assistance program is a collection of benefits companies may offer to employees that include a range of services that help people deal with personal issues. Counseling and referral services are some of the benefits offered in the program, which aims to help employees improve their job performance, health, and well-being. 

53. Exclusion: When an insurance company or medical plan does not cover something it is called exclusion. Health conditions, certain situations, equipment, services, or other expenses can be considered exclusions. For example, a Medicare exclusion could be coverage of prescription drugs or long-term care.

54. Family and Medical Leave Act: The Family and Medical Leave Act is a U.S. law that requires employers of private sector employers with 50 or more employees, public agencies, and public and private elementary and secondary schools to provide unpaid, job-protected leave for specified family and medical reasons. The critical aspect of the law is that eligible employers must provide their employees with health insurance under the same terms as if the employee had not taken a leave of absence. Families typically use their time (up to 12 weeks in a 12 month period) when they have or adopt a baby, get ill, or are caring for a family member.

55. Family Caregiver: A family caregiver is a person who provides unpaid care to a family member. They often help their relative who is ill, disabled, or dealing with a medical situation.

56. Federally Qualified Health Centers (FQHC): A “federally qualified health center” is a community health center that meets the government’s standards and receives government funding.

57. Geriatrician: A geriatrician is a doctor who specializes in providing care to elderly patients. These physicians typically treat seniors who have complex medical or social issues.

58. Guardian: A guardian is a person who is appointed by a court to make decisions on behalf of someone who is unable to make decisions for themselves. In the context of senior care, a guardian is responsible for making choices regarding an elderly person’s care.

59. Health Care Proxy (HCP): A “health care proxy” is a document that names a person to make health care decisions in the event that the patient is unable to do so.

60. Health Insurance Portability and Accountability Act (HIPAA): The Health Insurance Portability and Accountability Act is a law that gives U.S. citizens certain rights to privacy when it comes to their health information. Specifically, HIPAA determines who can and cannot view personal health records or have access to health information.

61. Health Maintenance Organization (HMO): A “health maintenance organization” is a type of managed-care organization that provides health care coverage for its clients, but only if it is administered by providers who have contracts with the HMO and are part of the network.

62. Health Spending Account (HSA): A “health spending account” is an employee medical expense system in which the employee pays a high deductible and low premium. The money in the account is tax-free and can be used for deductibles and copays. Money can roll over from year to year.

63. Heart Disease: A term that includes a number of diseases which affect the heart and is the number one cause of death in the U.S.

64. Home- and Community-Based Services (HCBS): “Home- and community-based services” are services that are provided outside of an institutionalized facility. This includes home health care and adult day care.

65. Home Health Agency: A “home health agency” is a Medicare-certified organization that provides health care-related services in a person’s home. In other words, they are responsible for coordinating and managing the care provided by home health aides to their clients. Nursing, social work, personal care, and various forms of therapy such as physical or occupational are often provided by these agencies.

66. Home Health Aide (HHA): A “home health aide” provides basic care, typically to people in their homes. This care includes waking, bathing, cleaning the living space, feeding, making sure medications are taken, and assisting with any medical conditions. Most HHAs care for elderly clients.

67. Home Health Care (HCA): “Home health care” is a type of care that is provided in a client’s home. It can include home health aides, registered nurses, and skilled or unskilled care.

68. Homemaker Services: Homemaker services are businesses that offer help with household duties like meal preparation, grocery shopping, cleaning, and laundry.

69. Hospice Care: “Hospice care” is end-of-life care that focuses on making the patient as comfortable as possible, while helping them cope with end-of-life issues. Specifically, hospice providers provide pain management, counseling, and comfort to care recipients and their family members. Hospice care continues until the end of life and can be provided in a facility, hospital, or private home, depending on the recipient’s wishes and circumstances. It’s worth noting that hospice care is for individuals who have a life limiting diagnosis of six months or less and is covered under Medicare. However, room and board in a hospice home or nursing home is generally private pay.

70. Hypertension: Chronic high blood pressure that can lead to other complications, such as a stroke.

71. Incontinence: The inability to control one’s bladder.

72. Instrumental Activities of Daily Living (IADL): “Instrumental activities of daily living” are tasks that are usually done each day. They are not necessary for basic functioning, but they allow a person to live independently. This includes using the phone, managing finances, preparing meals, maintaining the home, managing medications, shopping, and using transportation.

73. Intensive Care Unit (ICU): An “intensive care unit” is a part of the hospital for people who are in medically unstable conditions.

74. Intestate: The term used for when a person dies before having made a legal will.

75. Licensed Health Care Practitioner: Doctors, nurses, licensed social workers, who have met qualifications for health care workers set by the U.S. Treasury Department.are considered Licensed Health Care Practitioners.

76. Licensed Practical Nurse (LPN): A “licensed practical nurse” is a type of nurse who receives less training than a registered nurse, and is slightly more limited in the type of care that she/he can provide.

77. Life Plan Communities: A life plan community (formerly known as a “continuing care retirement community” or CCRC) is a retirement community for the elderly that helps them live as independently as possible. As the elder’s needs for assistance increase, so does the level of care provided. These communities usually have facilities that range from independent living apartments or condos to skilled nursing facilities. Seniors will often move into continuing care retirement communities because they provide various levels of care in one place.

78. Living Will: A “living will” is a legal order that outlines an individual’s desires about the types of medical treatments they wish to receive. It is helpful always to have one but especially so if someone has a terminal diagnosis.

79. Long-Term Care (LTC): “Long-term care” is health care that is provided over an extended period of time for people who are chronically ill, disabled, or mentally handicapped.

80. Long-Term Care Insurance (LCTI): “Long-term care insurance” is an insurance plan, separate from health insurance that is designed to cover the cost of long term care. Typically, it needs to be purchased before the need for long-term care exists as the cost of the plan is based on the individual’s age and health when purchasing the plan. What is covered in the policy will vary, so it’s important for families to understand components such as what type of care is covered, the amount of care that is covered and if there are any elimination periods as part of the policy.  

81. Long-Term Care Ombudsman: A “long-term care ombudsman” is a person who is responsible for resolving issues between seniors and/or their families and care facilities. People living in nursing homes and other long-term care facilities can file a complaint, and the independent, federally-funded ombudsman program will investigate their claims.

82. Macular Degeneration: A condition that affects the ability to see, especially in the center of one’s field of vision. This is a major cause of sight loss in older adults.

83. Magnetic Resonance Imaging (MRI): A type of medical imaging device that uses radio and magnetic waves instead of radiation.

84. Managed-Care Organization (MCO): A “managed-care organization” is a method that attempts to manage care costs by selectively contracting with certain health care providers and various other cost-management techniques.

85. Medicaid: Medicaid is a joint federal and state program that is administered by each state and provides health insurance for those who are financially unable to cover their own care. A large percentage of those who live in nursing homes are covered by Medicaid. Medicaid has certain federal requirements, but the specific coverage and eligibility requirements differ from state to state.

86. Medicare: Medicare is a federal program that provides health insurance coverage for seniors in the U.S who have paid into the benefit for a certain number of periods. There are different parts of Medicare that individuals can purchase and individuals must choose which plan type they would like. Typically, individuals become eligible at the age of 65, but individuals under the age of 65 with certain disabilities may be eligible.

87. Medicare Advantage (MA): The “Medicare Advantage” program (formerly known as the “Medicare+Choice” or Part C programs) is a private insurance policy that is meant to provide similar health insurance coverage to what Medicare provides. Keep in mind that there may be preferred networks with Medicare Advantage Plans and individuals are not eligible for a MediGap policy.

88. Medicare Savings Program: A “Medicare savings program” is a financial program that helps people who have Medicare, but who can’t afford some of the costs. It can cover the costs of premiums and copays.

89. MediGap Insurance: “MediGap insurance” is a supplemental insurance plan in which a Medicare recipient pays an extra monthly premium for coverage of the cost of services that Medicare does not cover. Services include copays, coinsurance and deductibles. Medigap cannot be used to cover the cost of long term care.

90. Multiple Sclerosis (MS): A disease in which the brain has difficulty communicating with the rest of the body. It generally results in physical and/or mental disability. Life expectancy is 5 to 10 years shorter than unaffected people.

91. Myocardial Infarction (MI): A heart attack.

92. Network: A “network” is the group of doctors, hospitals, pharmacies, and other health care professionals that a particular person has access to.

93. Nurse Practitioner (NP): A “nurse practitioner” is a registered nurse who has completed graduate-level education and is authorized to conduct many of the functions that a doctor usually does, such as acting as a primary care provider and writing prescriptions.

94. Nursing Care Center: A nursing care center (formally called a “nursing home” or NHA) provides care for seniors who require constant assistance and medical care. This term covers a wide range of options defined as providing 24/7, out-of-home care and monitoring by skilled medical professionals.

95. Occupational Therapy (OT): A kind of therapy that works with a person in order to help them be able to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

96. Older Americans Act (OAA): The Older Americans Act is a law that forbids discrimination of the elderly, and funds transportation, meals, senior centers, long-term care ombudsman, and other programs that benefit the elderly.

97. Operating Room (OR): The “operating room” is a room in a hospital that is used to conduct surgeries.

98. Out-of-Area Benefits: “Out-of-area benefits” are benefits that are offered outside of the HMO’s service area, usually only emergency services.

99. Out-of-Pocket Maximum: An “out-of-pocket maximum” is the total amount of money a person is required to pay every year for their health insurance’s deductibles and coinsurance. The cost is in addition to the insurance plan’s premiums.

100. Out-of-Pocket Payments (OPP): “Out-of-pocket” payments are health care costs that are not covered by any sort of insurance and have to be paid out of the consumer’s pocket.

101. Osteoporosis: A disease in which bones become frail and brittle and are easily broken.

102. Over the Counter (OTC): “Over the counter” is a term that refers to medication that does not require a prescription.

103. Pacemaker: A medical device that is implanted in the body and helps to regulate the heart rate by using electrical impulses.

104. Palliative Care: Palliative care is designed to reduce the physical and emotional pain that can come from having a serious illness. It’s important to note that an individual does not need a terminal diagnosis in order to receive palliative care. In addition to their work with chronically ill individuals, palliative care providers also provide support services to family members. Most palliative care is provided in hospitals or doctors’ offices.

Want to know more about the differences between hospice care and palliative care? Make sure to read our article, “Palliative Care and Hospice Care: Everything You Need to Know.”

105. Parkinson’s Disease: A degenerative disorder in which a person’s central nervous system gradually erodes a person’s ability to control the movements of his/her body.

106. Patient Assessment: A “patient assessment” is an assessment of the patient that is usually conducted in health care facilities (e.g., assisted living facilities). They can be used to determine the level of care that the patient requires.

107. Patient Days: The “patient days” are the number of days that a person is considered to be a patient in a health care facility. Certain insurance plans only include coverage for a certain number of patient days.

108. Personal Care Assistant (PCA): A “personal care assistant” is a person who is paid to provide those who are ill or chronically disabled assistance with their ADLs.

109. Personal Emergency Response System (PERS): A “personal emergency response system” is an alarm system that’s designed to alert medical personnel when there is an emergency. Generally, it consists of a wireless transmitter that can be easily activated (e.g., through pushing a button) in the case of an emergency. They are typically portable and worn by or kept near the person who might need it.

110. Physical Therapy (PT): A type of therapy that focuses on helping a person promote their ability to move, minimize pain, restore function lost through disease or injury, and prevent further disability.

111. Physician Assistant (PA): A “physician assistant” is a health care professional who is licensed to work under a physician’s supervision. A PA can conduct physical exams, write prescriptions, and diagnose and treat illnesses, among other functions.

112. Plan of Care: A “plan of care” is a written plan of medical services and care a person needs, typically prepared by the individual’s doctor.

113. Preferred Provider Organization (PPO): A “preferred provider organization” is a managed-care organization that has contracted with health care providers to provide discounted rates to patients covered under its insurance plan.

114. Pressure Sore: A type of skin degeneration due to pressure, temperature, age, medication, lack of movement, or a combination of all of the above. Generally, the condition can be treated by frequent turning of bed-bound patients, special medication, or in early stages moisturizers. This is also known as a pressure ulcer or bedsore.

115. Primary Care: “Primary care” is an outpatient medical setting that provides continuity and integration of health care to a patient across a broad spectrum of care (e.g., regular check-ups).

116. Primary Care Physician/Provider (PCP): A “primary care physician” or “primary care provider” is a health care provider who provides care to a person in the outpatient setting, both preventative and curative (e.g., regular check-ups and advice on basic medical issues).

117. Private Pay: “Private pay” refers to people who are paying for care out of pocket, instead of through public or private insurance plans.

118. Provider: A “provider” is a term used to refer to anyone who provides care for another person. This term can be used in reference to doctors, hospitals, medical facilities, home health aides or agencies, and other types of health care professionals.

119. Registered Nurse (RN): A “registered nurse” is a licensed health care professional who provides care in a variety of environments. They can conduct tests and other medical procedures under a physician’s supervision, but they cannot prescribe medications.

120. Respite Care: “Respite care” is a type of care that is provided in order to give a caregiver a break, or respite, from the normal stresses of caregiving. Respite care can last anywhere from an hour to a month. People typically need respite care if the regular caregiver becomes sick, goes on vacation, needs to run errands, etc. According to the National Institute on Aging, respite care “can be provided at home, in a health care facility, or at an adult day center.”

121. Rider: A rider is an add-on provision to an insurance policy that details additional benefits the policyholder will receive for an additional cost.

122. Skilled Nursing Facility (SNF): A “skilled nursing facility” is a facility that provides a high level of nursing care. It’s also known as a nursing home.

123. Social Security: Social security is a benefit that provides any eligible U.S. citizen with an inflation-adjusted monthly income for the rest of that person’s life. Once eligibility requirements are met, a person can receive Social Security benefits at age 62, or if they become disabled before they hit that age.

124. Social Security Disability Insurance (SSD/SSDI): “Social Security Disability Insurance” is a federal insurance program that covers people who are unable to work due to a disability. The aid is given in the form of a monthly stipend and is not dependent on income.

125. Spend Down: Typically referred to with Medicaid as a “spend down” is when someone must use their income and assets to qualify for Medicaid. For example, if someone does not quality for Medicaid because their income is too high, they may go through a Medicaid spend-down to spend their income and assets until they are eligible for Medicaid.

126. Supplemental Security Income (SSI): “Supplemental Security Income” is a federal program that provides stipends to those who are low-income and above 65, blind, or otherwise disabled.  

127. Veteran’s Affairs (VA): “Veteran’s Affairs” is a government veteran benefit program. Health care insurance is included as a benefit option as well as some benefits that can help cover the cost of long term care.

128. Visiting Nurses: “Visiting nurses” are registered nurses who provide in-home care. They can provide medical, rehabilitative, and hospice care.