Glossary

ADVANCE CARE PLANNING: is making decisions about the care you would want to receive if you become unable to speak for yourself. These are your decisions to make, regardless of what you choose for your care, and the decisions are based on your personal values, preferences, and discussions with your loved ones.

ADVANCE DIRECTIVE: A general term that describes two kinds of legal documents, living wills and medical powers of attorney. These documents allow you to give instructions about future medical care and appoint a person to make healthcare decisions if you are unable to make them yourself. Each state regulates the use of advance directives differently.

ARTIFICIAL NUTRITION AND HYDRATION (ANH):  Artificial nutrition and hydration is a form of life-sustaining treatment. It is a chemically balanced mix of nutrients and fluids, provided by placing a tube directly into the stomach, the intestine or a vein.

CAREGIVER: an unpaid or paid person who helps another individual with an impairment with his or her activities of daily living. Any person with a health impairment might use caregiving services to address their difficulties. Caregiving is most commonly used to address impairments related to old age, disability, a disease, or a mental disorder.

Typical duties of a caregiver might include taking care of someone who has a chronic illness or disease; managing medications or talking to doctors and nurses on someone’s behalf; helping to bathe or dress someone who is frail or disabled; or taking care of household chores, meals, or bills for someone who cannot do these things alone.

With an increasingly aging population in all developed societies, the role of caregiver has been increasingly recognized as an important one, both functionally and economically. Many organizations which provide support for persons with disabilities have developed various forms of support for carers as well.

CASE LAW: Law that is based on a judge’s decision in a court case, rather than by legislation.

CAPACITY: In the healthcare context, the ability to understand and appreciate the nature and consequences of health care decisions and to make an informed decision. ?e term competent is also used to indicate ability to make informed decisions.

DO NOT INTUBATE (DNI ): means that chest compressions and cardiac drugs may be used, but no breathing tube will be placed.

DO-NOT-RESUSCITATE ORDER (DNR): A DNR order is a physician’s written order instructing healthcare providers not to attempt cardiopulmonary resuscitation (CPR) in case of cardiac or respiratory arrest. A person with a valid DNR order will not be given CPR under these circumstances. Although the DNR order is written at the request of a person or his or her family, it must be signed by a physician to be valid.

DURABLE POWER OF ATTORNEY: A type of advance medical directive in which legal documents provide the power of attorney to another person in the case of an incapacitating medical condition. A durable power of attorney allows another person to make bank transactions, sign Social Security checks, apply for disability, or write checks to pay utility bills while an individual is medically incapacitated. Such documents are recommended for any patient who may be unable to make his or her wishes known during a long medical confinement.

EUTHANASIA: Based on a term meaning “good death.” term traditionally has been used to refer to the hastening of a suffering person’s death. “Mercy killing” is another term often used. Voluntary Active Euthanasia involves a physician engaging in an act to cause a patient’s death, such as by giving a lethal injection, with the patient’s full informed consent. Involuntary or Non-voluntary Active Euthanasia refers to an act to end a patient’s life, without that patient’s full informed consent.

HOME CARE NURSE: a nurse who is responsible for a group of clients in the home setting. Visits clients on a routine basis to assist client and family with care as needed and to teach family the care needed so that the client may remain at home.

Synonym(s): visiting nurse

HOME HEALTH AIDE: a trained and certified health-care worker who provides assistance to a patient in the home with personal care (as hygiene and exercise) and light household duties (as meal preparation) and who monitors the patient’s condition—abbreviation HHA.

HOSPICE CARE: A program to deliver palliative care to individuals who are in the final stages of terminal illness. In addition to providing palliative care and personal support to the patient, hospice includes support for the patient’s family while the patient is dying as well as bereavement support to the family.

LIFE-SUSTAINING TREATMENT: Treatments (medical procedures) that replace or support an essential bodily function (may also be called life support treatments). Life-sustaining treatments include cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, dialysis, and certain other treatments.

LIVING WILL: A type of advance directive in which an individual documents his or her wishes about future medical treatment should he or she be at the end of life and unable to communicate. It may also be called a “directive to physicians,” “healthcare declaration,” or “medical directive.” purpose of a living will is to guide family members and doctors in deciding how aggressively to use medical treatments to delay death.

MEDICAID: is a health care program that assists low-income families or individuals in paying for long-term medical and custodial care costs. Medicaid is a joint program, funded primarily by the federal government and run at the state level, where coverage may vary.

MEDICAL/PHYSICIAN ORDERS FOR LIFE SUSTAINING TREATMENT (MOLST/POLST):  is an approach to improving end-of-life care in the United States, encouraging doctors to speak with patients and create specific medical orders to be honored by health care workers during a medical crisis.

MEDICARE: is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

PALLIATIVE CARE: A comprehensive approach to treating serious illness that focuses on the physical, psychological, spiritual, and social needs of the patient. Its goal is to achieve the best quality of life available to the patient by relieving suffering, controlling pain and symptoms, and enabling the patient to achieve maximum functional capacity. Respect for the patient’s culture, beliefs, and values are an essential component. Palliative care is sometimes called comfort care.

PHYSICIAN-ASSISTED SUICIDE OR PHYSICIAN-HASTENED DEATH: A physician supplies the means, usually a prescription for a lethal dose of medication, which a terminally ill individual can use to end his or her own life.

POWER OF ATTORNEY: or letter of attorney is a written authorization to represent or act on another’s behalf in private affairs, business, or some other legal matter, sometimes against the wishes of the other. The person authorizing the other to act is the principal, grantor, or donor (of the power).

PROXY: a person who is given the power or authority to do something (such as to vote) for someone else power or authority that is given to allow a person to act for someone else

SUBACUTE REHABILITATION: Subacute rehabilitation is less intensive than acute rehabilitation. Patients in a subacute facility generally only receive one or two hours of therapy per day, and it is usually a combination of physical, occupational and speech therapy. Patients are seen by their attending physician on a monthly basis.

SURROGATE: also known as a health care proxy or as agents, are advocates for incompetent patients.  If a patient is unable to make decision or decide for themselves about personal health care, someone else must provide direction in decision-making, as the surrogate decision maker. 

SURROGATE DECISION-MAKING LAWS: Refers to laws that allow an individual or group of individuals to make decisions about medical treatments for a patient who has lost decision making capacity and did not prepare an advance directive. Some state advance directive laws also refer to the designated healthcare agent as the surrogate.

WITHHOLDING OR WITHDRAWING TREATMENT: Not beginning life-sustaining measures or stopping them after they have been used for a certain period of time.