Senior Care Terms: A California Glossary for Families

Quick answer: This glossary defines common senior care terms families encounter in California, including care settings (RCFE, board and care, SNF), payment programs (Medicare, Medi-Cal, ALW, SSI/SSP), legal documents (power of attorney, advance directive, POLST), and care concepts (ADLs, levels of care, hospice). Use it alongside conversations with doctors, care homes and placement advisors.

Senior care comes with its own vocabulary, and California adds terms of its own. Families often hear acronyms like RCFE, ALW, POLST and SNF in the middle of a stressful hospital discharge. This glossary of senior care terms explains them in plain language, with links to deeper guides where available.

A to C

• Activities of daily living (ADLs): basic self-care tasks such as bathing, dressing, eating, toileting, continence and transferring. Help with ADLs is central to assisted living and long-term care insurance benefit triggers.
• Adult day health care (CBAS): a Medi-Cal-covered day program with nursing, therapy and social services. See senior day care.
• Adult residential facility (ARF): a California-licensed home providing care and supervision for adults 18 to 59.
• Advance health care directive: a legal document naming a health care agent and recording treatment wishes.
• Aging in place: staying in one’s own home with support as needs change.
• Assisted living: a residential setting offering housing, meals and help with daily activities. Licensed as an RCFE in California. See assisted living in San Diego.
• Assisted Living Waiver (ALW): a Medi-Cal program that pays for care services, not room and board, in participating assisted living facilities.
• Board and care home: a small residential care home, often six beds, licensed as an RCFE. See board and care homes in San Diego.
• CalAIM Community Supports: optional services Medi-Cal managed care plans can offer, such as respite or help moving from a nursing home to assisted living.
• Care conference: a meeting to review a resident’s service plan with staff and family.
• Care level: a tier or points score that sets assisted living care fees.
• CDSS / Community Care Licensing: the California Department of Social Services division that licenses and inspects RCFEs. See RCFE licensing and inspection reports.
• CFRA: the California Family Rights Act, which provides job-protected family leave for eligible workers.
• Conservatorship: a court process that appoints someone to manage the care or finances of an adult who cannot do so.
• Continuing care retirement community (CCRC): a campus offering independent living, assisted living and nursing care, usually under a contract.
• Custodial care: non-medical help with daily living, which Medicare does not cover.

D to H

• Delirium: a sudden, often reversible change in attention and thinking, common after hospital stays.
• Dementia: a progressive decline in memory and thinking, including Alzheimer’s disease, vascular, Lewy body and frontotemporal dementia. See what to do after a dementia diagnosis.
• Delayed egress: a door system that delays opening to help prevent residents with dementia from leaving unsafely.
• Discharge planner: a hospital or SNF professional who arranges a patient’s next care setting.
• Durable power of attorney: a legal document naming an agent to manage finances, which stays effective if the person loses capacity. See should I be power of attorney for my parents.
• Elimination period: the waiting period before long-term care insurance benefits begin.
• Estate recovery: Medi-Cal’s process of seeking repayment for certain long-term care costs from a deceased member’s probate estate.
• Geriatric care manager: a professional who coordinates care for older adults.
• HICAP: California’s free, unbiased Medicare counseling program.
• Home health: skilled, short-term medical care at home, often covered by Medicare. See home health care.
• Home care (in-home care): non-medical help at home, usually paid privately. See in-home care in San Diego.
• Hospice: comfort-focused care for people with a terminal illness, covered by Medicare. See hospice care in San Diego.

I to M

• IHSS: In-Home Supportive Services, a Medi-Cal program paying for in-home help.
• Independent living: senior housing with services but no personal care. See independent living in San Diego.
• Instrumental activities of daily living (IADLs): tasks such as managing money, medications, shopping, cooking and transportation.
• LTACH: long-term acute care hospital, for complex medical needs over weeks.
• Long-term care insurance: private insurance that pays toward care once benefit triggers are met.
• Long-Term Care Ombudsman: a free advocate for residents of nursing homes and residential care facilities.
• Medi-Cal: California’s Medicaid program. See our Medi-Cal eligibility guide.
• Medicare: federal health insurance for people 65 and older and some younger people with disabilities.
• Medicare Advantage: private plans that provide Medicare benefits.
• Medigap: Medicare Supplement insurance that helps pay Original Medicare costs.
• Memory care: dementia-focused residential care, often secured. See memory care facilities in San Diego.

N to R

• Needs and services plan: the written plan describing a resident’s needs and services in a California RCFE.
• Observation status: outpatient hospital status that does not count toward Medicare’s three-day inpatient rule.
• PACE: Program of All-Inclusive Care for the Elderly, combining medical care, day center and home help.
• Palliative care: comfort-focused care for serious illness, which can be given with curative treatment. See our palliative care definition.
• Personal needs allowance: the small monthly amount a Medi-Cal nursing home resident keeps.
• Physician’s report: a medical form California care homes require before admission.
• Placement agency: a service that helps families find senior living, usually free to families. See our senior placement agency.
• POLST: Physician Orders for Life-Sustaining Treatment, a medical order for people with serious illness.
• PRN medication: “as needed” medication given based on written instructions.
• RCFE: Residential Care Facility for the Elderly, California’s license for assisted living, memory care and board and care. See what a residential care home for seniors is.
• Respite care: short-term care that gives family caregivers a break.

S to Z

• Share of cost: the portion of income a Medi-Cal member pays toward care before Medi-Cal pays.
• SNF (skilled nursing facility): a nursing home providing 24-hour licensed nursing. See skilled nursing homes in San Diego.
• Special enrollment period (SEP): a time outside normal enrollment when someone can change Medicare plans.
• SSI/SSP: Supplemental Security Income and California’s State Supplementary Payment, which includes a board and care rate.
• Sundowning: late-day confusion and agitation in dementia.
• Supported decision-making: an arrangement where trusted people help someone make their own decisions.
• TB screening: a tuberculosis test or screening required for care home admission.
• VA Aid and Attendance: a VA pension benefit for eligible veterans and surviving spouses who need care. See veterans assisted living.

You may also hear the term senior care placement, which describes a free advisory service that matches families with licensed homes and is paid by the home after move-in. Our family guide to board and care homes in San Diego puts many of these terms in context.

Terms you will hear on a care home tour

When families tour assisted living communities and board and care homes in San Diego, staff often use shorthand. These are the senior care terms that come up most on tours:

• Admission agreement: the contract between the resident and the home, listing services, rates, notice rules and reasons for discharge. Read it before signing.
• Awake overnight staff: a caregiver who stays awake through the night, rather than sleeping on call. Important for residents with dementia or frequent night needs.
• Fire clearance: approval from the fire authority that sets how many residents who cannot leave the building on their own a home may serve.
• Hospice waiver: permission from the California Department of Social Services that lets an RCFE keep residents who are on hospice.
• Incidental medical services: health-related help a licensed RCFE may provide under California rules, such as assisting with oxygen, catheter care or diabetes care, often with support from home health nurses.
• Non-ambulatory: a resident who cannot leave the building without help in an emergency, such as someone who uses a wheelchair or needs help to stand.
• Private vs. shared room: a private room usually costs $1,000 to $2,000 more per month than a shared room in San Diego.
• Resident council or family council: a group that meets to share concerns and suggestions with management, more common in larger communities.
• Two-person transfer: a resident who needs two caregivers to move safely, which some small homes cannot provide.

Cost and payment terms

Pricing language varies from one senior care home to the next. Knowing these terms helps you compare quotes fairly:

• All-inclusive rate: one monthly price that includes room, meals and personal care. Common in board and care homes.
• Base rate or base rent: the monthly price for the apartment and basic services before care fees are added. Common in assisted living.
• Community fee: a one-time move-in fee some communities charge. Ask whether any part is refundable.
• Level of care fee: an added monthly charge based on how much help a resident needs, often reassessed after a hospital stay or decline.
• Private pay: paying for care from income, savings, home equity or family help rather than a public program.
• Rate increase notice: the advance written notice a California RCFE must give before raising rates.
• Representative payee: a person or organization appointed by Social Security to manage someone’s benefits.
• Spend-down: using assets for allowed expenses until a person meets Medi-Cal’s asset limit.

In 2026, board and care homes in San Diego commonly cost about $5,500 to $9,500 a month, assisted living about $5,500 to $12,500, and memory care about $7,500 to $14,000. Our guide to assisted living costs in San Diego explains what drives the price.

Dementia care terms

• Exit-seeking: repeated attempts to leave, which may require a secured setting.
• Redirection: gently guiding a person with dementia to a different activity or topic instead of arguing.
• Secured perimeter: locked or delayed-egress doors and enclosed outdoor areas that keep residents safe.
• Shadowing: following a caregiver or family member closely, common in middle-stage dementia.
• Stages of dementia: often described as early, middle and late, each with different care needs.
• Dementia board and care home: a small RCFE that specializes in residents with dementia. In San Diego, these often cost about $6,000 to $9,500 a month.

Our comparison of memory care vs. assisted living explains when a secured setting makes sense.

Legal and decision-making terms

• Capacity: a person’s ability to understand and make a specific decision. Capacity can vary by decision and over time.
• Health care agent: the person named in an advance health care directive to make medical decisions if the person cannot.
• HIPAA authorization: a form allowing doctors and care homes to share health information with named family members.
• Living trust: a legal arrangement for managing and passing on assets, often used to avoid probate.
• LPS conservatorship: a California conservatorship for adults gravely disabled by mental illness, separate from a probate conservatorship.

These terms affect who can sign an admission agreement or make placement decisions. An elder law attorney can explain which documents your parent needs.

How to use this glossary of senior care terms

Bring a printed or saved copy of this glossary to hospital meetings and care home tours. When someone uses an unfamiliar term, ask them to explain it, and write down the answer. It also helps to keep one notebook or shared document for each parent with medications, contacts, benefits and decisions.

If you are comparing options, a free assisted living placement service can translate these terms into plain answers for your parent’s situation.

Frequently Asked Questions

What does RCFE stand for?

Residential Care Facility for the Elderly, California’s license for assisted living, memory care and board and care homes. Large communities and six-bed homes hold the same license type.

What are ADLs?

Activities of daily living: bathing, dressing, eating, toileting, continence and transferring. Needing help with two or more ADLs is often a trigger for long-term care insurance benefits.

What is the difference between home health and home care?

Home health is skilled medical care; home care is non-medical help with daily activities. Medicare may cover home health when ordered by a doctor, while home care is usually private pay.

What is a SNF?

A skilled nursing facility, providing 24-hour licensed nursing care. SNFs provide short-term rehab after a hospital stay as well as long-term care.

What is POLST?

A medical order for life-sustaining treatment preferences for people with serious illness. It is signed by the patient or decision-maker and a clinician, and it travels with the patient between care settings.

What is the Assisted Living Waiver?

A Medi-Cal program that pays care services in participating assisted living facilities. Space is limited and only some San Diego facilities participate, so waitlists are common.

What is the difference between assisted living and board and care?

Both are licensed as RCFEs in California and must meet the same care rules. Assisted living communities are larger, with apartments and amenities, while board and care homes are small houses, usually for about 6 residents. Our board and care family guide compares them in detail.

What is a hospice waiver?

A hospice waiver is permission from the California Department of Social Services that allows an RCFE to keep a resident who is receiving hospice care. Without one, a resident on hospice may need to move. Ask about it on tours if your parent has a serious illness.

What does non-ambulatory mean in a care home?

A non-ambulatory resident cannot leave the building without help in an emergency, for example someone who uses a wheelchair or needs help standing. Homes need the right fire clearance to care for non-ambulatory residents, so ask whether a home can accept your parent’s mobility needs.

Conclusion: senior care terms

Understanding senior care terms makes conversations with doctors, care homes and benefits programs easier. Bookmark this glossary, use the linked guides for more detail, and ask professionals to explain any term you do not understand. When you are ready to compare options, start with a free senior care assessment.