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In-home Care Services for People of all ages
Community Access Services for Children with Special Needs
Supported Employment Services Programs for People of all ages
LCFS Glossary*
* Unless otherwise noted all entries are from the Medicare Glossary

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N  |  O  |  P  |  Q  |  R  |  S  |  T  |  U  |  V  |  W  |  X  |  Y  |  Z

PARKINSON'S DISEASE* - Parkinson's disease may affect your ability to control how you move. Certain nerve cells in the brain normally produce a chemical called dopamine. Dopamine is a chemical messenger, or neurotransmitter, that these brain cells use to help direct and control the body's movement. In Parkinson's disease, the nerve cells that make dopamine break down, causing dopamine levels to drop. When this happens, it causes problems with movement.

What causes Parkinson's disease?

The cause of Parkinson's disease is unknown. Symptoms of the disease are caused by low levels of dopamine. While abnormal genes seem to be a factor in the development of Parkinson's disease in some people, there is no evidence strong enough to prove that the disease is inherited.

* WebMD Medical Library
PART A (HOSPITAL INSURANCE) - Hospital insurance that pays for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
PART A (MEDICARE) - Hospital insurance that pays for inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. (See HOSPITAL INSURANCE (PART A).)
PART B (MEDICAL INSURANCE) - Medicare medical insurance that helps pay for doctors' services, outpatient hospital care, durable medical equipment, and some medical services that aren't covered by Part A.
PART B (MEDICARE) - Medicare medical insurance that helps pay for doctors' services, outpatient hospital care, durable medical equipment, and some medical services that are not covered by Part A. (See MEDICAL INSURANCE (PART B).)
PARTIAL HOSPITALIZATION - A structured program of active treatment for psychiatric care that is more intense than the care you get in your doctor's or therapist's office.
PATIENT LIFTS - Equipment to move a patient from a bed or wheelchair using your strength or a motor.
PEABODY PICTURE VOCABULARY TEST - REVISED (PPVT-R)* - A testing instrument which assesses comprehension of single spoken words through a picture pointing task.

* Our Special Kids.Org
PERIPHERAL VISION* - Side vision; the ability to see objects and movement outside of the direct line of vision

* Our Special Kids.Org
PERSONAL CARE - Nonskilled, personal care, such as help with activities of daily living like bathing, dressing, eating, getting in and out of bed or chair, moving around, and using the bathroom. It may also include care that most people do themselves, like using eye drops. The Medicare home health benefit does pay for personal care services.

Significant Points - Excellent job opportunities are expected, due to rapid employment growth and high replacement needs. Almost a third of personal and home care aides work part time; most aides work with a number of different clients, each job lasting a few hours, days, or weeks. Occupational characteristics include low skill requirements, low pay, and high emotional demands.

Nature of the Work - Personal and home care aides help elderly, disabled, and ill persons live in their own homes or in residential care facilities instead of in a health facility. Most personal and home care aides work with elderly or disabled clients who need more extensive personal and home care than family or friends can provide. Some aides work with families in which a parent is incapacitated and small children need care. Others help discharged hospital patients who have relatively short-term needs. (Home health aides—who provide health-related services, rather than mainly housekeeping and routine personal care—are discussed in the statement on nursing, psychiatric, and home health aides, elsewhere in the Handbook.)

Personal and home care aides—also called homemakers, caregivers, companions, and personal attendants—provide housekeeping and routine personal care services. They clean clients’ houses, do laundry, and change bed linens. Aides may plan meals (including special diets), shop for food, and cook. Aides also may help clients move from bed, bathe, dress, and groom. Some accompany clients outside the home, serving as a guide and companion.

Personal and home care aides provide instruction and psychological support to their patients. They may advise families and patients on such things as nutrition, cleanliness, and household tasks. Aides also may assist in toilet training a severely mentally handicapped child, or they may just listen to clients talk about their problems.

In home healthcare agencies, a registered nurse, physical therapist, or social worker assigns specific duties and supervises personal and home care aides. Aides keep records of services performed and of clients’ condition and progress. They report changes in the client’s condition to the supervisor or case manager. In carrying out their work, aides cooperate with other healthcare professionals, including registered nurses, therapists, and other medical staff.

Training, Other Qualifications, and Advancement - In some States, this occupation is open to individuals who have no formal training. On-the-job training is then generally provided. Other States may require formal training. The National Association for Home Care offers national certification for personal and home care aides. Certification is a voluntary demonstration that the individual has met industry standards.

Successful personal and home care aides like to help people and do not mind hard work. They should be responsible, compassionate, emotionally stable, and cheerful. In addition, aides should be tactful, honest, and discreet, because they work in private homes. Aides also must be in good health. A physical examination, including State-mandated tests, such as those for tuberculosis, may be required.

Advancement for personal and home care aides is limited. In some agencies, workers start out performing homemaker duties, such as cleaning. With experience and training, they may take on personal care duties.

* U.S. Department of Labor
PERVASIVE DEVELOPMENTAL DISORDER* - 1. Extreme distortions or delays in the development of social behavior and language. 2. A term used to describe drug exposure to children while in the womb. Results of this exposure can cause extremely short attention spans. Behavior disorders, limited or no processing skills, and/or difficulty understanding spoken words.

* Our Special Kids.Org
PHYSICAL THERAPY - Treatment of injury and disease by mechanical means, such as heat, light, exercise, and massage.

Significant Points - Employment in the occupation is projected to increase much faster than the average, reflecting the growing number of individuals with disabilities or limited function and the increasing use of physical therapist assistants to reduce the cost of therapeutic services. Physical therapist assistants generally have an associate degree, but physical therapist aides usually learn skills on the job. Almost three-fourths of all jobs were in hospitals or offices of physical therapists.

Nature of the Work - Physical therapist assistants and aides perform components of physical therapy procedures and related tasks selected by a supervising physical therapist. These workers assist physical therapists in providing services that help improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease. Patients include accident victims and individuals with disabling conditions such as low-back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.

Physical therapist assistants perform a variety of tasks. Components of treatment procedures performed by these workers, under the direction and supervision of physical therapists, involve exercises, massages, electrical stimulation, paraffin baths, hot and cold packs, traction, and ultrasound. Physical therapist assistants record the patient’s responses to treatment and report the outcome of each treatment to the physical therapist.

Physical therapist aides help make therapy sessions productive, under the direct supervision of a physical therapist or physical therapist assistant. They usually are responsible for keeping the treatment area clean and organized and for preparing for each patient’s therapy. When patients need assistance moving to or from a treatment area, aides push them in a wheelchair or provide them with a shoulder to lean on. Because they are not licensed, aides do not perform the clinical tasks of a physical therapist assistant.

The duties of aides include some clerical tasks, such as ordering depleted supplies, answering the phone, and filling out insurance forms and other paperwork. The extent to which an aide or an assistant performs clerical tasks depends on the size and location of the facility.

Training, Other Qualifications, and Advancement - Physical therapist aides are trained on the job, but physical therapist assistants typically earn an associate degree from an accredited physical therapist assistant program. Not all States require licensure or registration in order for the physical therapist assistant to practice. The States that require licensure stipulate specific educational and examination criteria. Complete information on practice acts and regulations can be obtained from the State licensing boards. Additional requirements may include certification in cardiopulmonary resuscitation (CPR) and other first aid and a minimum number of hours of clinical experience.

According to the American Physical Therapy Association, there were 245 accredited physical therapist assistant programs in the United States as of 2003. Accredited physical therapist assistant programs are designed to last 2 years, or 4 semesters, and culminate in an associate degree. Programs are divided into academic study and hands-on clinical experience. Academic course work includes algebra, anatomy and physiology, biology, chemistry, and psychology. Many programs require that students complete a semester of anatomy and physiology and have certifications in CPR and other first aid even before they begin their clinical field experience. Both educators and prospective employers view clinical experience as integral to ensuring that students understand the responsibilities of a physical therapist assistant.

Employers typically require physical therapist aides to have a high school diploma, strong interpersonal skills, and a desire to assist people in need. Most employers provide clinical on-the-job training.

* U.S. Department of Labor

Significant Points - Employment is expected to increase faster than the average, as growth in the number of individuals with disabilities or limited function spurs demand for therapy services. After graduating from an accredited physical therapist educational program, therapists must pass a licensure exam before they can practice. About two-thirds of physical therapists work either in hospitals or in offices of physical therapists.

Nature of the Work - Physical therapists (PTs) provide services that help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease. They restore, maintain, and promote overall fitness and health. Their patients include accident victims and individuals with disabling conditions such as low-back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.

Therapists examine patients’ medical histories and then test and measure the patients’ strength, range of motion, balance and coordination, posture, muscle performance, respiration, and motor function. They also determine patients’ ability to be independent and reintegrate into the community or workplace after injury or illness. Next, physical therapists develop treatment plans describing a treatment strategy, its purpose, and its anticipated outcome. Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in implementing treatment plans with patients. Physical therapist aides perform routine support tasks, as directed by the therapist. (Physical therapist assistants and aides are discussed elsewhere in the Handbook.)

Treatment often includes exercise for patients who have been immobilized and lack flexibility, strength, or endurance. Physical therapists encourage patients to use their own muscles to increase their flexibility and range of motion before finally advancing to other exercises that improve strength, balance, coordination, and endurance. The goal is to improve how an individual functions at work and at home.

Physical therapists also use electrical stimulation, hot packs or cold compresses, and ultrasound to relieve pain and reduce swelling. They may use traction or deep-tissue massage to relieve pain. Therapists also teach patients to use assistive and adaptive devices, such as crutches, prostheses, and wheelchairs. They also may show patients exercises to do at home to expedite their recovery.

As treatment continues, physical therapists document the patient’s progress, conduct periodic examinations, and modify treatments when necessary. Besides tracking the patient’s progress, such documentation identifies areas requiring more or less attention.

Physical therapists often consult and practice with a variety of other professionals, such as physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists.

Some physical therapists treat a wide range of ailments; others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

Training, Other Qualifications, and Advancement - All States require physical therapists to pass a licensure exam before they can practice, after graduating from an accredited physical therapist educational program.

According to the American Physical Therapy Association, there were 203 accredited physical therapist programs in 2003. Of the accredited programs, 113 offered master’s degrees, and 90 offered doctoral degrees. All physical therapist programs seeking accreditation are required to offer degrees at the master’s degree level and above, in accordance with the Commission on Accreditation in Physical Therapy Education.

Physical therapist programs start with basic science courses such as biology, chemistry, and physics and then introduce specialized courses, including biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. Besides getting classroom and laboratory instruction, students receive supervised clinical experience. Among the courses that are useful when one applies to a physical therapist educational program are anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many professional education programs require experience as a volunteer in a physical therapy department of a hospital or clinic.

Physical therapists should have strong interpersonal skills in order to be able to educate patients about their physical therapy treatments. PTs also should be compassionate and possess a desire to help patients. Similar traits are needed to interact with the patient’s family.

Physical therapists are expected to continue their professional development by participating in continuing education courses and workshops. In fact, a number of States require continuing education as a condition of maintaining one’s licensure.

* U.S. Department of Labor
PHYSICIAN ASSISTANT (PA) - A person who has 2 or more years of advanced training and has passed a special exam. A physician assistant works with a doctor and can do some of the things a doctor does.
PLAN OF CARE - Your doctor's written plan saying what kind of services and care you need for your health problem.
POWER OF ATTORNEY - A medical power of attorney is a document that lets you appoint someone you trust to make decisions about your medical care. This type of advance directive also may be called a health care proxy, appointment of health care agent or a durable power of attorney for health care.
PRE-EXISTING CONDITION - A health problem you had before the date that a new insurance policy starts.
PREFERRED PROVIDER ORGANIZATION (PPO) - A managed care in which you use doctors, hospitals, and providers that belong to the network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
PREVENTIVE SERVICES - Health care to keep you healthy or to prevent illness.
PRIMARY CARE - A basic level of care usually given by doctors who work with general and family medicine, internal medicine (internists), pregnant women (obstetricians), and children (pediatricians). A nurse practitioner (NP), a State licensed registered nurse with special training, can also provide this basic level of health care.
PRIMARY CARE DOCTOR - A doctor who is trained to give you basic care. Your primary care doctor is the doctor you see first for most health problems. He or she makes sure that you get the care that you need to keep you healthy. He or she also may talk with other doctors and health care providers about your care and refer you to them. In many Medicare managed care plans, you must see your primary care doctor before you see any other health care provider.
PRIMARY PAYER - An insurance policy, plan, or program that pays first on a claim for medical care. This could be Medicare or other health insurance.
PROCEDURE - Something done to fix a health problem or to learn more about it. For example, surgery, tests, and putting in an IV (intravenous line) are procedures.
PROVIDER - A doctor, hospital, health care professional, or health care facility.


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