Dementia Resource Guide

18. Glossary

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There are many terms used when talking about dementia. This list defines some of the terms found in the Dementia Resource Guide or in resources referred to in the Guide. Key terms defined in the glossary are underlined throughout the Guide.

Term	Description
Accommodation bond	Amount of money you may be asked to pay for your accommodation, when you move into low or high-level care in a residential facility. It is an interest free loan to the facility and the income earned is used by the facility to improve its building standards and the quality and range of its aged care services [1]
Accreditation standards	The Accreditation Standards are standards specified in the Aged Care Act 1997 that the approved providers of Australian Government-subsidised aged care homes must meet before they receive Australian Government funding. [1]
Acetylcholine	One of a group of chemicals known as neurotransmitters. Found throughout the brain, acetylcholine enables nerve cells to communicate with each other. In Alzheimer's disease, the levels of acetylcholine are lower than usual. [2]
Activities of daily living	The range of tasks we ordinarily carry out on a day to day basis including personal care tasks, house cleaning, shopping, managing bills and money etc.
Acute confusional state	Refer to Delirium.
Advance Directive	A written statement specifying what treatment you do and don’t want to have in the future. Advance directives are also called Advance Health Directives and Advance Health Care Directives and in South Australia these are called Anticipatory Grants or Anticipatory Directions. There are substantial differences in Advance Directives in different States and Territories in Australia. In some States you have to use a specific form and satisfy requirements, such as having particular people witness you sign it. In other States the process is not so formal. [3]
Advance Health (Care) Directives	Refer to Advance Directive.
Advocate	A person who supports and represents another person in their dealings with others.
Aged Care Assessment Team/Service (ACAT/ACAS)	ACAT/S help older people and their carers work out what kind of care will best meet their needs when they are no longer able to manage at home without assistance. ACATs provide information on suitable care options and can help arrange access or referral to appropriate residential or community care services such as Home and Community Care (HACC). An ACAT assessment and approval is required before people can access residential aged care, Community Aged Care Packages (CACPs) or Extended Aged Care at Home (EACH) Packages [4].
Aged Care Standards and Accreditation Agency	The Aged Care Standards and Accreditation Agency is an independent company established in 1997 under corporation law, and subject to the Commonwealth Authorities and Companies Act 1997. It was appointed by the Secretary of the Department of Health and Ageing as the 'accreditation body' under Section 80-1 of the Aged Care Act 1997. [1]Top of page
Agitation	A state of emotional disturbance or/and restlessness.
Alzheimer’s disease	The commonest form of dementia that affects memory and other cognitive functions. [5]
Amyloid	A protein found in the brains of people with Alzheimer's disease. It is deposited throughout the brain in microscopic clumps known as plaques. Its purpose is unknown and may be the cause of deterioration of brain function. [2]
Anticholinergic medications	A term used for medications that block the action of acetylcholine on nerve cells. Many commonly used medications have anticholinergic effects and can lead to adverse effects such as of confusion and dry mouth. These adverse effects need to be considered in elderly people.
Anticipatory Grants or Directions	Refer to Advance Directive.
Anti-hypertensives	Medications to lower blood pressure.
Anti-inflammatory agents	Medications to reduce inflammation and pain. [5]
Antiplatelet agents	Medications that reduce clotting. [5]
Antipsychotic medications	A range of tranquillisers, also known as neuroleptics, that help to reduce symptoms of aggression, agitation and psychotic features such as hallucinations. Examples include Haloperidol, Risperidone and Olanzepine.
Apolipoprotein E	A protein that binds to fat and transports it around the body. [5]
Aricept	The brand name for Donepezil, a dementia medication. [2]
Brain scan	Any investigation that produces pictures of the brain. A CT scan or MRI scan shows slices through the brain. A SPECT scan shows the brain's blood supply. [2]
Brassica family	A family of vegetables including broccoli, cabbage, bok choy, radish and cauliflower.
Capacity except for qual care	Refer to Legal capacity. Top of page
Carer	A carer is a person who provides help and support to another person, usually a relative or friend. More specifically, a carer is someone who looks after another person would not otherwise be able to live independently at home. [2]
CAT scan	Abbreviation for Computerised Axial Tomography scan. Another name for a CT scan. [2] (Refer to Brain scan)
Cerebral cortex	The outer layers of the brain, involved in many complex functions including thinking, memory, movement and the senses eg. smell, vision, hearing, touch [2]
Cholesterol	A fat that is essential to cell structure In excess it can cause blood vessel occlusion. [5]
Cholinesterase inhibitors	See acetylcholinesterase inhibitors.
Cognition	The process of awareness, learning, thinking and judging.
Cognitive therapy	A treatment that involves teaching a person to think differently about a problem or situation. [2]
Commonwealth Carelink Centre	Provides a single point of contact for the general public, carers, service providers, general practitioners and other health professionals to access up to date information on local community, aged and disability services such as personal care and domestic help, respite options, and accommodation residential aged care services. [1]
Complementary medicine / therapies	An approach to health care that explores alternatives to conventional treatments. Acupuncture, homeopathy, aromatherapy and spiritual healing are examples of complementary therapies. [2]
Community Aged Care Packages (CACPs)	Individually planned and coordinated packages of care tailored to help older Australians with low-level care needs so that they can remain living in their own homes. Funded by the Australian Government to provide for the complex care needs of older people. [1]
Community care	The care and support for people who want to remain independent and live at home for as long as possible. This includes Home and Community Care (HACC) services, Community Aged Care Packages (CACP) and respite care services for carers. [1]
Confusion	A mental state characterised by lack of clear thought, concentration and behaviour.
Continence	Continence is the ability to exercise voluntary control over the bladder and/or bowel. [1]
CT scan	Refer to CAT scan. Top of page
Dehydration	A state in which there is insufficient water, or excessive loss of water from the body. It occurs when a person's fluid intake fails to balance with fluid lost through sweating, vomiting or diarrhoea. [2]
Delirium	A clinical syndrome characterised by sudden onset of confusion. Describes a set of symptoms that impair cognitive and physical function and can lead to severe illness and possibly death. [6]. It is often brought on by an underlying medical illness or medications.
Dementia	The impairment of brain function, involving memory, thinking and concentration. Dementia usually becomes progressively worse, eventually making it difficult for the person to manage independently without help. There are many causes of dementia including Alzheimer's disease, Vascular dementia, Lewy body dementia and Frontal lobe dementia. [2]
Dementia Behaviour Management Advisory Services (DBMAS)	Dementia Behaviour Management Advisory Services are established to help people manage behaviours associated with dementia. They will provide advice, assessment, case management and specialised support to community and residential care workers and carers. [1]
Dementia Collaborative Research Centre (DCRC)	An Australian Government initiative. Three Centres have been established to facilitate dementia research, translation of research into practice, disseminate research findings, support up-skilling of emerging researchers and develop guidelines, tools and other resources.
Dementia medications	A term for medications used to treat dementia. They include acetylcholinesterase inhibitors such as Aricept and Reminyl. Other medications such as Memantine, have a different mechanism of action. These drugs may slow down the progression of dementia in some people. [2]
Dementia with lewy bodies	A form of dementia characterised by deposits of Lewy bodies in the brain. [5]
Depression	An illness characterised by feeling low, tearful, and with a loss of enjoyment. Depression may affect sleep, appetite, motivation and concentration. It can usually be treated. [2]
Diagnosis	The process of identifying and naming a disease from the signs and symptoms a person exhibits. A diagnosis may involve talking with the doctor and a physical examination. In some cases special investigations may be required. [2]
Discrimination	Treating someone less favourably because they have a disability or they are of a certain sex, age, race or nationality. It is generally unlawful for employers and other people to discriminate against someone with dementia. [3]
Disinhibition	Loss of shame or embarrassment that helps a person control his or her actions in society. Disinhibition results in inappropriate or improper behaviour. [2] Top of page
Disorientation	A state in which someone loses his or her awareness of time and place. For example, they may fail to recall the date or the year and may not know where they are. [2]
Donepezil	The generic name of Aricept, a dementia medication. [2]
Enduring Power of Attorney	A formal document appointing a person to be your substitute decision-maker. It is called an Enduring Power of Attorney because it endures after a person loses his or her legal capacity to make decisions. People with legal capacity can organise an Enduring Power of Attorney (financial or medical) and appoint a person to make decisions on their behalf. Commonly this person can make decisions regarding financial affairs. In some States the appointed person can also make decisions about medical treatment. [3]
Evidence	In the context of this Guide, evidence usually refers to whether a particular intervention or strategy has been scientifically researched and found effective.
Exelon	The brand name for Rivastigmine, a dementia medication. [2]
Extended Aged Care at Home	Extended Aged Care at Home (EACH) packages are individually planned and coordinated packages of care, tailored to help frail older Australians with high-level care needs to remain at home. They are funded by the Australian Government to provide for the complex care needs of older people. [1]
Extended Aged Care at Home Dementia	The EACH Dementia Program (EACHD) packages are individually planned and coordinated packages of care to help frail older people with dementia and behaviours of concern associated with their dementia, who require management of behaviours and services, generally including nursing, because of complex care needs. These people would otherwise be eligible for high-level care. EACHD packages are funded by the Australian Government. [1]
Familial Alzheimer’s disease	Alzheimer’s disease that is inherited. If one or other parent carries the relevant mutated gene their children will have a 50 per cent chance of developing the disease later in life. [5]
Folate	A vitamin essential to brain and blood cell formation. [5]
Frontal Lobe dementia	A form of dementia in which the disease mainly affects the frontal lobes of the brain. Memory is affected less than with other forms of dementia, but there may be loss of motivation and disinhibition. [2]
Frontal Lobes	Parts of the cerebral cortex situated at the front of the brain. This is the area of the brain that controls movement of the body. It is also involved in higher functions such as planning ahead, problem solving and initiative. [2] Top of page
Frontotemporal dementia	A form of dementia in which the disease mainly affects the frontal and anterior temporal lobes of the brain.
Galantamine	The generic name of Reminyl, a type of dementia medication. [2]
Generic	A generic drug is one that is sold under its official medical name (generic name) rather than under a patented brand name. [2]
Genes	Material contained within the chromosomes. Genes carry the blueprint for the body. Traits including the colour of our eyes and skin, how tall we are, our gender and many other details are determined by genes. Some genes have defects, or mutations, which cause disease. [2]
Geriatrician	A doctor who specialises in the care of older people. [7]
HACC	Refer to Home and Community Care.
Hallucination	A perception (hearing, seeing, smelling or feeling something) without an appropriate stimulus. For example, hearing voices when there is no one talking. Hallucinations are quite common in people with dementia. [2]
High-level care	High-level care is the care that is provided for people who have been assessed by an ACAT, and need almost complete assistance with most daily living activities. It includes accommodation services such as meals, laundry and room cleaning as well as personal care. Medical needs are managed by nursing staff and visiting General Practitioners. High-level care was previously known as Nursing Home care. [1]
Home and Community Care (HACC)	Provides a comprehensive, coordinated and integrated range of basic maintenance and support services to help people maintain their independence at home and in the community. It is a joint Australian and state/territory government program. [1]
Homocysteine	A marker of folate and vitamin B12 metabolism; elevated levels are associated with poor health outcomes. [5]
Hormone Replacement Therapy	The use of female hormones for those who have decreasing levels of these hormones, most commonly during or following menopause. [5]
Huntington's disease	Also known as Huntington's chorea, a disease in which mental deterioration is accompanied by involuntary twitching and muscle spasms. [2]Many people with this disease develop dementia.
Hypertension	High blood pressure. [5] Top of page
Incontinence	Incontinence is the inability to control the bladder or bowel. Incontinence can affect men and women of any age but should not be considered normal. It can be a sign of other health problems and can often be treated or managed with the right advice or treatment. [1]
Legal Capacity	Also called Legal Competence and in South Australia, Mental Capacity. Legal capacity is a person’s ability to make decisions that the law will uphold. As the symptoms of dementia increase, it is possible for an individual to lose legal capacity. This means it is wise to appoint someone to make decisions as early as possible. [3]
Lewy body dementia	A form of dementia characterised by deposits of Lewy bodies in the brain. [5]
Low-level care	Low-level care is the care provided for people who have been assessed by an Aged Care Assessment Team (ACAT), and who need accommodation and services such as meals, laundry, room cleaning as well as help with personal care and nursing care if required. [1] Low-level care was previously known as hostel care.
Memory	The retention of information that may be later recalled. [2]
Mild Cognitive Impairment	Usually defined as significant memory loss without the loss of other cognitive functions. People with Mild Cognitive Impairment have more memory problems than expected from others of a similar age. People with Mild Cognitive Impairment are able to function independently and do not usually show other signs of dementia, such as problems with reasoning or judgment.[1]
MRI scan	Abbreviation for Magnetic Resonance Imaging scan. A type of brain scan that creates pictures using a powerful magnetic field rather than X-rays. [2]
Multi-infarct dementia	Another name for Vascular dementia. The term Multi-infarct dementia is not commonly used.
Multi-Purpose Services (MPS)	Multi-Purpose Services are designed specifically for rural and regional areas and bring together a range of health and aged care services. These may include hospitals, community services, family support and aged care. The types of services offered depend on the needs of local communities.[1]
Nerve growth factor	A hormone that stimulates growth of some nerve cells. [5]
Neuroleptic drugs	Another name for antipsychotic medications. [2]
Neurologist	A doctor who specialises in the diagnosis and treatment of disorders of the nervous system, including the brain, spinal cord and nerves. [7] Top of page
Neuropsychologist	A psychologist who specialises in the assessment of disorders of the brain and how they affect memory, thinking and behaviour. [7]
Neurotransmitters	A group of chemicals in the brain that enable nerve cells to communicate with each other. Groups of adjacent nerve cells tend to use the same neurotransmitter. Examples include acetylcholine, serotonin and dopamine. [2]
Non-tricyclic antidepressants	A particular group of antidepressant medications that includes Mirtazepine.
Occupational therapist	A person who can advise on ways of helping someone to maintain their skills and independence for as long as possible. They can also advise on aids in their home. [2]
Omega-3 fatty acid	A form of fat that is generally good for health. [5]
Palliative care	Palliative care is provided for people of all ages who have a life limiting illness with little or no prospect of cure. The primary treatment goal of palliative care is quality of life. Palliative care uses a holistic approach, managing pain and other symptoms while addressing the physical, emotional, cultural, social and spiritual needs of the person, their family and their carers. It focuses on living well until death. [1]
Parkinson's disease	A progressive disease of the nervous system that is characterised by slowness of movement, tremor and an expressionless face. Some affected people also develop dementia. [2]
Person Responsible	In Tasmania and Victoria, this is the first person on a list of people who can legally make a decision about a person’s medical treatment when the person is unable to make that decision. The idea of the Person Responsible is to make it clear which family member or friend will be the one to make the decisions about medical treatment when a person is unable to make the decision. Other States and Territories do not use this system. (Queenslanders: Refer to Statutory Health Attorney). [3]
PET scan	Abbreviation for Positron Emission Tomography scan. A sophisticated brain scan that looks at the brain in great detail. It is not generally available in clinical practice. [2]
Physiotherapist	A person trained to perform physical treatments for joint and muscle problems. [2]
Pick's disease	A rare form of dementia that affects more younger people than Alzheimer's disease. It affects language and personality before there is any significant change in memory. [2] (Refer to Frontal lobe dementia). Top of page
Power of Attorney	A formal document appointing someone to be your substitute decision maker. A Power of Attorney is no longer valid after someone loses the legal capacity to make decisions. Enduring Power of Attorney should be considered for people with dementia. (Refer to Enduring power of attorney). [3]
Psychiatrist	A doctor specialising in the diagnosis and treatment of mental health disorders, emotional disturbances and thought disorders. [7]
Psycho-geriatrician	A psychiatrist who specialises in mental health disorders affecting older people. [7]
Psychologist	Someone with training in psychology, the study of behaviour. Clinical psychologists assess and treat people who have mental health disorders. [2]
Psychotherapy	A talking therapy that can help people to understand their own feelings and therefore feel more confident to deal with them. [2]
Public Trustee	A body set up by the government in most states and territories to manage the financial affairs of people unable to look after their own financial affairs. A court, board or tribunal that looks after guardianship matters in your State or Territory can appoint the Public Trustee to look after your finances if there is no other appropriate person to appoint. [3]
Reality orientation	A psychological treatment in which every opportunity is taken to make people with dementia aware of the time, place and the world around them. [2]
Rehabilitation	Rehabilitation helps a person who is recovering from illness or injury to regain as much of their previous ability and independence as possible. [1]
Reminiscence therapy	A treatment that aims to stimulate memory by means of old films, pictures, music, etc. [2]
Reminyl	The brand name for Galantamine, an acetylcholinesterase medication. [2]
Resident	If a person’s care needs can’t be met through community support, they may be eligible for a place in an aged care facility. In an aged care facility people are known as a residents. [1]
Residential care/ residential aged care facility	Residential aged care is for older people who can no longer live at home. Australian Government-subsidised places are provided in aged care homes owned and operated by organisations that have the approval of the Australian Government. It is at the discretion of an aged care home whether they accept a person as a resident. [1]. (Refer to High-level care and Low-level care). Top of page
Resident Classification Scale (RCS)	Funding tool that determines a subsidy according to the level of care required by the resident. The resident's documented assessed care needs are rated using the RCS and the Government then makes a subsidy payment to the aged care home based on this rating. [1]
Respite	A service that enables a carer to take a break. Respite can either be provided as a community service where someone looks after the person in their own home, or it can be residential respite where the person needing care moves into a residential facility for a period of time (for example, a week or two).
Rivastigmine	The generic name for Exelon, an acetylcholinesterase inhibitor. [2]
Secretase enzymes	Proteins that break down larger proteins. [5]
Sedative drugs	Drugs used to reduce symptoms of anxiety and agitation and to help people sleep. Sedative drugs can increase confusion in people with dementia. [2]
Selective Serotonin Reuptake Inhibitors (SSRIs)	A particular group of antidepressant medications that includes fluoxetine (Prozac) and sertraline (Zoloft).
Sleep apnoea	A condition where breathing stops, usually at night, causing a range of health problems. [5]
Snoezelen	A special room designed to gently stimulate the senses and to calm people who are agitated with dementia.
SPECT scan	A Single Photon Emission Computed Tomography scan. A highly technical investigation similar to a PET scan. [2]
Statin	A drug used to lower cholesterol. [5]
Statutory Health Attorney	This is Queensland’s version of the Person Responsible. Where a person has not appointed a substitute decision-maker using a power of attorney or guardianship order, and has lost the ability to make a decision about his or her medical treatment, the first person on a list of people (such as the person’s spouse or child over the age of 18) will be the person who can make a decision about the medical treatment. Other states and territories do not use this term. [3] Top of page
Stroke	The result of a haemorrhage in the brain or a blood clot in an artery of the brain. This may lead to various neurological problems including paralysis of part or all of one side of the body, loss of speech, loss of consciousness or death. The paralysis may be sudden or gradual in onset. [2]
Sundowning	When people with dementia become confused, restless or insecure late in the afternoon or early evening. It can be worse after a move or a change in their routine (for example, hospitalisation). They may become demanding, restless, upset, suspicious, disoriented and even see, hear or believe things that are not real, especially at night. Attention span and concentration may be limited and some people may become impulsive placing themselves at risk. [1]
Support group	A group, also known as a self-help group, that aims to provide mutual support for its members. A support group gives people an opportunity to share their feelings, problems and information with other people undergoing similar experiences. [2]
Tranquillisers	Medications used to help people who are very anxious. These drugs can cause increased confusion in people with dementia. [2]
Vascular Dementia	A type of dementia associated with problems affecting the circulation of blood to the brain, such as may result from a series of small strokes. [2]

References

1. Australian Government Department of Health and Ageing, Glossary.
2. Cayton, H., N. Graham, and J. Warner, Dementia: Alzheimer's and other dementias - the 'at your fingertips' guide. 2002.
3. Alzheimer's Australia, Position paper 5. Legal planning and dementia. 2005, Alzheimer's Australia.
4. Australian Government Department of Health and Ageing, Aged Care Assessment Teams. 2006. p. website.
5. Alzheimer's Australia, Position paper 6. Dementia: Can it be prevented? 2005, Alzheimer's Australia: Higgins.
6. Harding, S., Delirium in older people. 2006, Commonwealth of Australia.
7. Alzheimer's Australia, Position paper 10. Early diagnosis of dementia. 2007, Alzheimer's Australia.

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