Health Care Terminology

This is the typical hospital most of us picture when we think “hospital”. It has an Emergency department, areas for surgery, ICUs (Intensive Care Units), and units for medical and surgical patients. People are generally admitted to acute care for serious conditions that require intensive, short-term care.

Unlike acute care, sub-acute care usually has no emergency or surgical departments and admits medically stable patients for longer admissions, sometimes for months to years. Sub-acute care includes rehabilitation (including Stroke Rehab, Geriatric Rehab, Respiratory Rehab), Complex Continuing Care, and Palliative Care.

In Ontario, the term complex continuing care (CCC) is used interchangeably with chronic care. Chronic care provides continuing, medically complex and specialized services to both young and old, sometimes over extended periods of time. Chronic care is provided in hospitals for people who have long-term illnesses or disabilities typically requiring skilled, technology-based care not available at home or in long-term care facilities. Chronic care provides patients with room, board and other necessities in addition to medical care.

LTC houses residents with care needs that cannot be safely met in the community. Once people move to LTC, it is considered their home, so they are residents rather than patients. Personal and nursing care is funded by the government. People pay room and board according to their income.

These are private for-profit residences that may provide a wide array of nursing services, called assisted living services. Residents pay for care as well as accommodation.

Having completed a bachelor’s degree, RNs provide skilled, direct care to patients, ranging from provision and coordination of patient care to education, advice and emotional support.

After a shorter training program, LPNs assist RNs to provide patient care. They generally work with less independence than RNs.

PSWs are unregulated health care providers who assist with daily tasks for people in care. They are sometimes referred to as Personal Care Attendants, Health Care Aides, or Nursing Attendants. People who need assistance with dressing and toileting often benefit from a PSW.

USW is a relatively new designation for people hired to assist patients and residents with needs not related to their care, such as helping them make a virtual connection with family and friends who were unable to visit.

Registered nurses who have additional education and experience that enables them to work independently to assess, diagnose, treat and monitor a wide range of health problems.

PAs are highly skilled health care professionals trained in the medical model to work with the supervision of physicians.

OTs enable people to become more productive and overcome obstacles when experiencing issues participating in everyday activities. They may provide valuable assistance when a patient needs an assistive device to participate in an artistic activity.

PTs work to promote optimal mobility, help improve physical activity and overall health and wellness as well as prevent and treat disease, injury and disability.

SLPs assess, diagnose, treat and help to prevent communication and swallowing disorders. In elder care, they frequently assist with worsening swallowing function and communication difficulties after strokes.

Spiritual Care providers attend to a person’s spiritual or religious needs as they cope with illness, loss, grief or pain, and can help them heal emotionally as well as physically, rebuild relationships and regain a sense of spiritual wellbeing.
https://www.baycrest.org/Baycrest/Healthcare-Programs-Services/Culture-Arts-Spiritual-Care/Spiritual-Care/What-Is-Spiritual-Care

Therapeutic Recreation is a health care profession that utilizes a therapeutic process, involving leisure, recreation and play as a primary tool for each individual to achieve their highest level of independence and quality of life.
https://canadian-tr.org/about-recreation-therapy/

RRTs are trained in critical care and airway management. In complex continuing care, they assist with the management of people who require ventilators to breathe.

These are caregivers external to the healthcare organization who are designated by the resident or patient as essential to their well-being. They are provided basic training in Infection Prevention protocols by the healthcare site and expected to follow all protocols.

Worldwide, dementia is on the rise, partly due to shifting demographics, and partly due to increases in obesity and diabetes. Dementia is a set of symptoms that can affect cognitive abilities, language, mood and behaviour. It increasingly interferes with independence, first with complex tasks, then impacting activities of daily living, such as eating and dressing. Common types of dementia include:

Vascular dementia
Alzheimer’s dementia
Mixed dementia (a combination of more than one type)
Lewy body dementia
FTD or Frontotemporal dementia
https://www.canada.ca/en/public-health/services/diseases/dementia.html

Strokes are the third leading cause of death in Canada, and many people live with changes to their function after a stroke. A stroke is a sudden loss of brain function caused by a brain blood vessel blockage (ischemic stroke) or rupture (hemorrhagic stroke). Symptoms can include weakness, loss of sensation, confusion, difficulty speaking, vision changes, headache, or loss of balance. People may fully recover after a stroke, or may have ongoing symptoms, such as weakness on one side of their body, difficulty speaking (dysphasia), or difficulty swallowing (dysphagia).
https://www.canada.ca/en/public-health/services/publications/diseases-conditions/stroke-canada-fact-sheet.htm

Parkinson’s is the world’s fastest growing neurological disease. People with Parkinson’s have a range of motor and non-motor symptoms that affect their movement and lives. Typical motor symptoms are slowness of movement, rigidity, tremor, and postural instability. Some examples of non-motor symptoms are constipation, restless legs, drooling and depression.
https://www.parkinson.ca/about-parkinsons/symptoms/

People who have had a traumatic brain injury, possibly from a fall or motor vehicle accident, sometimes require complex continuing or long-term care. Depending on the extent of the injury, people with a TBI may require basic assistance (for example, bathing and dressing) or may require breathing support with a ventilator.
https://www.canada.ca/en/public-health/services/injury-prevention/canadian-hospitals-injury-reporting-prevention-program/injury-reports/2020-spotlight-traumatic-brain-injuries-life-course.html

This is a rare neurological disease that affects the nerve cells or neurons that control voluntary muscle movement. There is no cure, and people with ALS gradually lose their strength and ability to speak, eat, move or breathe. People with ALS who opt for ventilator therapy will often require Complex Continuing Care.

Trachs: Some people in care have a tracheostomy with a tube going directly from their neck into their trachea. Sometimes it is connected to a ventilator, and sometimes it remains in place to provide an alternative to breathing through the mouth or nose. People who are not on a ventilator may have a speaking valve to facilitate communication.
https://www.ohsu.edu/sites/default/files/2019-03/OHSU-Trach-Care-Guide.pdf

Wheelchairs are common in healthcare settings, sometimes for temporary use, and sometimes needed permanently as a mobility device. Some people can use their wheelchairs independently, either with hand, foot, or electric propulsion. Other people need assistance to move with their wheelchairs. Always ask before moving someone in a wheelchair. They have brakes that should always be activated before transfers out of a wheelchair, and there are often removable footrests.
https://www.avacaremedical.com/blog/10-tips-for-interactions-with-wheelchair-users.html

Walkers can be invaluable to increase people’s independence and to prevent falls. Walkers may have no wheels, 2 wheels or 4 wheels. Some may have accessories, such as baskets, trays, or seats. When visiting someone who uses a walker, ensure it is always accessible for them, with brakes on for transfers (for example, when sitting down after a walk).
https://www.physio-pedia.com/Walkers

The IPAC team works to ensure that evidence-based practices and procedures are applied consistently in healthcare to prevent or reduce the risk of transmission of microorganisms. When enriching healthcare environments with the arts, we need to comply with IPAC protocols in order to keep bad bugs away from vulnerable people.

Masks and gowns worn to decrease the risk of transmission of microorganisms. During pandemic precautions, PPE in healthcare settings involves masks and possibly face shields, or safety glasses, worn by all. At times, gowns or more extensive PPE are required to enter rooms where special precautions are necessary. If you are ever uncertain what you need to do in a given situation, ask before proceeding.

These are currently the standard required in healthcare settings and will be offered as you enter. If you have singers’ masks with three layers of protection, these may be permitted. However, if you wish to wear your own mask, you need to check with the healthcare site before your arrival. Valved masks will not be permitted, as they do not protect others from you.

Some sites also require face shields or eye protection, which will be offered if required.

Any change in position is referred to as a transfer. People commonly need to transfer out of bed or transfer to use a toilet. Some people in care are independent for some transfers, while others may require 2-3 people or a mechanical lift for transfers. If you are visiting someone who requests to transfer back to bed or to use the toilet, do not try to assist them directly. Contact staff to request assistance.

Grand rounds are a method of medical education, helping doctors and other healthcare professionals keep up to date in important evolving areas. The clinical team, including learners, gather regularly to hear the newest research and treatments related to a patient’s medical problem, usually prefaced by the patient’s story, sometimes with the patient present.