Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.
The principal objective of this study was to analyze and conceptualize the socio-psychological burden in utilizing a nursing home for elderly. The subjects were five elderly from a private nursing home located in Seoul and their familial caregivers. An old male and three females were currently staying at the facility, and a female had been discharged already from there. Data were collected through depth interviews, observations and review of records at the facility For analysis, the data were classified by similar contents among significant expressions and factors in common. The subjects' motives to consider admission to the nursing home might be attributed to familial caregivers' burden, a shortage of support, environmental improvement and feeling of helplessness for the case elderly. The concept of burden is including family members' being badly off in living, their weariness, complications among family members, feeling psychological uneasiness, and hospital expenses. The identified image of nursing homes for the elderly in Korea was generally negative at the point of high cost, unreasonable requisites and limitations for admission to the facilities, inferior situations, and especially in that there were few long-term care facilities within the community boundary. From their experience of nursing homes, the interviewees have felt the sentiments of sorry for their old parents, with the thought of being an undutiful, bitterness, and empathy. Additionally, they expressed a sense of anxiety of relative deprivation against the fact that there were no long-term care facilities available for the middle class. On the basis of these, multi-dimensional needs could be identified for the elderly with chronic illnesses.
Purpose: The purpose of this study was to investigate the expected family involvement of family members of elderly residents in nursing homes. Methods: This study utilized a descriptive design with a survey research method. Data were collected using the Expect Family Involvement Questionnaire Scale, which was completed by 112 family caregivers of older adults in nursing homes in Seoul and Gyeong-gi Province. The collected data were analyzed using descriptive statistics. Results: Responses to the questionnaire indicated the highest value was recorded for the item, 'use of a room for family privacy' with $2.41{\pm}0.43$ points, followed by the item, 'staff calling family for advice with resident problems' with $2.38{\pm}0.38$ points and 'education about nursing home programs' with $2.32{\pm}0.42$ points. Conclusion: In order to promote family involvement in long-term care facilities, various approaches, interventions, and government supports with the respective of the family are required. The nursing home placement process should include understanding discuss on the importance of the role of family, and should help promote positive relationships between the elderly residents and their families. Staffs and administrators of nursing home are to consider the family as a partner rather than visitor.
Purpose: This study aimed to investigate the effects of a program for increasing self-care with activities of daily living among the elderly living at home. Methods: The study adopted a non-equivalent control group pretest-posttest design. The number of participants were 30 in the experimental group and 30 in the control group. Participants were persons aged 65 years and above in Busan. The experimental group was provided with for 16 different types of self-care behaviors by family nurses who made weekly home visits to these participants. Each visit lasted for more than 30 minutes, and the visits were conducted for 12 weeks. The research instrument used in this study was a scale developed by Shimanouchi et al. (2003) which assessed self-care behavior, activities of daily living, and depression. Results: The experimental group showed an increase in self-care behavior compared to the control group. Time and group variables were also found to have an interaction effect on the daily living activity level. The experimental group showed an increase in the activities of daily living compared to the control group. Depression scores dropped from 9.4 to 5.8 in the experimental group and from 8.6 to 7.0 in the control group. Conclusion: We found that the self-care behavior program improved the levels of independence and activities of daily living among the elderly living at home.
The Korean society is recently becoming the aging society at an unprecedentedly rapid speed. Following the increase of the older population, their needs for special care is also rocketing. However, due to the increase of working women, nuclear-families, and old persons living alone, new facilities for the elderly such as nursing home are urgently needed. Thus, many nursing homes for the elderly are also rapidly providing. It is needed to examine if such nursing homes are properly designed for the dependent elderly to live. This study was carried out by the field observation using a checking sheet with measuring and taking photograph. The subjects were 12 nursing homes which gave positive responses for walking through their facilities. The items for observing and measuring were made based on the regulation on improving the facilities for the disabled, the elderly, and the pregnant. Whether each item fits the regulation or not was examined. The 9 areas in each nursing home were examined : entrance, hallway and corridor, stair, elevator, ramp, bed room, shower and locker room, bathroom, and rest room. It was founded that many accessible-related items were met. However, many supportive-related items such as ones for the visual disabled, and many supportive-related and accessible-related ones for bathroom, shower room, and restroom were unmet. In the process of this research, it was founded that the tool for evaluating the design of nursing home in terms of universal design should be developed.
Purpose: The study was conducted in order to identify factors influencing depression and quality of life in elderly customized home visiting health services. Methods: A total of 442 people participated as the subjects of this study. Data were collected during the period from June to September in 2010 and the measurement tool used for this study was the customized home visiting health service recording sheet recommended by the Ministry of Health. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression with SPSS/WIN 17.0. Results: Depression was correlated negatively with quality of life. According to the results of this research, factors influencing depression in elderly customized home visiting health services were quality of life, customized home visiting health service period, and IADL. Factors influencing quality of life in elderly customized home visiting health services were depression, joint exercise capacity, age, connection to volunteerism, IADL and ADL. Conclusion: The results of this study can be leveraged as complementary information for the effective management of customized home visiting health service subjects. Moreover, the results can be used as a reference for future studies.
Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.
Purpose: The study was a survey study to identify the Activities of Daily Living (ADL) and nursing needs of the elderly in the nursing home and derive the fundamental data for offering the better quality of nursing service to them. Methods: The subjects were the 111 elderly aged over sixty five living in the nursing home located in Seoul. Measures were the nursing needs scale and ADL scale. The data were analyzed by SAS 11.0. Results: First, with regard to the nursing needs, the general need was scored average 3.0, and the emotional' social need was 3.7, and the physical need was 3.1, and the informational need was 2.7. Second, the ADL was scored at the average of 2.7, bathing 1.9,. eating 3.1. Third, In correlation between the nursing needs by area, the informational nursing needs showed the sheer correlation with the physical nursing needs, emotional' social nursing needs. The physical nursing needs showed the sheer correlation with the informational. social nursing needs, and the inverse correlation with the ADL. Conclusion: It is necessary that it should improve the service to meet the emotional and social nursing needs and develop the extensive nursing programs satisfying their desires based on the general traits of the elderly.
Recently, the long-term care insurance for the elderly was carried out according to the elderly is increased rapidly and the formation of sympathy that a nation and society try commonly to share health and welfare promotion of the elderly. The purpose of this study is to analyze the present status of nursing home after that the long-term care insurance is enforced in chungcheongbuk-do and to utilize as basic data. The study limited its survey to those facilities that refer to the Ministry of Health and Welfare data, that had the capacity of more than 50 people. The result are as followings. Firstly, most of the nursing home were located on the outskirts of the city. But it must be constructed in the city center if the recent deinstitutionalization trend is reflected. Secondly, notwithstanding the provisions of the Elderly Welfare Law, if the Livability and amenity are considered, the plan of a single or a twin room is needed. The ondol(溫突) system bedroom for the safety of the elderly had to be planned and for the color planning of a bedroom, a heating, the furniture, the form of a door, corridors, etc. should be partly improved. The fastener in which it is appropriate for the main exit, a stair, an elevator, the lighting device, and etc. is needed and the installation of a wandering path for the dementia patient and etc. is required. Thirdly, most of the dining room arranged on the first floor but it is not nearly used and it used for employee or the other use. Therefore, we have to consider the system in which it can deliver the meal to a bedroom. If the smell of the elderly and etc. is considered, the sufficient height of the floor should be reflected for the ventilation equipment. Lastly, The improvement of the existing law are required.
There are three main purposes in this study. First, we project the number of elderly dementia population in the future based on the projection of the elderly population in the Kyungpook area. Second, the demands of home-based care service and facility-based care for the elderly dementia are estimated. Thirdly, some policy implications for the improvement of welfare services for the elderly dementia are addressed. The findings of this study are as follows. Considering the size of the elderly dementia population, facilities for the elderly dementia are extremely insufficient and most of the elderly dementia patients rely heavily on home-based care. Although we expect that there will be a rapid increase in the number of the elderly dementia in the next two decades, the social welfare services for them in the future are very unreliable. Home nursing for the demented elderly needs to be recognized by law and financed by the government. In this context, we address some issues regarding the rapid growth of the elderly dementia population in the future and social welfare services for them as well. Finally we suggest some policy implications regarding this matter.
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