• Title/Summary/Keyword: Health care for the elderly

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A Policy Implementation Analysis on the Care Voucher for the Aged -Focusing on Choice and Competition- (노인돌보미바우처 정책집행분석 -선택과 경쟁은 실현되는가?-)

  • Yang, Nan-Joo
    • Korean Journal of Social Welfare
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    • v.61 no.3
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    • pp.77-101
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    • 2009
  • As a case study in the field of policy implementation research, this study focuses on how the logic of consumer choice and provider competition operates on the front line of policy processing. To find the implementation process of the program, 39 interview data were analyzed, including voucher users, care workers, social workers in 4 agencies and local public officers in one of the district in Seoul, and relevant officials from the Ministry for Health, Welfare and Family affairs and the Center for Social Service Management. The main results are as follows: In the level of policy implementation, user choice and competition, which was the main logic behind the implementation of the voucher program, did not occur as expected by policy makers. Instead of user choosing his/her provider, it was found that the providers were choosing its users. Secondly, the case study found that providers have formed a caucus which allocated the local users equally amongst the providers. In this process, local public officers have supported the meeting by providing them with a list of users. Such results may be interpreted as a habitual execution from the tradition of supply-side subsidy, rather than the way of implementation in the market system. Thirdly, although voucher users could not choose their preferred agency in the first stage of service, some other choices exists so that users may choose their preferred care-giver and time for service. Finally, the change of agency and care-giver in the way of delivering services were observed.

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Nurses' Management of Nursing Home Residents' Remaining Functional Ability: Concept Development (노인요양시설 간호사의 거주노인 잔존기능관리: 개념개발연구)

  • Lim, Sun-Young;Chang, Sung-Ok;Kim, Su-Jin;Kim, Hyun-Ju;Choi, Jung-Eun;Park, Min-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.1
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    • pp.57-68
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    • 2014
  • Purpose: Nurses' management of Nursing Home residents' remaining functional ability is phenomena emphasizing as the main practice focus in long term care and has specific meanings within the context of quality of life for fragile and disabled elderly people in nursing homes. This study was conducted to clarify and to conceptualize the phenomena of nurses' management of nursing home residents' remaining functional ability. Method: The Hybrid Model of concept development was applied to develop a concept of nurses' management of residents' remaining functional ability. Results: This concept of nurse' management emerged as a phenomenon having meanings in two different dimensions, deliberation and enactment for five types of residents: residents with declining function and dementia requiring nursing assistance, bed-ridden residents with moderate dementia, residents with advanced dementia and behavior problems, but good physical health, residents at the end of life stage, and bed-ridden residents with intact mental health. Conclusions: Results indicate that nurses' management of remaining functional ability of residents in nursing homes is a concept having types of needs that should be treated in specified ways. Interventions should have a positive impacts on practical applications in nursing homes and on enhancing residents' remaining function.

The Effect of Brain-computer Interface-based Cognitive Training in Patients with Dementia

  • Oh, Se-Jung;Ryu, Jeon-Nam
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.59-65
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    • 2018
  • PURPOSE: The purpose of the present study is to investigate the changes in the cognitive function of elderly dementia patients residing in a residential care facility, following six weeks of brain-computer interface (BCI)-based cognitive training and to determine whether BCI-based cognitive training effectively improves their cognitive functions. METHODS: Thirty subjects diagnosed with dementia were randomly assigned to either the experimental or control group. Pre- and post-test cognitive function assessments were conducted using the mini mental state examination-Korean (MMSE-K) and Korean-dementia rating scale (K-DRS). The experimental group received BCI-based cognitive training, which consisted of games such as flying a ball and exploding a bomb, while the control group participated in music listening activities and National Health Gymnastics. Both groups engaged in a total of 18 sessions (3 times per week for 6 weeks, for 40 minutes per session). RESULTS: After 6 weeks of intervention, the experimental group had significantly increased MMSE-K scores ($19.53{\pm}1.30$ to $22.20{\pm}1.15$; p<.0011) and total K-DRS scores ($87.20{\pm}4.16$ to $99.33{\pm}1.15$; p<.0011). In addition, the experimental group showed greater cognitive improvements than the control group. CONCLUSION: The results of this study suggest that BCI-based cognitive training is a positive intervention tool for improving the cognitive function of dementia patients.

Smart-Telemedicine System Design and Business Model Analysis for Longitudinal Healthcare (예방의학을 위한 Smart-Telemedicine 시스템과 비즈니스 모델의 설계와 분석)

  • Kim, Chanyoung;Kwon, Dosoon;Lee, Jaebeom;Kim, Jinhwa
    • Information Systems Review
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    • v.14 no.2
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    • pp.1-19
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    • 2012
  • Recently due to the enhancement of education and lifestyle, the trend of healthcare services are changed to a more active and differentiated service in which a continuous self health care is possible. The Smart-Telemedicine system offers medical services by merging Blue-tooth and telecommunication modules to former blood pressure, blood sugar, heartbeat and temperature measuring devices. Moreover, it could analyze one's health pattern which would be helpful for the patient to prevent potential future illness. In addition, the easier accesses to various remote controllable medical check-up programs are offered to public as a number of available smart phone are rapidly escalating. The Smart-Telemedicine system provides the most ideal interactive medical service via accessible smart phones and mobile medical check-up devices at anywhere and anytime. It is very beneficial since it can save patients' time and money because people can reach to the service right at their home and be allowed to take charge of their health care process via longitudinal health data. Therefore, not only social costs that occur in elderly community would be saved, but also business in various forms of medical service field transactions could be possible. This paper will suggest the Smart-Telemedicine System for preventive medicine, its design and analysis of business models and the evaluation of those model.

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Treatment with upper complete denture and lower implant-fixed restorations on an elderly patient presenting fully edentulous maxilla and bilateral posterior edentulous mandible: a case report (상악 완전무치악 및 하악 양측 구치부 결손 고령환자에 대한 상악 가철성, 하악 고정성 보철치료: 증례보고)

  • Joseph Junesirk Choi;Richard Leesungbok;Suk-Won Lee;Phyo Ei Ei Htay;Jeong-yun Park;Jin-Young Chon
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.284-292
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    • 2023
  • Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient's posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.

Development and Efficacy Validation of an ICF-Based Chatbot System to Enhance Community Participation of Elderly Individuals with Mild Dementia in South Korea (우리나라 경도 치매 노인의 지역사회 참여 증진을 위한 ICF 기반 Decision Tree for Chatbot 시스템 개발과 효과성 검증)

  • Haewon Byeon
    • Journal of Advanced Technology Convergence
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    • v.3 no.3
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    • pp.17-27
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    • 2024
  • This study focuses on the development and evaluation of a chatbot system based on the International Classification of Functioning, Disability, and Health (ICF) framework to enhance community participation among elderly individuals with mild dementia in South Korea. The study involved 12 elderly participants who were living alone and had been diagnosed with mild dementia, along with 15 caregivers who were actively involved in their daily care. The development process included a comprehensive needs assessment, system design, content creation, natural language processing using Transformer Attention Algorithm, and usability testing. The chatbot is designed to offer personalized activity recommendations, reminders, and information that support physical, social, and cognitive engagement. Usability testing revealed high levels of user satisfaction and perceived usefulness, with significant improvements in community activities and social interactions. Quantitative analysis showed a 92% increase in weekly community activities and an 84% increase in social interactions. Qualitative feedback highlighted the chatbot's user-friendly interface, relevance of suggested activities, and its role in reducing caregiver burden. The study demonstrates that an ICF-based chatbot system can effectively promote community participation and improve the quality of life for elderly individuals with mild dementia. Future research should focus on refining the system and evaluating its long-term impact.

Child Health Behaviors and Health Education about Atopic Dermatitis in Ulsan Area (울산지역 초등학생들의 아토피 피부염과 천식 관련 생활습관과 보건교육 실태)

  • Moon, Ki-Nai;Jung, Jong-Hyeon;Pae, Hyang-Sun;Seo, Bo-Soon;Joo, Dong-Jin
    • The Journal of Korean Society for School & Community Health Education
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    • v.11 no.1
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    • pp.135-148
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    • 2010
  • Objectives: In this study, knowledge of environmental disease, experience of environmental health education and necessity of environmental health education of elementary school pupils were compared and analyzed. Methods: The population of this study was from grade 1 to 6 elementary school pupils in Ulsan city, Korea. Five elementary schools were randomly selected from Ulsan City. Seven hundred and twenty-eight responses from the five schools were analyzed (seventy-two were excluded). A self-administered questionnaire measuring sociodemographic variables, Knowledge of environment related disease(atopic dermatitis, asthma etc), as well as educational experience and necessity of environmental health education was analyzed. The survey results were analyzed using SPSS-PC Program 12.0 and the following results by implementing Frequency Analysis, Cross-tabulation Analysis and ANOVA are as follows. Result: Pupils of lower grades more informed than those of higher grades about atopic dermatitis. Among asthma sufferers, many responded that symptoms occurred or improved during the lower grades of elementary school. In terms of the lifestyles of patients with atopic dermatitis or asthma, female pupils, especially those in the lower grades, tended to make changes in their daily habits based on their disease. Also, parents tended to intervene/mediate more in the dietary habits and personal hygiene habits of lower-grade pupils compared to their higher-grade counterparts. Personal hygiene education is currently not provided in schools, and upper-grade pupils have more experience with personal hygiene education compared to lower grade pupils. 430 (59.0%) of pupils replied that education about personal hygiene is necessary in their curriculum. 490 (67.3%) of elementary pupils are aware of the close connection between education in hygiene and human health. When asked if education in hygiene should also be undertaken by teachers and parents, 406 (55.7%) students said that it should be done. Conclusions: Developing a concrete health education program and raising instructors' awareness of the necessity for education in hygiene. Placement of professionals in the personal hygiene education field, is important to provide good health education for elementary school pupils.

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A Preliminary Study for Evaluating on Demonstration Project of Community-based Home Health Care Nursing Services by the Seoul Nurses Association (지역사회중심 가정간호 시범사업 성과평가를 위한 기초연구- 서울시 간호사회 주관 -)

  • 유호신;이소우;문희자;황나미;박성애;박정숙;최행지;정기순;한상애
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1488-1502
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    • 2000
  • This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

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The Adult Guardianship and Medical Issue According to the Amendments of Civil Code (성년후견과 의료 -개정 민법 제947조의 2를 중심으로-)

  • Park, Ho-Kyun
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.125-153
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    • 2012
  • The adult guardianship system has been introduced through amendments of Korean Civil Code for the first time in the March 2011(Act No. 10429, 7. 1. 2013. enforcement). The adult guardianship system has the main purposes to provide a lot of help vulnerable adults and elderly, and protect them on the welfare related with property act, treatment, care, etc. There could be a controversy about whether the protection Legal Guardian's consent(formerly known as the Mental Health Act) or permission of the Family Court(revised Civil Code) are required to, or the Mental Health Act should be revised, when mental patient will be hospitalized forcibly. The author proposes that mental patient with Adult guardians should be determined by Legal Guardian's consent and approval of the Family Court, but mental patient without Adult guardians could be determined by Legal Guardian's consent. The issue of Withdrawing of life-sustaining treatment could be occurred due to the aging society and the development of modern medicine, and this has provided difficult, various problems to mankind in Legal, ethical, and social welfare aspects. The need of Death with dignity law or Natural death law has been reduced for a revision of the Civil Code. Therefore, on the issue of Withdrawing of life-sustaining treatment, in the future, intervention of the court is necessary in accordance with the revised Civil Code Section, and Organ Transplantation Act and the brain death criteria may serve as an important criterion.

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Chronic Disease Management using Smart Mobile Device (스마트 모바일 기기를 이용한 만성질환 관리)

  • Kim, Gui-Jung;Han, Jung-Soo
    • Journal of Digital Convergence
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    • v.12 no.4
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    • pp.335-342
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    • 2014
  • According to the recent trends in the growing elderly population, the chronically ill have increased. Thus the importance of the health care issues for them has emerged. In this paper, we want to implement a chronic disease management system using smart mobile devices. Proposed chronic disease management system is consisted of the biometric sensor, smart mobile devices, the patient management server, patient management DB, and patient symptoms analysis agent. The biometric sensor detects a biological information. Smart mobile devices receive the patient information from the sensor and transmit the information to the patient management server. The patient management server, patient management DB, and patient symptoms agent analysis agent analyze to process data delivered through a wireless communication network. Bio-signals includes modules of ECG, blood pressure, blood sugar and PPG. We are able to determine the current health status by monitoring measured biometric data through chronically ill health management system. We will focus on the individual service to be appropriate for a patient group in a mobile environment.