This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units. The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.
The main objective of this study is to examine the situations of group-homes for the elderly and clarify the problems of them. This study investigates the present conditions of welfare facilities and supply conditions. 4 group-homes were surveyed in Jeonju and Kwangju cities. Data was collected through various ways including the survey conducted by facility operators, the measurement of living space, and photo-takings. The major results of this study are as follows: 1) With the introduction of nursing care insurance in 2008, the increase of the demand and supply to group-home will be expected, due to less cost for recuperation. The care of elderly in homelike atmosphere is effective to the elderly suffering from dementia. Therefore, it is proper that the supply of group-homes for dementia will be needed. 2) Group-homes for the elderly are being supplied under the standards of welfare facilities in the present. Separate supply standards, however, are needed because they are not suitable for small scale group-homes. 3) To supply Group-homes for the elderly on a one-unit basis would cause various problems such as economical unreality, personnel distribution and so on. It is necessary to supply more than two units for more efficient management. 4) The management of group-homes for the elderly is financially unstable because the operating funds heavily depend on the users or people who are connected with the facilities through private networks. Therefore, additional support is needed to settle the financial problem. It would be helpful to build the public networking that provides information about the group-home for the elderly for the public. 5) In case of the increase in the supply of the group-home in a residential area, it could be helpful to promote the group-home to the public. 6) The operators state that the main problems of group homes for the elderly lie in financial difficulties and the shortage of professionals and volunteers. The financial, personnel, and material support for personnel and the supervision of management are required for the transparency and effectiveness of the facility management. In addition, the closer network and cooperation system with the community is required. 7) The present living environments for group-homes for the elderly leave much room for improvement, considering the physical condition of the elderly. The more careful selections in the color, shape, material, and equipment of the facilities should be made for the convenience of the elderly users.
The purpose of this study was to provide basic information about efficient space use in the dining and bathing area through the analysis of service flowing. Four researchers observed the service flowing and the using behavior at those areas. The results of the study were as follows: Dining service was proceeded as resident moving, waiting, meal serving, dining, moving and arranging in order. The waiting stage was one of the problematic processes since the staffs made the residents wait to) long at a fixed position. The program right before the meal serving will be helpful for reducing tediousness of the elderly residents. Another problem was that the area was not big enough for the meal sowing. The legal regulation Is needed to prescnbe for the size of dining area per resident. The flowing of bathing service was proceeded as staff preparation, moving, waiting, undressing, bathing, drying, dressing, moving and arranging in order. There were more problems in the dressing area than in the bathing area. The elderly with stretcher or wheelchairs had difficulty in entering the narrow doorway. The dressing area was so crowded with the staffs, undressed elderly, dressed elderly, and other laundries. The division of dressing and undressing area is required to avoid the confusion of the users in the area.
In Japan, there are over the 100's fires in the social welfare organs every years. People are interested in fire protection who live in an institution for the aged or weak person's places and worried about it. I surveyed the social welfare organs were safety from fire to firewarden who worked at an institution for the aged in Tokyo. In the paper, I asked how do you think about the fire safety problems and condition of the facilities. And base on firewarden's view, I reviewed(examined) the fire prevention measures, each facility's problems and how to improve the fire protection.
Korea's health care delivery system is based on the Medical law and the National Health Insurance Act. In order to efficiently operate limited medical resources, it is classified to use medical institutions according to the severity of the disease. The question is whether a tertiary care hospital can terminate a medical contract for a patient, if treatment for severe diseases has already been performed at a tertiary care hospital. In the case of termination of treatment, the Korean court has both a judgment that recognizes the right to terminate and a judgment that denies the termination. Among the U.S. rulings, there are rulings that order transfer to a skilled nursing facility or nursing home or home if acute treatment is no longer needed. Considering that medical resources are limited, it is necessary to acknowledge the right to terminate the contract of the medical institution when treatment by a medical institution is completed.
Objective: The purpose of this study was to perform a systematic literature review focusing on international studies to identify various factors affecting the quality of life(QOL) of dementia patients admitted to long-term care facilities. Methods: From January 2000 to July 2018, the articles published in foreign journals were searched through CINAHL and MEDLINE databases. The main search terms were'dementia or Alzheimer's'. 'quality of life', 'long-term care', 'care home', 'nursing home', 'care institution', 'residential care', 'small- scale setting'. The first 1706 articles were searched, but 10 studies were selected using the selection and exclusion criteria. Results: Analysis of ten cross-sectional studies showed that factors such as physical functioning status, ability to perform activities of daily living, and cognition showed a positive correlation with QOL. Depression and anxiety, severity of dementia, and neuropsychiatric symptoms were found to be negatively correlated with QOL. In addition, two longitudinal studies have confirmed that factors affecting QOL are affected by individual functional status and social environmental factors rather than the size and form of care facilities. Conclusion: This study summarized 10 papers and analyzed them through a systematic review of literature. We found that factors such as individual characteristics and social environment determine QOL of patients with dementia. In this study, various intervention methods to improve QOL of patients with dementia should be developed and used in long-term care facilities by identifying the factors affecting QOL of dementia patients and using them.
The purpose of this study was to provide the design guidelines for the activity spaces in the skilled nursing facilities for the elderly through the investigation of the spatial characteristics and using behavior The researcher interviewed the staff regarding programs in 15 facilities, investigated and observed the use of the spaces from 15th of December, 2004 to 19th of February, 2005. The programs in facilities were categorized into human knowledge, arts, music, exercise, recreation, cooking gardening, religious and social activities, and those were peformed once to 4 times a day. They were conducted in the elderly individual rooms, lounges, program rooms, dining room, or(and) auditorium. The results of the study were as follows: First, investigating the activity spaces, the lounges and elderly individual rooms were mostly on the same floor so that the elderly had no big trouble in access to the lounge. The program rooms of the facilities in suburban and rural area were on the same floor as the elderly individual rooms and they were likely to combine with another usage, compared to those On city were mostly separated from the residence floor. Most of dining rooms and auditorium were on the basement or on the 1st floor. Second, in the programs by the activity spaces, elderly individual room and the program room were used more for the human knowledge and art programs with small group. The lounges were for recreation and social activities with (both of) small or(and) big group and dining rooms were mainly used for cooking programs. In auditorium, recreation, religious and social activity were performed with big group. Third, the individual rooms for the elderly had more capacity if those did not have any beds, but often had a trouble in making a passage way. The lounges needed to remove decorations and displayed furniture obstructing the passages and to arrange both of the western and eastern type of tables for the efficient use of the spaces. It took a long time in preparation of the furniture and other equipment if the program room was with another usage.
The purpose of this study was to analyse the relations among the residents' characteristics, the policy of the facility, and the physical characteristics of activity areas, and to understand the elements for the lively use of activity areas in the elderly nursing facilities. The results of the study are as follows: First, there was a relationship between the characteristics of semi-public activity areas and the residents' management-control policy. The facilities having semi-public areas of living room type showed more flexibility in time and place and more respects for the residents. Second, the activity areas of connection type were much more used than the compartment type, especially in the facilities having more residents incapable of walking. On the other hand, the facilities having high control for the residents showed high using rate in public activity areas, and all those did not have semi-public areas or showed low using rate in there. Third, in the analysis of the relationship between the physical characteristics and the using rate of activity areas, the public activity areas having compartment type in the spatial composition and hall as a form were likely to have multiple usages. On the whole, the various form of activity areas, the area per residents, openness, accessibility and centrality were having interactions each other for high using rate in activity areas. Especially, many stimulations and the furniture arrangements that were good for the residents' interactions had a function of compensation for the poor physical characteristics of activity areas. This study investigated only the using rates to understand the lively use of the space. For the future study, it is suggested that the detail using behavior of the residents should be examined to understand the influential elements.
This study identified the perception and coping ability of an emergency involving the elderly for facility directors in charge of services in long-term care facilities, and used it as basic data for developing educational programs and policy data for improving the ability of emergency facilities. The subjects were 192 directors of elderly care facilities and home care centers. Data were collected from March 15 to April 20, 2019 and analyzed using the SPSS WIN 25.0 program. Data analysis was performed using t-test, One-way ANOVA, Pearson's correlation coefficient, Scheffe, and multiple linear regression. The results revealed 97.4% of emergency experience, 6.16 points of emergency perception, and 62% of correct answers, and coping ability of an emergency was 69.61 ± 13.537. The negative correlation between emergency experience and ability to cope with emergencies(r=-.202, p= .005) was the long-term care facility type(β = 8.253, p<.001). Overall, an education program considering the type of long-term care facility is needed when applying emergency education for facility directors.
The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.
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