The Japanese elderly welfare policy has focused on facility policy for the aged and preventive care service for healthy elderly people. This paper has conducted a comparative analysis on Geriatric Gealth Services Facility and Special Nursing Home for the Elderly. For this, each service function has been divided into six categories; daily life / nursing and caring / medical service / management / supply / miscellaneous. Then the change in real structure by category has been analyzed through a plan analysis on case facilities. In the Geriatric Health Services Facility, the biggest change was observed in 'livelihood' among six categories. In the Special Nursing Home for the Elderly, 'the nursing and care parts' and 'medical service part' are decreased since 1999. At that time, the facilities started to be individualized and divided into a unit. To pursue home-like care instead of unit care, there was a change in construction planning to help the aged with dementia live a self-sufficient life.
The purpose of this study is to present our elderly welfare policy and welfare facilities for the elderly and to propose the future direction of policy for the elderly with comparison to that of Japan. The comparative study results of Korea and Japan are as follows: As the basis of elderly welfare, care insurance for the elderly is now fixated in the two countries. On the other hand, for quantitative expansion in Korea, the quality level has been gone down. Due to qualitative evaluation, the growth of facilities has slowed and material welfare providers was also a decline in the number of operators. Two countries in the field of community welfare in recent years has been actively promoting. It is the most important to solve the social welfare problem with local councils who know the area, which is a part of the future to focus and to support. Due to huge construction investment of facility, there is the burden of operators. This facility is appropriate for an extension of the home. However, it is in the hard economic times. Until now, the number of people in a room is at least four according to the legal standard of Korea, there are a few private rooms. On the other hand, in Japan, unit-care was phased since 2002 and private rooms have been expanded. In Japan, health center for the elderly plays an important role with special elderly nursing home among facilities for the elderly. Health center provides services that are recovering, nursing, and caring to support independence for the elderly after acute phase of treatment. As treatment and care, the aim of health center is to return the elderly to home. On the other hand, there are a few health centers for returning the elderly to home in Korea. Furthermore, in Japan, a project for preventive care has been begun. The project is needed in Korea.
Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.
The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1, 352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below, 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and / or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the control and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1% of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal-neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior(8.89%), with health-re-lated educational needs(8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources(3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by com-munity based home care nurses.
Purpose: The study was performed to compare the contents of jobs and job satisfaction of resident nurses at free elderly homes with nursing homes in Korea. Method: The subjects consisted of 138 resident nurses at free elderly homes and nursing homes. Data were collected from the 1st of January to the 22nd of February in 2005 using a structured questionnaire containing questions on general characteristics. contents of the nurses' daily tasks, health program. job satisfaction and pay satisfaction. Collected data were analyzed using SPSS (version 11.5) through descriptive statistics, $X^2-test$, t-test and ANOVA. Result: For nurses at free elderly homes and nursing homes. their daily tasks consisted of health assessment. medication care and eating care. The general job satisfaction of the nurses was similar between those at free elderly homes and those at nursing homes, but working conditions and pay were significantly different according to the sub content of job satisfaction. Job satisfaction was significantly different according to marital status in resident nurses at the free elderly home, and according to the experience of living with the elderly and the experience of receiving special training or lectures in elderly nursing in resident nurses at free nursing homes. Conclusion: Resident nurses at free elderly homes and nursing homes had various types of tasks, and it is necessary to differentiate tasks and payment systems for them according to their job.
본 연구는 요양시설 치매노인들의 인지기능과 구강건강상태 및 구강 내 병원성 미생물의 관계를 파악하기 위해 시도되었다. 대구소재 요양기관에 거주하는 70세 이상 치매노인이라는 특수성으로 비확률적 표본방식을 통해 30명을 대상으로 2019년 2월 한 달간 자료를 수집하였다. SPSS window ver. 21.0 프로그램을 이용하여 기술통계, ANOVA, Pearson's 상관계수로 분석하였다. 연구결과 요양판정등급이 낮을수록 고위험 병원성 세균이 많았고, 현존 치아수가 많을수록 구강 내 미생물의 수가 높게 나타났다. 하지만 인지기능과는 무의미한 차이를 보였다. 따라서, 요양시설의 치매노인 구강건강 관리를 위해서는 구강 내 환경에 따라 관리 방법을 달리하여야 하고 실제적인 건강관리를 위해서는 전문적인 관리자가 구강건강관리를 할 수 있어야 한다고 제언한다.
This study was conducted with whole home care nurses nationwide to provide secondary analyzed data to understand on their usage of medical equipments and their need of them for a month. This study found that treatments given by home care nurses were nelaton catheterization, bladder washing/urethral washing, newborn care, exchange and care for nasogastric tube and suction in that order of frequency. Second, instruments and equipments used for home care were reported to be stethoscope, patient monitor, blood pressure measuring equipment, air flotation mattresses, beds for patients, mattresses, suctioning device sets, enteral feeding equipment and dressing set in that oder of frequency. Moreover, need assessment of medical instruments and equipments showed renal dialysis was most needed and patient monitor, blood pressure measuring equipment, enteral feeding equipment, solution and other supplies for renal dialysis and beds for patient were necessary in that order. In conclusion, the results of this study investigating special treatments and medical instruments and equipments used for home care patients and analyzing patients' need, were expected to be useful for expansion of application of long-term care insurance for the elderly and health insurance as well as for quality control of home care and development of medial instruments and equipments used at home.
The purpose of this study was 1) to review communal housing in the UK, 2) to consider the policy implications for elderly communal housing in Korea. The research methods used were 1) literature review about communal housing and related policy in the UK 2) field survey in the UK 3) interpretative suggestion for the proper policy implication to develope communal housing for the elderly in Korea. Sheltered housing in the UK had been developed as communal housing for the elderly with special needs since the 1970s. The type of sheltered housing were category 1 and category 2. Very sheltered housing with more facilities and meal services was added in 1980s. Sheltered housing was evaluated as the most humanistic solution for older people in the UK in 1980s. Because of the policy of moving institutional care to community care, sheltered housing became less in demand because of more options for older people including being able to stay in their own home. So new completion of sheltered housing by registered social landlords reduced saliently. Sheltered housing already totalled over half million units in which 5% of all elderly over 65 still lived and a small quantity of private sector for sale schemes emerged in the 1990s. The reason why the residents moved to sheltered housing was for sociable, secure, and manageable living arrangements. In general the residents were satisfied with these characteristics but dissatisfied with the service charge and quality of meals, especially in category 2.5 schemes. The degree of utilisation of communal spaces and facilities depended on the wardens ability and enthusiasm. Evaluation of sheltered housing indicated several problems such as wardens duty as a \"good neighbour\" ; difficult-to-let problems with poor location or individual units of bedsittiing type with shared bathroom ; and the under use of communal spaces and facilities. Some ideas to solve these problems were suggested by researchers through expanding wardens duty as a professional, opening the scheme to the public, improving interior standards, and accepting non-elderly applicants who need support. Some researchers insisted continuing development of sheltered housing, but higher standards must be considered for the minority who want to live in communal living arrangement. Recently, enhanced sheltered housing with greater involvement of relatives and with tied up policy in registration and funding suggested as an alternative for residential care. In conclusion, the rights of choice for older people should be policy support for special needs housing. Elderly communal housing, especially a model similar to sheltered housing category 2 with at least 1 meal a day might be recommended for a Korean Model. For special needs housing development either for rent or for sale, participation of the public sector and long term and low interest financial support for the private sector must be developed in Korea. Providing a system for scheme managers to train and retrain must be encouraged. The professional ability of the scheme manager to plan and to deliver services might be the most important factor for the success of elderly communal housing projects in Korea. In addition the expansion of a public health care service, the development of leisure programs in Senior Citizens Centre, home helper both for the elderly in communal housing and the elderly in mainstream housing of the community as well. Providing of elderly communal housing through the modified general Construction Act rather than the present Elderly Welfare Act might be more helpful to encourage the access of general people in Korea. in Korea.
Purpose: This study conducted a survey on the elderly of 65 years and over with physical debilities and ones capable of living at home residing in Jeju Special Self-Government Province to compare and analyze demo-sociological characteristics and factors influencing on oral health related living quality. And also this study intended to provide basic data for developing effective public medical policies and health promotion programs to increase oral health related living quality of the elder. Methods: The elderly of 65 years and over living in Jeju Special Self-Government Province were interviewed individually from 7 February 2011 to 18 April and interview results of a total of 220 subjects were analysed for this study. Results: Current status of the elderly including ones with & without physical debilities influenced functional limitation and behavioral aspects of GOHAI criteria used in this study. The elderly with physical debilities experienced less limitation in food chewing and swallowing, and pronunciation than ones capable of living at home. On the analogy of the previous study(by Park, N. G., 2010) in which oral health related quality and satisfaction of life of the elderly with physical debilities were different due to their physical, circumstantial and psychological limitations, the former's oral health conditions are worse than the ones capable of living at home and because of medical care accessability limitation they suffer from deteriorated oral condition. By the comparison of factors influencing on the living quality relating to the oral health of the elderly with physical debilities and ones capable of living at home, 2 factors, age and living area, were meaningful factors commonly influencing on the oral health related living qualities of both. The elderly of 75 years and over were more affected by psychological and behavioral aspects of oral health related living quality than the ones of 65-74 years, and the ones living in country suffered from functional limitations, pains and discomfort more than ones in city. Additionally, being different from the elderly capable of living at home, the ones with physical debilities were influenced by the factors of average monthly income and medical security type. Conclusion: Improvement of programs and systems to increase oral health related quality of life needs to be carried out preferentially for the elderly of 75 years and over, and dwelling in country. Also this study suggests that the policy of paying the denture insurance allowance in 2012 need effective planning considering the elderly's current status, age, living area, medical security type.
Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.
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