• Journal of the Korean Dietetic Association
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• v.10 no.2
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• pp.197-204
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• 2004

The purposes of this study was to analyze the operational difference of foodservice center for homebound elderly by the presence of the dietitian. The questionnaire was developed to measure all variables for menu management and distributed to 103 meal service centers in charge of congregate meal service program and 57 centers for home-delivered meal service program. The data of 160 centers in charge of congregate meal service and home-delivered service centers were usable for analysis. Statistical data analysis was completed using the SAS 8.1 package program for descriptive analysis and chi-square test. Only 21.9% meal service centers had dietitians, what is more, they were not professionals who did menu management but foodservice managers, volunteers, cook or social workers. The current foodservice programs for the homebound elderly were operated without professional. In the part of menu managemet, dietitians were more actively involved in menu planning in the elderly foodservice center in the presence of the dietitians. The performance level of healthcare service was not significantly different, but the nutrition education in the elderly foodservice center with the dietitians was more frequently performed than that without the dietitians(p<0.05). In the food purchasing and food production management, the significant differences were shown that in the elderly foodservice centers in the presence of the dietitians, the proportion of the contract purchasing was significantly higher than that of direct purchasing(p<0.01). In food sanitary management, the significant differences were not shown in the part of management of keeping meal for identifying the cause of food-borne illness and left-over, but the sanitation education for the foodservice employees was performed more frequently by the presence of the dietitians(p<0.01). In conclusion, the foodservice management was more systematically conducted in the elderly foodservice centers in the presence of the dietitians than that without dietitians. The elderly foodservice program has offered the health-related support for homebound elderly. Although there were several problems in elderly foodservice management, the program delivered well-targeted, effective, and efficient nutrition services and wide range of supportive service to the at-risk older population. It needs to be managed by professional for the improvement in the elderly foodservice.

• Korean Journal of Community Nutrition
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• v.8 no.6
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• pp.919-926
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• 2003

The purpose of this study is to examine the current congregate meal service program for homebound elderly. One hundred three meal service centers in charge of the congregate meal service programs as part of the elderly foodservice program were surveyed for administrative structure, menu management, food purchasing and production management, hygiene, equipment, and facilities. Statistical data analyses were completed using the SAS 8.1 program for descriptive analysis and ANOVA. The meal cost of 54.4% of the congregate meal service centers ranged from ￦l,500 to ￦l,999 per meal. According to the menu analysis, all nutrients except calcium and Vitamin B2 were at levels of more than 33% of the Recommended Dietary Allowances for Koreans. A total of 81.5% of the centers were operated without the services of a dietitian, and food purchasing, menu planning and other foodservice management processes were handled by non-professionals, such as volunteers, cooks or social workers. Although 88.3% of the centers required a therapeutic diet menu for the health of the elderly, most directors (77.6%) replied that in their current status they could not afford to serve therapeutic diets. These results suggest that financial and systematic supports by government is very necessary. Fifty-five percent of the centers never used standard recipes. For determining portion sizes, 93.2% of the congregate meal service centers depended on the personal experience of the personnel. Finally, the current congregate meal services for the homebound elderly were not operated systematically. To improve the elderly food service program, it is strong1y recommended that it be managed by Professionals.

• Journal of the Korean Dietetic Association
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• v.12 no.4
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• pp.313-328
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• 2006

This study was objectively performed to identify dietitians' job in the elderly health-care facilities, to assess facilities and dietitian's demographic characteristics, and to determine performance and importance of dietitian's job including the demand of therapeutic diet development. Survey was conducted by mail and samples were the dietitians working in 376 facilities which capacity is over 50 members from nationwide 583 the elderly health-care facilities. Returned questionnaire was 102 and used for statistic analysis. The distributions of the elderly health-care facilities showed 39 the elderly nursing facilities(38.2%), 32 skilled nursing facilities (32.4%), 13 geriatrics hospital facilities(12.7%) and 9 the elderly cost nursing facilities(8.8%). 60.0 percent of the samples showed its menu price as 1,000 to 1,500 won. A cycle-menu program was in-use at the 79.0% facilities, but only 7.1% facilities have been introduced a selected menu system. 92.9% facilities employed only one dietitian. In the demographic characteristics of dietitian only 14.7% dietitian had a clinical dietitian license and 51.5% of respondents answered at least 1 to 3 months internship program is needed. Job activities of the dietitian in the elderly health-care foodservice were identified as 45 activities with 9 dimensions. Job performance score evaluated dietitian oneself was 4.71 of 7 points. The average importance score that the dietitian evaluated their own job was 5.66 points of 7. The job activities shown higher importance but lower performance were therapeutic diet development for in-patients, menu development suitable for taste of the elderly, and leadership. Job performance score by characteristics of dietitian and their elderly health-care facilities was significantly associated with experience of dietitian in elderly health-care (F=4.480, p<0.05), education of dietitian(F=2.659, p<0.01), number of dietitian(F=2.245, p<0.05), and number of employee in foodservice(F=2.607, p<0.05). Most common diseases of the aged was proved as hypertension(81.7%), diabetes mellitus(71.4%), and dementia(65.0%). The therapeutic diets frequently provided were diabetes mellitus diet, dysphagia diet, low sodium diet, high fiber diet, and high protein diet, in order. For those reasons, dietitian in the elderly health care emphasized that the information about therapeutic diet development such as diabetes mellitus diet, dysphagia diet, low sodium diet and hypertension diet must be continuously developed and provided. The result from this study can be applicable to enlarge and enrich job activities of dietitian in elderly health-care foodservice.

• Journal of Nutrition and Health
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• v.31 no.9
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• pp.1498-1507
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• 1998

The purposes of this study were to : a) examine the current foodservice management practices of twenty-one seniors centers in charge of hoke-delivered meal programs, b) evaluate the attitudes of one hundred and ten recipients of meal service program, and c) provide feedback for the efficient and effective foodservice management for the elderly. Statistical data analysis was completed using the SAS package program for descriptive analysis, T-test, and ANOVA. The results of quantitative analysis indicated that the costs of meals, containers and special foods were mostly dependent on the support from local government(Seoul city). The centers where the volunteers were over seventy five p ercent of the workers were frtty-eight percent and sixty-seven percent of the subjects in food preparation and food delivery to the homebound clients, respectively. Meal preparation and food purchasing were mainly practiced by social welfare worker. Standardized recipes were not developed and meal preparation was controlled under the cook' and volunteers' experiences. The survey results of recipients who participated the home-delivered meals program showed that the mean of meal satisfaction score was rated over three point five in the five-point scale. There were significant differences between dependent variables(volunteer's kindness, plate waste, menu variety) and independent variables(sex, receiving periods and family type of the subjects). (Korean J Nutrition 31(9) : 1498-1507, 1998)

• Korean Journal of Community Nutrition
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• v.8 no.5
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• pp.736-743
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• 2003

The purpose of this study was to research the current home delivered meal (HDM) service programs for seniors living in the community. Fifty seven centers which operated a HDM service program were surveyed with respect to their administrative structure, menu management, food purchasing and production management, hygiene and equipment and facility. -Statistical data analyses were completed using the SAS 8.1 program for descriptive analysis and t-test. The results showed that 55 percent of the study group were from 70 to 79 years old. All of the participants received free HDM. As a result of the meal cost analysis, the meal cost at 56.1% of the HDM service centers was from ￦2,000 to ￦2,499 per meal. A total of 68.4% of the HDM service centers were operated without the services of a dietitian. According to the menu analysis, all nutrients except Vitamin B2 were at levels of more than 33% of the Recommended Dietary Allowances for Koreans. Although 96.6% of the HDM service centers required a therapeutic diet menu for the health of the elderly recipients, 68% of the directors responded that they could not afford to serve therapeutic meal. Food purchasing, menu planning and other foodservice management processes were handled by non-professionals, such as volunteers, cooks or social workers. Forty two percent of the HDM service centers never used standard recipes. For determining portion sizes, 75.4% of the HDM service centers depended on personal experience. Finally, the current HDM service programs for the homebound elderly were not operated systematically. It is suggested that professionally trained personnel should be included among the staff members to provide a more effective HDM service. The HDM service programs should be supported financially and systematically by the government.

• Journal of the Korean Society of Food Culture
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• v.17 no.5
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• pp.584-593
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• 2002

The purpose of this study was to evaluate the diet quality of the menus delivered by 17 free meal service centers for the low-income home-bound elderly in Chung- cheong buk-Do. Statistical data analysis was compleleted using the SPSS package program for descriptive analysis, T-test, and ANOVA. The meals offered by free meal service centers were not met the 1/3 recommended dietary allowances in calcium and vitamin $B_2$. There were significant differences between dependent variables(nutrient content, nutrient density, nutrient deficiency, NAR, MAR, food group intake patterns) and independent variables (operation type, operation status, operation period, nutritionist, food cost).

• Korean Journal of Community Nutrition
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• v.10 no.3
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• pp.303-310
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• 2005

The purpose of this study was to compare the nutrient intake and foodservice satisfaction of homebound elderly had lunch at the local community centers by the difference of meal service charge. Two local community center with cons-regate meal service program located in Daegu and Gyongsan were selected; one with free of meal service charge (F), and the other with 500-1,000 won for meal service charge (K), According to the dietary assessment, energy and nutrient intakes of the 156 elderly subjects were as a whole under the Korean Recommended Dietary Allowance (RDA). Elderly or F service conte. showed higher $\%$ RDA for the selected nutrients and MAR (mean adequacy ratio) than those of K service center (p<0.001). Participants were satisfied with most of the congregation meal service from community conte. with different reasons such as 'tasty (K service center)' and 'free of charge (F service center)'. In conclusion, elderly had the lunch at the community center with free of meal service charge was poor nutrition status and lower socioeconomic level than the other type of community center in this area. Therefore, healthy menu for elderly should be developed and managed by professional dietitian, as well as its impact on health status of this group, and congregate meal service system might be extended to the homebound elderly of whole community with free of charge.

• Journal of Nutrition and Health
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• v.37 no.8
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• pp.675-687
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• 2004

This study is designed to assess the prevalence at risk of malnutrition according to the Mini Nutritional Assessment (MNA) and evaluate the factors influencing on the nutritional risk of the elderly. Three hundred and nine elderly (110 men and 199 women: mean age =74.1) who participated in meal service in the Chung-buk province were investigated. Mean MNA total score was 21.9 and women had significantly lower MNA scores than men (respectively, 21.5 and 22.8). In the mean time mean MNA-SF (Short Form) score was 10.7, respectively 10.6 for the women and 11.0 for the men, with the difference being statistically significant. The MNA classified 33% of the elderly as well-nourished, 61.7% as at risk of malnutrition and 5.3% as overt malnourished. However, MNA-SF categorized the examinees 40.2% as good and 59.8% at nutritional risk. Those who identified as malnourished elderly had significantly lower mean BMI, mid-arm and calf circumference, poorer functional abilities (ADL, IADL) , lower MAR and food habits scores, and higher number of nutrient $\leq$ 75% of RDA than those with at risk of malnutrition and well nourished. Also socioeconomic status such as educational level, self-rated economic status, poverty level, and marital status significantly influenced nutritional status. Similar effect was observed in self-rated nutritional status and health status, dental status, appetite change according to MNA score. Stepwise multiple regression analysis indicated that weight loss was the most predictive item in the total MNA and MNA-SF score. It was found that items such as mobility, living status (home vs institution) , mode of feeding, and pressure sores were inappropriate for assessment of the elderly who are able to participate meal service program. Also, some modifications of items in MNA are needed in order to apply to Korean elderly. Even though the MNA seems to be an useful tool to screen those old people at risk of malnourished, a lot of work is still to be done with this assessment tool to secure its reliability.

• Proceedings of the KSCN Conference
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• 2004.12a
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• pp.132-132
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• 2004

• Journal of the Korean Dietetic Association
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• v.6 no.2
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• pp.57-70
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• 2000

The purpose of this study were to : a) evaluate the nutrition status of one hundred and forty five recipients and one hundred and forty nine non-recipients of home-delivered meals service program, b) examine the teeth status of recipients of the program, c)analyze the nutritional values of meals, and identify the attitudes of recipients and non-recipients were found. Four meals offered by Nambu seniors center were met the recommended dietary allowances in calorie, protein, and vitamin C. The mean score of meal satisfaction was 3.7 out of five-point scale.