Journal of the Korean Institute of Rural Architecture
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v.11
no.4
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pp.51-58
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2009
The senior adults which are a central manpower of economic activity of the nation decreased and the elderly sustenance allowance already went over 10%. And the economic activity participation of the woman which are the supporter of the unpaid the elderly within the family is increasing. This big change is expected to support awareness. To respond to these changes, the improvement of social welfare system for elderly with the job of retirement lifestyles of the elderly, a figure that is needed for the ceremony. The elderly medical treatment facility that began in 2008 the elderly long-term medical treatment law enforcement because of the demand is expected to grow. It is forecast with the fact that the data which is fundamental is most important will become that old person medical treatment facility of the middle-aged layer which is a central role of the protector who decides the facility use of the preliminary consumer of the elderly care facility and currently the very the elderly and manhood ceremony and the preference to plan of the elderly welfare facility. The purpose of this study is to present the fundamental data about the elderly care facility for comparative analysis the awareness & perfernces of the elderly care facilities of the senior adults & the elderly.
There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.
BACKGOUND/OBJECTIVES: This study investigated nutritional status of the elderly with dementia in a care facility with the aim of improving the meal quality of the facility. SUBJECTS/METHODS: Data were collected from 30 dementia patients aged more than 65 years in a long-term care facility in Hongseong. The data were obtained from questionnaires and medical records. The food intake data was obtained using food photographs and the nutrient intakes were calculated using the CAN-Pro 5.0. The data were compared with the dietary reference intakes for Koreans (KDRIs). The nutrient density, diet quality such as nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ), as well as dietary diversity score (DDS) were evaluated. The data were analyzed using SPSS statistical programs. RESULTS: The average daily energy intakes for men and women were much lower than the estimated energy requirements of the KDRIs. The average intakes of energy and most nutrients in the general diet group were significantly higher than those of the other two groups. Significant differences in diet quality and diet diversity were observed according to the meal type groups. The NARs of some minerals (calcium, iron, and zinc) and vitamins (vitamin $B_6$ and folic acid) were less than 0.5 in all study groups. The NARs of protein, iron and MAR of the general diet group were significantly higher than those of the liquid diet group. The DDS scores of meats, fruits and diary food group were very low in all meal type groups, meaning that the diet qualities of the study subjects were not appropriate in all meal type groups. CONCLUSIONS: The food intakes of the study groups showed some limitations by a direct comparison with KDRIs because of the very low physical activities of the study subjects. The diet quality and diet diversity indices suggest the need for improvements in the nutritional quality in all types of diet. Overall, new intervention strategies targeting facility residents with dementia in Korea are needed as soon as possible.
Journal of The Korea Institute of Healthcare Architecture
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v.16
no.2
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pp.55-64
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2010
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.
Background: Workplace violence (WPV) is becoming an issue that needs immediate attention in the United States, especially during this period as more states are adopting the "stand your ground laws to promote worker protection." This study was conducted to investigate how WPV has contributed to an unsafe environment for nurses and nursing assistants who work in long-term medical care facilities. Methods: A structure questionnaire was used to collect data for the study. Three facilities were sampled and 80 nurses and certified nursing assistants participated in the study. Ninety-two percent (n = 74) were female and 8% (n = 6) were male. Approximately 62% were black or African American, approximately 33% were Caucasians, and only 2% were from other ethnicities. Results: We found that 65% of the participants had experienced WPV while 41% believed that management shows little or no concern for their safety. Approximately 23% of respondents believed that reporting supervisor's WPV act is an unsafe action. In addition, 22% of those who reported that they have experienced WPV believed that the work environment is not safe to perform their duties. This significant difference in perception of workplace safety between those who had experienced WPV and those who had not was significant (t = 3.95, df = 158, p < 0.0001). Conclusion: WPV is an epidemic problem that affects all health-care professionals. The findings of this study could help long-term medical care facilities' management identify the areas to focus on mitigating, controlling, and/or eliminating incidents of WPV.
Nursing Homes do not have a defined standard in the space area nor does it have a detailed standard facility requirement by law. This can possibly lead to the deterioration of the facility and the system. This directly affects the medical treatment space area within the nursing home. The medical treatment area provides medical treatment to seniors and this is where the seniors get most of their daily services. Therefore, this is research is about the study of the space area of the medical center and the ratio trend of the space area for the medical treatment facility located in senior nursing homes. Ten facilities have been selected in this study to analyze the correlation factors between space area and its trends. The analysis performed includes the conditions relating to the area and what affects the center. We have followed up with a proposal for improvement of the facility and area configuration for the medical treatment facility. Based on the analysis, the following conclusion can be made: First, the senior welfare centers are mostly used as a residence purpose followed a temporary stay of residence facility for the seniors. Second, research indicates that the bigger the facility, nursing and public functions took a larger portion of the space area compared to other services within the senior welfare centers. Third, the study shows the management space area took up about 1%~6% of the entire medical center within the nursing home which is a narrow space area because of the integrated management. Fourth, analysis based on the trend in the time-series indicate after the adoption of the system, there is a continued decline in the space area of nursing, management and public areas. Lastly, since before and after 2008, the space area composition of the nursing facility shows a continuous decline in our study. We can safely conclude that the revised senior welfare act's construction plan has an effect in the facility and is effectively working to meet its requirement. Therefore, the revision of the law is required to reflect the social needs of the residents.
Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.
This purposes of this study is to develope policies on the facilities for the elderly care in Korea. Methodology of this study adopts comparative analysis on the facilities for the elderly care in 6 countries which have experienced various problems on the elderly. These 6 countries are Japan, Sweden, America, Australian, England and Germany. Major issues for comparative analysis are the standard of care facilities, residence condition, finance of facilities establishment and expense, operating system, management, and the law and administrative structure about the facilities for the elderly care. The elderly people need various kinds of welfare services such as medical care facilities, nursing home facilities, home care facilities etc.. Thus the public policies for the aging population nations are compose of income maintenance program, health and medical care services and social welfare services. The policies of facilities for elderly care are very important since these policies include the characteristics of income maintenance, me\ulcorner미 care program and welfare program. This study willsupply basic data for the development of facilities for the elderly care in Korea, especially conceming the system and institutional device of the facilities.
Park, Min Woo;Shin, Seung Hwan;Cha, Jeong Ok;Lim, Hyeon Jeong;Kim, Jun Nyun
Journal of Environmental Health Sciences
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v.46
no.5
/
pp.599-609
/
2020
Objectives: Coronavirus disease 2019 (COVID-19) first emerged in December 2019 in Wuhan, China, and has rapidly become a global pandemic with over 26.4 million confirmed cases and approximately 871,000 fatalities worldwide as of this writing. In the Republic of Korea, disease clusters frequently occurred in long-term care hospitals where the majority of residents are elderly with underlying medical conditions. Despite the fact that public health authorities and local community health centers have put tremendous efforts into preventing the spread of disease, positive cases have continued to occur. Thus, the Korea Centers for Disease Control & Prevention rapid response team decided to conduct an environmental investigation of a long-term care hospital to identify whether environmental contamination has remained and contributed to the spread of COVID-19. Methods: An environmental investigation was conducted at Hospital A. The characteristics of the facility and its HVAC system were assessed by checking the layout and interviewing the people in charge. A total of 64 surface samples were collected from areas of concern, including patient rooms, toilets, elevators, and nurses' station. These samples were tested by a regional health and environmental research institute using real-time reverse transcription polymerase chain reaction. Results: All samples from Hospital A were confirmed to be negative. Through interviews with high-level personnel at the regional community health center, we found that extensive disinfection is frequently performed on potentially contaminated areas in Hospital A in accordance with government guidelines. Conclusion: The environmental control measures implemented in Hospital A had been sufficient for mitigating the risk of further infection, suggesting that such measures may also be effective for other long-term health care facilities.
Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.
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