• Title/Summary/Keyword: 노인 돌봄

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The Impact of Community-based Integrated Care Service Policy's Home-visiting Exercise Guidance Services on Depression, Pain, and Balance among the Elderly: A case study (지역사회 통합돌봄 정책에서 방문운동지도 서비스가 노인의 우울증과 통증 그리고 균형에 미치는 영향: 사례 연구)

  • Gwan-Hyeok Go;Byeong-Jo Kim
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.179-188
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    • 2024
  • Purpose : The home-visiting exercise guidance service is a component of the community-based integrated care policy in District J of Busan Metropolitan City. This study aims to investigate the effects of the service provided by physical therapists on depression, pain, and balance among the elderly. Methods : Three elderly individuals were selected as study participants. Depression was assessed using the beck depression inventory (BDI) and the short geriatric depression scale-Korea (SGDS-K). Pain was evaluated using the visual analog scale (VAS). Balance was assessed using the berg balance scale (BBS), functional reach test (FRT), and timed up and go test (TUGT). The evaluation data were compared by averaging the values from the first and eighth sessions. Additionally, the overall satisfaction with the home-visiting exercise guidance service was surveyed. Results : In the depression assessment, the beck depression inventory score decreased (by 16.67±5.69 points), and the short geriatric depression scale score decreased (by 4.67±2.52 points). The visual analog scale score for pain decreased (by 2.67±0.58 points). In the balance assessment, the berg balance scale score increased (by 7.67±2.52 points), the functional reach test distance extended (by 4.67±0.58 cm), and the timed up and go test time decreased (by 5.33±0.58 s). Overall satisfaction with the home-visiting exercise guidance service was high (4.26±0.14 points). Conclusion : The home-visiting exercise guidance service received high satisfaction ratings from the participants. It was effective in reducing depression and pain while improving balance, potentially reducing fall risk factors among the elderly. These findings suggest that the home-visiting exercise guidance service, delivered by physical therapists, could significantly enhance the quality of life for elderly individuals by addressing issues related to depression, pain, and fall prevention within the community. Consequently, it is recommended that this service be continued and expanded as part of government policy.

Constructing a Conceptual Framework of Smart Ageing Bridging Sustainability and Demographic Transformation (인구감소 시대와 초고령 사회의 지속가능한 삶으로서 스마트 에이징의 개념과 모형에 관한 탐색적 연구)

  • Hyunjeong Lee;JungHo Park
    • Land and Housing Review
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    • v.14 no.4
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    • pp.1-16
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    • 2023
  • As population ageing and shrinking accompanied by dramatically expanded individual life expectancy and declining fertility rate is a global phenomenon, ageing becomes its broader perspective of ageing well embedded into sustained health and well-being, and also the fourth industrial revolution speeds up a more robust and inclusive view of smart ageing. While the latest paradigm of SA has gained considerable attention in the midst of sharply surging demand for health and social services and rapidly declining labor force, the definition has been widely and constantly discussed. This research is to constitute a conceptual framework of smart ageing (SA) from systematic literature review and the use of a series of secondary data and Geographical Information Systems(GIS), and to explore its components. The findings indicate that SA is considered to be an innovative approach to ensuring quality of life and protecting dignity, and identifies its constituents. Indeed, the construct of SA elaborates the multidimensional nature of independent living, encompassing three spheres - Aging in Place (AP), Well Aging (WA), and Active Ageing (AA). AP aims at maintaining independence and autonomy, entails safety, comfort, familiarity and emotional attachment, and it values social supports and services. WA assures physical, psycho-social and economic domains of well-being, and it concerns subjective happiness. AA focuses on both social engagement and economic participation. Moreover, the three constructs of SA are underpinned by specific elements (right to housing, income adequacy, health security, social care, and civic engagement) which are interrelated and interconnected.

The Comparative Study on Performance Evaluations of Social Service Delivery Types (사회서비스 공급유형별 성과평가 비교 : 노인관련 사회서비스를 중심으로)

  • Seo, Jeong-Min;Kim, Nang-Hee
    • Journal of Digital Convergence
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    • v.14 no.5
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    • pp.39-46
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    • 2016
  • The history of Social service is above 10 years. Owing to corresponding to the user's needs social services sector is expanding. And, to deal with them, the social delivery systems has been changed. Traditional social welfare delivery system is provided by public facilities and private facilities. On the other hand, Social Services is made up of the traditional social welfare delivery system and new delivery system which is composed of profit organizations and non-profit organizations. Considering this, Study attempted to compare the performance evaluation of supply type-profit and non-profit social service organizations. Performance evaluation method was applied to net income, except for expenditure in total revenue. Net income difference between profit organization non-profit organization was assessed by T-test. We conclude that the two population means are different at the 0.05 significance level. Looking in detail, the non-profit organizations were found to be higher than the non-profit organizations, labor costs, operating costs, facility cost and consumable costs, but part of the business expense costs, the non-profit organizations was higher than the profit organizations.

Caregiver Burden of Patients with Dementia and Day Care Center of Small Size Model within a Zone of Life (치매환자 부양자부담과 생활권 내 소규모 주·야간 돌봄 서비스 모델)

  • Na, Seung-kwon;Park, Eun-Ju
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.9 no.4
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    • pp.428-438
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    • 2016
  • The aim of this study, in order to reduce the support burden of dementia primary caregiver, within the framework of long-term care insurance system to present its founding model for the development of new services. Previous research as analytical materials and based on the CARE study between 2012 to 2013. Primary caregiver burden of patient are both physical, psychological and economic aspects as well as difficulties in many aspects and had influence on many factors such as age, care burden, economic, health, and social support. It also came high-risk primary caregiver suffer from depression. This primary caregiver to take advantage of the elderly long-term care insurance system implemented at the time of the institutional support necessary for since 2008, presented additional services in this study. Of increasing the small sizes day care center (tentative name) to open an as established in the settlements at a scale of less than nine, within 5 minutes from the residence, limited dementia by expertise in the disease home care services scale model of the current system service It was to improve the quality of existing shares, small group sizes for day care centers and community life apart.

An Analysis on the Demand of Rural Settlement Support Services for Rural Residents (경북 울진군 기성면 척산리 중심의 농촌정주지원 서비스 요구사항 분석)

  • Choi, Yoon-Ji;Hwang, Jeong-Im;Kim, Young;Park, Gwang-Rae
    • Proceedings of the Korean Society of Community Living Science Conference
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    • 2009.09a
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    • pp.106-106
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    • 2009
  • 영국에서는 농촌문제의 심각성과 범정부적 대책 마련에 대한 부처간 인식 공유가 증가함에 따라 2000년 "농촌백서"에 '농촌서비스 표준화(Rural Services Standard, RSS)'를 제정하였다. RSS는 농촌 주민의 삶의 질 제고와 복지 서비스 향상을 위해 달성할 주요 서비스의 National Minimum을 의미한다. 매년 RSS 운용에 대한 지속적인 모니터링을 통하여 내용을 매년 업데이트 하고 있다. 교육 및 아동서비스, 광대역 통신, 사회적 돌봄, 우체국 서비스, 보건, 인터넷 접속, 긴급 서비스, 교통의 8개분야 13개 서비스 기준을 설정 제시하고 있다. 우리의 경우도 농촌 주민의 삶의 질 향상을 위한 범정부적 투자가 이루어져 왔지만 농촌지역의 사회서비스 기준을 도시와 비교해 보면 아직도 부족한 부분이 많이 있다. 농촌 인구가 감소되고 있는 상황에서 지속적인 하드웨어 중심적 투자에 대한 의문제기와 함께 농촌 주민들이 최소한의 공적 서비스를 활용할 수 있는 기반이 되어야한다는 의견이 대립되고 있는 가운데 그 해결책을 찾기 위하여 '농촌 서비스 기준'을 설정하자는 논의가 추진되고 있다. 이에 본 연구에서는 인구 5만 이상 군지역에 속하는 경상북도 울진군 기성면 척산리를 중심으로 농촌 정주지원 서비스 요구사항을 분석하였다. 척산리에는 총가구 187호 363명이 거주하고 있으며 지난 3년간 인구 이동이 전혀 없었다. 주민들의 연령대는 50~60대가 가장 많으며 척산 3리가 가장 고령화 되어 있는 것으로 나타났다. 교통 환경은 좋은 편이었는데 기성공용버스 정류장에 10곳 이상의 차편이 있고 7번 국도가 있어 타 지역으로 이동도 용이하였다. 마을에 보건/의료를 담당하는 곳은 보건진료소뿐이었으며 잦은 외근과 구급약 부족 등으로 불편을 호소하고 있었다. 응급상황 발생시 수송 가능한 응급체계는 갖춰져 있지 않았고 노인들이 가장 많이 이용하는 물리 치료실은 일주일에 3번 개방하기에 불편하다고 하였다. 3층 건물의 복지회관이 있으나 장날(5일장; 1일, 5일)만 개방되어 이용에 한계가 있었고 마을주민을 위해 운영되는 프로그램은 없었다. 논농사 중심의 경제생활이었고, 부녀회와 청년회 등은 면단위 또는 행정리로 묶어서 운영하고 있었다. 주민들은 울진군 면소재지 중 척산리에만 약국이 없어 불편한 사항이 많기에 약국, 물리치료실의 상시 개방을 필요로 하였으며 장날을 이용한 노인대상 영화상영, 강연회 등 다양한 문화프로그램 운영을 희망하였다.

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Delirium Management: Diagnosis, Assessment, and Treatment in Palliative Care (섬망의 돌봄: 완화의료 영역에서의 진단, 평가 및 치료)

  • Seo, Min Seok;Lee, Yong Joo
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.201-210
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    • 2016
  • Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

A Study on Social Supports for the Elderly Housing in Senior Concentrated Cities in the United States and Canada : Focused on Small Cities along Rural Counties (미국과 캐나다 노인밀집도시의 노인주거관련 사회적지원에 관한 연구 : 농촌지역 소도시를 중심으로)

  • Lee, In-Soo
    • Journal of Families and Better Life
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    • v.29 no.3
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    • pp.23-41
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    • 2011
  • The purpose of this study is to explore social supports for elderly housing and their residential lives in small cities along rural counties of the United States and Canada, and suggest future implications for age-concentrated rural villages in Korea. In this study, five small and medium cities in non-metropolitan counties of California and Ontario province were visited and elderly residents and service experts were interviewed about their perceptions of community integrated social support networks for senior residences. The senior housing complexes were built due to influx of both metropolitan and rural residents seeking warm localities, traffic connections, business purposes in active production areas. and leisure attractions. There are five main social support networks for senior housing issues in these areas. First, the areas are claimed for senior zones and accordingly health industries are encouraged by local authorities. Second, the community is homogeneously constructed as a senior friendly environment and include features such as an RV park and mobile cottages. Third, senior-helping seniors are offered active work through golf-cluster active retirement communities. Fourth, traditional theme production camps are mobilized by the elderly workers. Lastly, an information system is maintained for screening volunteers and for senior abuse prevention. On the other hand, residential lives are occasionally negatively influenced by unbalanced concentrations of elderly facilities such as nursing stations and funeral homes. For the future of Korean rural elderly policies, suggestions are made as follows: first, an integrated urban and rural township that contains attractive places for early retiring people who seek a warm atmosphere in later life needs to be constructed. Second, an integrated model retirement village of urban and rural retirement life needs to be initiated as a measure of evaluating the adaptation process of movers in senior concentrated zones. Third, a cooperation system among governmental ministries needs to be formed with the long- term goal of establishing a traditional rural town of independent housing districts and medical facilities in rural areas. Fourth, productive and active lifestyles need to be maintained as the local community and government develop successful retirement rural villages, by limiting the expansion of nursing related facilities. Finally, generation integrated visiting welfare programs and services need to be further developed for the housing areas especially in the winter, when social integration and activity are relatively low.

A Grounded Theory Approach to Person Centered Communication between People Living with Dementia and Their Caregivers (사람중심 치매커뮤니케이션에 대한 근거 이론적 연구)

  • Kim, Dong Seon;Shin, Soo Kyung
    • The Journal of the Korea Contents Association
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    • v.22 no.5
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    • pp.746-764
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    • 2022
  • Communication breakdown has been mentioned causing a heavy burden for dementia caregivers. This study aims to inspect and structure the process and results of communication between people with dementia and their caregivers. The impeding/facilitating elements of communication are also extracted. Interviews with 21 of dementia care experts about the direct and indirect experiences of communication with people with dementia were analyzed based on the grounded theory. Results show that combination of the cognitive and communication decline of the people with dementia, confusing environment and caregivers' inappropriate attitude and lack of communication skills leads to communication breakdown and relations severance. Minimal contacts and task-oriented conversation results in conflicts and people with dementia's increasing agitation, anxiety and violent behaviors while understanding of individuality and listening with heart lead to recovered lucidity in the state of serious dementia, recovered pleasure and voluntary participation in the daily activities for people with dementia. Core paradigm was defined as 'Person Centered Care through relation formation'. There are 4 types of communication with people with dementia : partnering, patronizing, conflicting, avoiding types. Researchers suggest that Person Centered based communication skills be educated and trained for dementia caregivers.

A study of the multicomponent therapeutic recreation function intervention strategy by analysis on the operating condition of the cognitive rehabilitation program in dementia care center

  • Moon-Sook Lee;Byung-Jun Cho;Jae-Sik Yang
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.12
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    • pp.155-166
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    • 2023
  • This study was conducted with 50 elderly people each (5) participating in the cognitive rehabilitation treatment program at the Dementia Care Center in D City to derive the development direction and contents of a multidimensional therapeutic recreation program and a revitalization plan through analysis of the current status and actual conditions of the cognitive rehabilitation program at the Dementia Care Center. aperture) was selected, and 9 people were selected as the subject of expert group opinion collection. The collected data was SPSS ver. Using the 18.0 statistical program, descriptive statistics and the importance and priority of each component were analyzed by hierarchical structure analysis. First, unlike the needs of users, the cognitive rehabilitation support programs currently being provided are not sufficient and require considerable experience. It was found to be low, and the areas for improvement were the expansion of care and protection facilities and the development of various programs to meet the needs of users. Second, the importance and priority of each component of therapeutic recreation were categorized into 6 major categories: exercise therapy , middle category (16 items) behavior-centered approach to exercise therapy, small category (47 items) strength and brain gymnastics, and silver health gymnastics were the highest. This result shows that a multidimensional program plan that considers the priorities of each area must be made when developing a therapeutic recreation program.

A Study on the Clinical Usefulness of MMSE and BCRS for Cognitive Function Test in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관질환 환자에서 인지평가도구로서 정신상태소검사(MMSE)와 간이인지평가척도(BCRS)의 임상적 유용성에 대한 연구)

  • Choi, Hong;Lee, Young-Ho;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Sook-Haui;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hie
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.68-78
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    • 1996
  • Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.

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