In Japan, a lot of elderly housing types have been developed in order to meet various needs of the older person and the change of social situations. Elderly housings can be divided into three categories elderly housings for healthy older persons, elderly care homes for the healthy and elderly care facilities for the unhealthy. Elderly housings include public and private rental housings. Sometimes they can be designated only for the elderly. Elderly care homes for the healthy elderly include full fee charging elderly housing, elderly homes, low fee charging elderly homes and care houses. Elderly care facilities for the unhealthy elderly consist of full fee charging elderly care homes, group homes for the dementia, elderly health facilities, nursing homes, elderly hospitals, and so on. However "elderly care facilities" have been proved not to be efficient for the delivery of elderly welfare services nor satisfactory to the frail older person. Therefore, based on the concept of the "Normalization", daily services have been provided for the elderly in order that they can live at their own home in the community for themselves. As a result, Japan aims not only to reduce elderly welfare expenses but also to increase elderly users' satisfaction. Emphasis on non-institutionalization and in-home services, regional characterization, harmony between Hard and Soft, user oriented services, substantiality, universal design and so on are sought for the sake of those goals.
Purpose: The purpose of this study is to identify factors influencing the quality of life of the elderly living alone and living with their families with regard to their health statuses and health behavior experiences. Methods: We used source data from the 2014 Community Health Survey. The subjects of this study included some elderly people aged 65 and over, and analyzed the data of 13,373 elders living alone and 13,322 elders living with family. Results: Factors influencing the quality of life of the elderly living alone and living with their families include gender, age, education, household income, current occupation, subjective stress level, depression, number of diagnosed diseases, walking exercise, the experience of health screening, and the experience of not having necessary medical services (p<.001). Region was a significant variable influencing the quality of life of the elderly living with their families (p<.001). Conclusion: In order to improve the quality of life of the elderly, it is necessary to provide sound conditions for working, emotional support, walking exercise and promotion of health screening, and to supplement the environment and institution for them to receive necessary medical services.
현재 우리나라가 겪고 있는 고령화는 사회복지서비스의 질적, 양적 확대를 요구하고 있다. 특히, 노령인구의 급격한 증가는 노인과 관련된 다양한 복지 및 의료수요를 유발하여 이에 대한 해결대응이 시급한 실정이다. 또한, 우리나라의 IT기술력은 하루가 다르게 발전하고 있고, 특히 유비쿼터스 분야중 하나인 U-Health의 연구가 활발히 진행 중에 있다. 본 논문에서는 U-Health 기술을 활용하여 노인 Care시스템 모델에 대해 연구하였다. 노인전용 주거환경의 Care시스템에 대해 설계하고, 설계한 내용을 중심으로 유비쿼터스 기술을 접목한 노인 Care시스템에 대해 연구하였다. 기존 사회기반모델과 IT기술을 융합한 노인 Care시스템과 모바일기기간의 연동으로 Care서비스 어플리케이션을 제공하여, 기존의 Care 및 의료수요의 문제점을 해결할 수 있을 것이다.
Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.
Purpose: This study was conducted to identify health problems and support received from the health and welfare service using MDS-HC(Minimun Data Set for Home Care) in the aged living at home. Method: Eighty-one elderly persons were selected from those listed in community-welfare service centers in Seoul and Kyunggi Province between December 2002 and January 2003. Result: Eleven health problems per elderly person on average were identified, and the frequent care needs were in order: preventive health measure, health promotion, visual function, depression & anxiety, communication disorders, social function, pain, environmental assessment, oral health, cognition and falls. The number of health problems by the level of ADL was ‘ADL 1(Independence)’ 9.87, ‘ADL 2(Partial independence)’ 12.78, ‘ADL 3(Dependence)’ 13.73. Utilization of formal health & welfare services among the elderly was ‘meals on wheels’ 40.7%, ‘home helper’ 38.2%, ‘visiting of social welfare worker’ 21.0%, ‘physical therapy’ 19.6%, ‘day care center’ 12.3%, ‘volunteer's service’ 9.9%, ‘home visiting care’ 3.7%, ‘occupational therapy’ 3.7%, and ‘speech therapy’ 2.5%. Conclusion: The results suggest that using the MDS-HC 2.0 is applicable to help decide criteria for both health and welfare service supplied to the elderly.
This study was purposed to find health promotion and care needs of the elderly in rural area of Korea. As the rural elderly are limited in accessibility to health care resources and could not immediately solve their health care needs when they need. health promotion and care services are expected to bring better and more practical solutions of their health care needs. Thus, the type of health care services to be developed in Korea rural area is discussed to have emphasis on health care service component in addition to health promoting components. Methods of this study was based on survey data analysis : total 322 persons aged older than 55 living at one 'Kun' in Korea administrative unit were interviewed by health workers working at the region and also get trained for this study data collection. The data collection interview was continued from February till May in 1996. The interview questions were modified with adjustment to Korea situation. with basis of the WHO's health promotion program components. The collected data were analyzed using SAS program for frequency, correlation, regressions. The major findings were as follows : (1) $74.8\%$ of the surveyed were sick at the survey time point. and $95.9\%$ known the diagnosis name of the disease. The most frequently complained diseases were Muscular-Skeletal diseases $(43.7\%)$. $34\%$ of those sick had never treated or discontinued therapeutic procedures. so that shown the necessity of systematic and usual health care services with health promotion program development for the elderly. (2) The percent of those who make social participation was $95.3\%$. and the activities were visiting neighbors $(70.4\%)$ and lack of qualified social activity programs. (3) $78.1\%$ of the surveyed had health counseling and education from professional health workers. Those ceased smoking and drinking were $59.6\%,\; 60.3\%$. respectively. Those had no application of therapeutic drugs or nutrion supplements was $40.7\%\;and\;94.1\%$ had regular meals. Those practiced exercises was low remarking $17.7\%$. (4) Positive health behaviors were better carried out by sick groups than by the healthier. except smoking. regular meals. and exercise. $17.5\%$ of sick group smoke more than one case of cigarettes. in contrast to $9.5\%$ of the healthier. (5) Mental health status was heathier among positive health behavior earners. Health counseling and education shown better score of mental health than those never counseled. (6) Positive health behavior practice frequency did not show significant differences when crossed by social activity participation status. (7) Health behaviors of the rural elderly people were carried out better when they had positive 'continuency in therapeutic procedure' 'health status'. 'familial relationship'. 'Health Status' of the rural olderly were explained by 'exercise'. 'drinking'. 'familial relationship'. 'activities of daily living'. Thus, health behaviors practice mutually interact with health status. In conclusion. the health promotion and care program component are recommended to include ation on the necessity of positive health promotion active social acitivities. pleasant life style, adaption into changes on the elderly, safety in residential area. community acitivity and resource utilization. etc .. in addition to the elderly's disability and sickness caring services.
The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.
Objectives: The purpose of this study was to investigate the factors influencing on the denture satisfaction in the low income elderly people. Methods: The subjects were 143 elderly people from 60 to 75 years old wearing dentures and receiving consistent follow-up in the public health center in Busan. A self-reported questionnaire was filled out by the elderly people from February 1 to March 1, 2013. The questionnaire consisted of denture satisfaction, social variables, and psychological variables. Data were analyzed by ANOVA and multiple regression analysis using SPSS 18.0. The sociodemographic characteristics included gender, age, and chronic diseases. The recognition of oral health included pronunciation, denture maintenance, mastication ability, and education for denture care. The questionnaire was measured by Likert 5 scale. Results: Gender, chronic disease, denture care instructions, and the self-preception of the oral health after denture treatment were closely correlated with denture satisfaction(p<0.001). Age and the number of repairs were very important factor to denture satisfaction(p<0.05). Elderly women were more satisfied with denture than men and those who had no chronic diseases tended to be more satisfied with denture. Those who received oral care instructions were more satisfied with the denture than those who did not. The younger age group and no repairing prosthetic group tended to be more satisfied with the denture. Conclusions: It is important to provide the denture management services to the low income elderly when they demand the services. The national dental health policy must be focused on connection of the elderly people denture services with the public health center.
The study was performed to provide basic data for developing a coordinated health and social service model. Method: The subjects consisted of 1000 residents in Wonju city. The sampling process was randomized stratified into 26 geographical areas. The data was collected from Apr. 16nd, to May. 15nd, 2002 by using a structured questionnaire that included general characteristics, the patterns of disease, the family function and the community support systems. The collected data was analyzed by the SPSS. windows program via descriptive statistics, correlation testing and t-tests. Result: 61.7% of the elderly perceived their health status as being poor. There were correlations among age, income and the way clients perceived their health status. The prevalence rate of chronic disease was 70.8% in the elderly. The prevalence rate for arthritis was the highest (33.6%). The average number of diseases in the target populations was 2.31; it was 2.65 in the deprived elderly group and 2.47 in the elderly group. 35.4% of residents did not have any family care giver. 61.2% of the clients needed support by the health and social services. Conclusions; Coordinated health and social services need to be allocated by priority to the elderly and to the socially and economic deprived clients.
Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-highways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.
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