• 의료법학
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• 제19권2호
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• pp.173-207
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• 2018

일본은 고령화가 빠르게 진전되어 이미 총 인구 중 65세 이상 인구가 차지하는 비율이 20% 이상인 초고령사회에 해당한다. 일본의 판례는 요양시설에 입소한 고령자가 사상을 당한 다수의 사안에서 요양시설의 손해배상책임을 인정하였다. 구체적인 사안들은 ①전도 또는 전락, ②배회 또는 무단외출, ③질식, ④욕창 및 ⑤이용자 간 사고의 5가지 유형으로 나눌 수 있다. 판례는 대부분의 사안에서 채무불이행책임을 중심으로 검토하였으며, 과실 또는 안전배려의무 위반을 인정하였다. 과실 또는 의무위반은 시설의 관리자 또는 직원이 입소자를 주시하고 주의를 기울일 의무를 위반한 경우 뿐 아니라, 경우에 따라서는 인적·물적 체제를 정비하지 못한 것 자체만으로도 인정된다. 특히 일본에서는 신속한 권리 구제를 위하여 손해배상에 관한 특약 조항이 있는 경우 원고는 사고 및 손해의 발생을 주장·입증하면 충분하고, 피고로서는 불가항력에 의한 사고임을 주장·입증하지 않는 한 손해배상책임을 부담한다고 하여 입증책임의 전환을 인정한다. 그런데 요양시설의 손해배상책임은 시설에서 대상자의 입소를 허락하고 서비스이용계약을 체결하는 것을 주저할 만큼 과중한 것이어서는 안 될 것이다. 이러한 점에서 일본 재판소가 상대적으로 과실상계와 소인감액을 널리 인정한 논리는 충분히 음미할 필요성이 있다. 개호사고 소송에서 법원의 판단은 구체적인 사실관계에 근거한 사례판단이지만, 개호사업자와 이용자에 대한 관계를 살펴보는 것은 향후 우리나라에서 개호사고 소송의 심리·판단 뿐 아니라 요양자의 일탈 및 사고 등을 인식할 수 있는 체제를 구축하기 위한인적·물적 체제를 구축하는 기준을 제시하는 법안을 입안함에 있어서도 시사점을 제공할 수 있을 것이다.

• 보건행정학회지
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• 제8권1호
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• pp.203-230
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• 1998

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.

• 예술인문사회 융합 멀티미디어 논문지
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• 제9권5호
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• pp.781-791
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• 2019

본 연구에서는 장기요양기관 관리자, 요양보호사, 입소노인을 대상으로 하여 2015년도 장기요양기관의 평가(평가등급, 평가등급의 변화, 평가지표의 적합성), 요양보호사의 서비스의 질, 입소노인의 서비스 질 만족도, 삶의 만족도, 시설 선택에 미치는 영향을 파악하고자 하였다. 이를 위해 IRB를 받은 뒤 2018년 1월과 2월에 장기요양기관 관리자 79명, 요양보호사 381명 및 입소 노인 381명을 대상으로 설문조사를 완료하였다. 설문조사는 2015년도 장기요양(시설급여) 평가결과를 반영한 할당표본을 실시하였다. 연구결과 장기요양기관 평가의 주된 목적이라 할 수 있는 입소노인의 삶의 질 향상에는 요양보호사의 서비스 질 보다 기관평가(평가등급, 평가등급의 변화, 자표의 적합성 인식)가 더 큰 영향을 미치는 것으로 나타났다. 그러나 퇴소 후 시설재선택의향은 요양보호사의 서비스의 질에 더 큰 영향을 받았다. 따라서 시설재선택의향을 제외하고 보면, 국민건강보험공단의 평가의 호과성이 부분적으로나마 검증되었다고 볼 수 있다.

• 디지털융복합연구
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• 제18권5호
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• pp.325-336
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• 2020

본 연구는 장기요양기관에서 서비스를 총괄하고 있는 시설장을 대상으로 노인 응급상황에 대한 인식 및 대처능력을 파악하여 시설장의 응급상황 대처능력 향상을 위한 교육프로그램 및 정책자료 개발시 기초자료로 활용하기 위한 서술적 조사연구이다. 대상자는 노인요양시설 및 재가센터 시설장 192명이며, 자료수집은 2019년 3.15~4.20, 수집된 자료는 SPSS WIN 25.0 프로그램을 이용하여 분석하였으며, t-test, One-way ANOVA, Pearson's correlation coefficient, Scheffe, Multiple linear regression을 사용하였다. 연구결과 시설장의 응급상황 경험은 97.4%로 높았고, 응급상황 인식도 6.16점, 정답률 62%로 중간정도 수준이였고, 응급상황 대처능력은 평균 69.61±13.537점 이었다. 응급상황 경험과 응급상황 대처능력(r=-.202, p=.005)은 음의 상관관계, 응급상황 대처능력 영향 변수는 장기요양기관 유형(β=8.253, p<.001)이었다. 연구결과를 근거로 시설장 대상 응급교육 적용 시 장기요양기관 유형을 고려하여 교육프로그램을 개발하고 적용할 필요가 있겠다.

• 동서간호학연구지
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• 제26권1호
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• pp.28-38
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• 2020

Purpose: The aim of this study was to provide information on the extent and variations of elderly residents' nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse's aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers' perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제15권4호
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• pp.33-43
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• 2009

As a result of rapid aging speed in our society, many problems related to elderly people have happened in many parts of our society. Among them, supply for elderly housing is one of the biggest problems. To solve these problems, 'long-term care insurance' has been put in operation from July 2008. By the time of the insurance operation, Ministry of Health and Welfare is increasing facilities every year according to '10-year expending plan of Care service infra' from 2002. As a result, the supply rate of elderly facilities has been raised. But the differences of facility supply rate between regions are very high in some cases. Therefore older people who need care sometimes cannot get proper care services in some areas. In that case, the frail older people have to use other care facilities of other regions. This is not a proper situation from the point of "Aging in Place". In order to prevent that case, it is necessary to set up proper 'Daily Living Spheres' and establish elderly care plan for it. Considering the points above, this study proposes the size of 'Daily Living Spheres' for the elderly, the kind and amount of elderly care facilities in it for the construction of Community Based Elderly Care System.

• Nutrition Research and Practice
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• 제13권1호
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• pp.32-40
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• 2019

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.

• 한국치위생학회지
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• 제10권4호
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• pp.727-734
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• 2010

Objectives : The aim of this study was to assess the oral health care of the elderly in long-term care facility on caregivers' behaviors. Methods : Cross-sectional study in a cluster sample of 171 caregivers recruited from 17 facilities located in the Province of Gangwon. The Questionnaire was consisted of 16 items contained oral hygiene care, denture care, oral health education and general characteristics(Chronba's ${\alpha}$=0.87). Using SPSS WIN 12.0, descriptive statistics and chi-square test were conducted to examine the subjects general characteristics, the status of oral health education and denture care. Results : 1. The mean age of care givers was 42 years and 88.9% education experience rate was found. 2. Above 70% of them was found in daily oral hygiene care after every meal. They used toothbrush and toothpaste, they keep the toothbrush properly. 3. The denture care was conducted by most of care givers, containing proper storage. But three of ten care givers was cleaned denture by toothpaste or used water only. It was severe at the care givers didn't received oral health education(p<0.05). Conclusions : The contents of oral health education for care givers should contain the denture care(time and the reason shouldn't use toothpaste). Further large-scale longitudinal studies are needed to determine professional oral health care and to develop evidence of the dental hygiene practice for the elderly in long-term care facilities.

• 보건행정학회지
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• 제4권2호
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• pp.27-57
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• 1994

The objective of running a long-term care institution is to provide services helpful for maintaining, supporting, and improving elderlies' optimum level of physical, mental, and psychosocial functioning. For the purpose of analyzing the current situations of institutional long term care facilities in Korea, 27 facilities were selected proportionately from each of the cities and provinces, out of the total 152 facilities. About 20% of those who were institutionalized during 25 August through 2 Qctober 1993, the 391 elderlies were chosen on a systematic random basis. The instrument of this study was developed by modifying the tools of CARE, MAI and PCTC. A multivariate approach of discriminant analysis and clustering technique were employed for this study. The Stiudy reveals that there is no clear differentiation of goals and functions among the longterm care institutions in Korea. Staffing patte군 of long-term care facilities shows a shortage of nurses, physical therapists, and dieticians. The linkage between acute care facilities and long-term care is weak, and administration of long-term care faciltiy is carried out by non-professionals. They are responsible for assessing health status before entering the facility, and evaluating elderlies' care. Therefore, it is not surprising to find that most of the facilities have accommodated agede regardless of their real needs and health status. Based upon findings of the analysis, this study has classified long-term care facilities into four types : Type I is to help elderlies maintain independence in daily living activities. Type II facilities have the objective of maintaining and improving the current level of elderlies' function. Type III is to maintain maximum independence of elderlies in activities of daily living. And Type IV is identified for the group of facilities designed to restore or improve functional abilities of elderlies. In conclusion, the following suggestions are made : the need for long-term care should be assessed by multidimensional measurement. Institutional long-term care facilities should be classified and developed in response to type of type of care and service need. Both acute and long-term care facilities should be linked together in order to support the evaluation of service operation and program development.

• 한국농촌건축학회논문집
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• 제17권1호
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• pp.65-72
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• 2015

Recently the concerns of aging & care according to the aged Society were on the increase about Home for the elderly facility. In order to moment, the purpose of this study is to analyze planning direction and Architectural Environments in medium and small scale Elderly Care Facilities. This survey are used to investigate with latest building data, which is Long-term Care Insurance Code for the Elderly was started on July 2008 in Korea. The results of this paper are as follows. First, various type of home for the elderly and the elderly group homes are spread out, attached to day care center type, nursing home type, city region type, countryside rural type, near the university and remodeling type. Secondly, per capita room area-$6.32m^2$ are sufficient in regal comparison with $6.6m^2$. Thirdly, Sunlight environments is inappropriate condition as south direction proportion-41.95%. According to the present situation various facility type and model for our baby boomers generation should be more developed with preemptive systems of senior welfare concept.