• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

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.

• 지역사회간호학회지
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• 제15권3호
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• pp.450-459
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• 2004

Purpose: The purpose of this study is to grasp the welfare service for the demented people staying at home and the service that caregivers want to use. Therefore, we are going to develop a Korean senile dementia-care management model. Method; It analyzed the data of 185 demented people and caregivers, who registered in 16 public dementia care centers in B city since June 2002. Results: 1) The types of services used by the aged people with dementia staying at home were, in the order of frequency of use, the day-care center(26.5%), and home-help service (21.6%). 2). The types of services according to the degree of dementia were as follows; mild cases: home care service (5.4%), moderate cases: day-care service (40.0%) and severe cases: day-care service (26.0%). 3). The caregivers who want to use senile welfare institutions accounted for 23.3%, and the major reason they could not use the institutions was due to their economic situation. 4) The Korean senile dementia care management system must be excuted, considering caregivers' economic state and severity of dementia. Since the system was actively operated, many small sized welfare service institutions showed development. Conclusion: The welfare services appropriate to the severity of dementia should be provided. With the model developed in this study, the dementia management requires sufficient care and should be achieved to reduce the caregivers burden.

• 한국융합학회논문지
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• 제13권5호
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• pp.559-565
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• 2022

고령화 사회가 되면서 치매발병률 또한 증가하고 있다. 2017년 탈시설화와 통합돌봄의 본격적 도입으로 지역사회 기반 치매환자 돌봄이 더욱 중요해졌다. 치매에 대한 관점도 기존의 의료 모델, 사회적 모델에서 인간 중심 모델로 변화하고 있다. 본 연구에서는 장기요양재가이용시설인 노인주간보호센터의 돌봄 종사자들의 치매지식을 분석하여 치매서비스 개선방안을 제시하였다. 2곳의 주간보호센터에서 근무연한 2년 이상의 돌봄 종사자들을 대상으로 포커스 그룹 인터뷰를 진행하여 7가지 영역에서 소주제를 도출하였다. 개선방안으로는 지역기반 서비스의 중요성과 규칙적 일상 실천, 치매와 함께 동행하기 위한 치매인식 개선, 개별성과 다양성을 기반으로 한 인간중심 서비스의 실천 등이 제시되었다.

• 지역사회간호학회지
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• 제14권1호
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• pp.106-119
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• 2003

This study was executed to develop the model of the format of the day care center which supplies the total service on the health care in the day time and social program related with the work and to evaluate the processing courses which was adjusted for 3 years from March 1999 to December 2001 in order to improve the quality of life of the family who experience dementia, dementia prevention, and the old and the burden of daily activities. The processing courses of this business model were evaluated to the confirmation on the health condition, application of the nursing processes, and the precise medical examination, and 20 sorts of social programs. The methods used in this model were the simplified MMSE-K, Ability for ,Daily Life(ADL), Instrumental Activities of Daily Living(IADL), and nursing process, and so on. The execution effects of this model are as follows. 1. It can contribute to the delay in the dementia process of the old people who are related with the dementia and maintenance and improvement of the health by confirming the stopping of the process of the dementia as the objective estimation method while the dementia symptom is maintained as the current condition through the medical and social total services. 2. The reduction of the burden for the daily care of the subject people and their families for the old people who are concerned with the dementia helped to improve the quality of life of the subject people and their family by enabling them to have jobs. 3. It enabled them to positively cope with the demand for the health and nursing of the local residents related to the old people. 4. It enabled them to enhance the recognition for the socialization of the local social organization and residents for the old people. 5. It enabled them to reinforce the related system among the local social organizations, and develop and provide the various social programs which are proper for the old people.

• 대한간호학회지
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• 제37권4호
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• pp.613-623
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• 2007

Purpose: The purpose of this study was to describe the operation, staffing, and services provided at adult day care centers in Korea. Methods: The study was a cross-sectional descriptive survey. The subjects were 209 centers among 280 centers registered in Korea (response rate 74.6%). The data was collected from August to December in 2006. Results: 48.8% of centers were located in a city area. The centers were based on the Social Model 65.5% of the centers were open Monday to Friday, an average of $7{\sim}8$ hours per day Dementia, stroke or frail elderly could use the center, and 57.4% of centers were used for dementia and stroke elderly together. The enrollment of elderly was 13.5. The number of total staff was 8.27, the number of RN's and social workers was 0.67, and 2.54 respectively. The social services(Meal preparation 98.6%, Special event 98.1%, Transportation, 97.1%) were provided more than the health services(Physical therapy 98.1%, ADL training 95.2%, Counseling 84 7%, Vaccination 82.8%, Health monitoring 78.9%, Health education 78.5%, Bathing 66.1%, and Speech therapy 28.2%). Conclusion: These results suggest we have to develop a health-focused adult day health care model based on the needs of elderly and their families. Nurses will have an important role in adult day health care.

• 한국정보전자통신기술학회논문지
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• 제9권4호
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• pp.428-438
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• 2016

본 연구의 목적은 치매환자 부양자의 부담을 감소시키기 위해 장기요양보험 제도의 틀 안에서 새로운 서비스 개발을 제시하는 것이다. 분석 자료로 선행연구와 2012-2013년에 걸쳐 조사된 Caregivers of Alzheimer's Disease Research(CARE study)를 사용하여 부양자의 특성과 부담을 조사하였다. 치매환자의 주부양자 부담은 신체적, 심리적, 경제적 측면뿐만 아니라 다양한 측면에서 어려움을 겪고 있으며 연령, 경제력, 건강상태, 사회적지지 등 여러 요인이 부양부담에 영향을 미치고 있었다. 또한 부양자가 우울증을 겪을 위험도 높게 나왔다. 이에 부양자에 대한 제도적 지원이 필요한 시점에서 2008년부터 시행된 노인장기요양보험 제도를 활용하여 본 연구에서 추가적인 서비스를 제시하였다. 현 제도의 재가서비스 확장 모델로 소규모 주 야간보호서비스(가칭)를 신설하는 것으로 9인 이내의 규모로 주거지에서 5분 이내 거리에 개설을 하고 치매환자에만 국한시켜 질환에 대한 전문성을 높이고 서비스의 질을 향상시켜 기존의 주 야간보호서비스와 소규모 노인요양공동생활가정과 차별화하는 것이다.

• 한국보건간호학회지
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• 제16권1호
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• pp.13-29
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• 2002

The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

• 한국노년학
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• 제36권3호
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• pp.883-903
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• 2016

본 연구는 부양자가 인지한 치매노인의 증상 정도와 치매노인 부양자의 자살생각의 관계에서 부양부담의 하위 요인을 세분화하여 매개효과를 검증하고, 치매노인 부양자를 위한 사회복지적 개입 방안 제시를 목적으로 한다. 이를 위해 2015년 현재 서울시, 경기도와 부산의 각 지역에서 데이케어센터 및 요양기관을 이용하는 치매노인 부양자를 대상으로 설문을 진행하였고 총 428부의 자료를 수집하였으며, 이들 중 응답이 부실한 13부을 제외한 415부의 설문지를 최종분석에 사용하였다. SPSS 21.0을 사용하여 매개효과와 그 유의성을 검증하였고 그 결과는 다음과 같다. 첫째, 치매노인 부양자 중 최근 1년간 자살에 대한 생각을 해본 적이 있다고 응답한 부양자는 21%로 나타냈다. 둘째, 치매노인의 증상 정도는 부양부담에 정적인 영향을 미치는 것으로 나타났다. 셋째, 부양자의 부양부담은 부양자가 인지한 치매 노인의 증상정도와 부양자의 자살생각과의 관계를 부분적으로 매개하고 있었고 이 매개효과는 통계적으로 유의미한 결과를 보여주었다. 이를 통해 부양자의 자살생각에 정적인 영향을 미치는 부양부담을 낮추기 위한 방안으로서 치매노인과 부양자에 대한 접근이 개선되어야 한다는 점을 제시하였고 이를 달성하기 위한 사회복지 중심의 프로그램 도입을 제안하였다.

• 재활치료과학
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• 제2권1호
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• pp.66-76
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• 2013

목적 : 본 연구는 주간보호시설을 이용하는 치매노인의 욕구 및 제한점을 파악하고 목표 설정을 하고자 함이다. 연구방법 : 주간보호시설 이용 치매노인 1명을 대상으로 2012년 5월 1일부터 5주에 걸쳐 주 2회 정기적으로 30여 분간 심층 면담 및 평가를 실시하였다. 인간작업모델을 기반으로 한 작업질문지(Occupational Questionnaire; OQ)와 여가활동평가(Interest checklist; IC), 의욕조사표(Volitional Questionnaire; VQ), 의사소통과 상호작용기술평가(The Assessment of Communication and Interaction Skills ACIS), 작업수행 일생 면담II(Occupational Performance History Interview-II OPHI-II), 자가작업평가(Occupational Self Assessment OSA), 작업환경 평가면담과 등급화(The Occupational Circumstances Assessment Interview and Rating; OCAIR)를 대상자에게 실시하였다. 또한 대상자의 사례관리자와 보호자 각 1명씩을 대상으로 직 간접적인 면담을 시행하였다. 결과 : 인간작업모델을 적용하여 면담 및 평가를 실시한 결과 사회와 가족관계형성과 재 정 문제, 전반적인 행복에 제한이 있는 것으로 파악되었다. 결론 : 본 연구의 결과를 통해 치매노인을 대상으로 인간작업모델을 적용하여 전인적으로 판단 할 수 있었으며 대상자를 바라보는 새로운 관점과 해결방안을 제시가능 하였다. 이를 통해 작업치료의 질 향상과 서비스의 영역을 확대하는데 기여할 것이다.

• 한국산학기술학회논문지
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• 제19권4호
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• pp.472-480
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• 2018

본 연구는 경도와 중등도 치매 환자의 인지 기능과 작업 참여 능력을 알아보고, 인지 기능과 작업 참여의 상관관계를 알아보고자 시행하였다. 2017년 9월부터 2017년 11월까지 대구광역시 지역의 주간보호센터를 방문하는 95명의 치매 환자를 대상으로 하였다. 인지 기능을 측정하기 위하여 한국판 간이정신상태 판별검사(MMSE-K)와 한국판 로웬스타인 작업치료 인지 평가-노인용(Loewenstein Occupational Therapy Cognitive Assessment Geriatric population: (LOTCA-G)을 사용, 작업 참여를 측정하기 위하여 인간작업모델 선별 평가도구(MOHOST)를 사용하였다. 본 연구 결과는 SPSS 20.0 통계처리 프로그램의 기술 통계를 이용하여 연구 대상자의 인지 기능과 작업 참여 정도를 분석하였고, 인지 기능과 작업 참여 간 상관관계 분석을 위해 피어슨 상관분석을 실시하였다. 연구 결과 치매 환자의 인지 기능과 작업 참여 간 상관관계를 확인할 수 있었다. 본 연구의 결과를 바탕으로 치매 환자의 평가 및 치료적 목표 수립 시 인지 기능과 관련한 작업 참여도 고려해야 할 것으로 사료된다.