• Title/Summary/Keyword: vulnerable older adults

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Meal and Food Provision Services for Community-dwelling Vulnerable Older Adults Perceived by Health & Welfare Service Providers in Seoul (서울 지역 건강·복지담당자가 인식하는 취약계층 고령자를 위한 지역사회 식사·식품지원서비스 실태)

  • Jang, So-Mang;Bae, Jeong-Sook;Lee, Kyung-Eun
    • Journal of the Korean Dietetic Association
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    • v.25 no.4
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    • pp.295-309
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    • 2019
  • The purpose of this study were to identify the dietary practices of vulnerable older adults and to assess the foodservice and food provision service programs perceived by the health and welfare service providers in the community. A survey was conducted on health and welfare service providers working in outreach community centers and community health centers in Seoul. A total of 260 nurses and social workers participated in the survey and 224 responses were used for data analysis after excluding significant missing data. The respondents consisted of nurses (58.5%) and social workers (41.5%). In terms of the dietary life of the vulnerable older adults, they perceived that the food cost was burdensome to the older adults and poor dental conditions prohibited them from eating various foods. The health and welfare service providers rated highly for 'home-delivered meal and side dish services are effective for checking older adults' conditions' but rated low for availability of menu choices. In targeting vulnerable older adults for food and nutrition service programs, the home-delivered meal service was found to be suitable for older adults living alone, those over age of 80 years, those with mobility difficulties, and those with economic difficulties. The food provision service was appropriate for older adults living with their spouse or other family members. Vulnerable older adults are a heterogeneous population with diverse needs related to food and nutrition. Home-delivered meal/side dish service and food provision services will achieve their goals when they reach the correct targets with a customized service.

Transitional Care for Older Adults with Chronic Illnesses as a Vulnerable Population: Theoretical Framework and Future Directions in Nursing

  • Son, Youn-Jung;You, Mi-Ae
    • Journal of Korean Academy of Nursing
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    • v.45 no.6
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    • pp.919-927
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    • 2015
  • Purpose: Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. Methods: The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. Results: An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. Conclusion: Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

A Study on Identification of the Heat Vulnerability Area - Case Study in Chungcheongnamdo - (폭염 취약지역 도출에 관한 연구 - 충청남도를 대상으로 -)

  • Lee, Gyeongjin;Cha, Jungwoo
    • Journal of Korean Society of Rural Planning
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    • v.25 no.1
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    • pp.67-74
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    • 2019
  • This study is to identify the heat vulnerability area as represented by heat risk factors which could be attributable to heat-related deaths. The heat risk factors were temperature, Older Adults(OA), Economic Disadvantage(ED), Accessibility of Medical Services(AMS), The population Single Person Households(SPH). The factors are follow as; the temperature means to the number of days for decades average daily maximum temperature above $31^{\circ}C$, the Older Adults means to population ages 65 and above, furthermore, the Economic Disadvantage means to the population of Basic Livelihood Security Recipients(BLSR), the Accessibility of Medical Services(AMS) means to 5 minutes away from emergency medical services. The results of the analysis are showed that the top-level of temperature vulnerability areas is Dong, the top-level of vulnerability OA areas is Eup, the top-level of AMS vulnerability is Eup. Moreover, the top-level of vulnerability ED area appears in the Eup and Dong. The result of analysing relative importance to each element, most of the Eup were vulnerable to heat. Since, there are many vulnerable groups such as Economic Disadvantage, Older Adults in the Eup. We can be figured out estimated the number of heat-related deaths was high in the Eup and Dong by the data of emergency activation in the Chungcheongnam-do Fire Department. Therefore, the result of this study could be reasonable.

New Directions in Communicating Better Nutrition to Older Adults

  • Guldan, Georgia-Sue;Wendy Wai-Hing Hui
    • Journal of Community Nutrition
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    • v.2 no.1
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    • pp.62-70
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    • 2000
  • Nutrition education should be an important component of ongoing health promotion for older adults and their caregivers. This is because prevention through sound nutrition and food hygiene practices and regular excercise is the most cost-effective way to reduce risks for and deal with their major health problems. nutritions education services should effectively promote optimum intake and successful self-care. Unfortunately, however relative to other vulnerable groups, nutrition education for older adults has not been systematically developed or evaluated. Usually oder adults care a lot about their health, so this should be a relatively easy group to teach - but their increasing numbers, longevity and great diversity with respect to health, physical, and economic status and educational level present challenges. Some older adults may not perceive they would benefit from nutrition education, so interesting and motivating them is a challenge. The food and nutrition knowledge of older people has been acquired through a lifetime of experience. For most older adults in the Asian region, their sources are restricted by their restricted education, so that their major sources of information have been informal sources, such as television, radio, friends, family, and perhaps newspapers and magazines if they are literature. Nonetheless, dietary advice for older people should build on their existing knowledge and ingrained values. It should provide information useful in daily food selection, and focus on food, not nutrients - the same foods and groups considered appropriate for younger people, with consistent messages as given throughout the population. Attention must also be paid to discovering learning styles in older people. When we teach in schools, the young students are a captive audience resigned to their learning role. Learning by an older adult, however, reflects an effort to meet his or her perceived needs. Therefore, nutrition education should be a positive experience in a non-threatening environment, relaxed and non-competitive, and perhaps even social environment. The messages also need to be practical and achievable. A needs assessment is essential, because our ability to provide the most effective nutrition education will depend on our success in matching the needs, both perceived and unperceived. of this vulnerable group. Therefore, go to the potential older learners to assess their interest and preferences. Nutrition education activities for older adults are widespread, but few have been evaluated. Evaluation is therefore also recommended, particularly when new methods are used. Tips from other countries for giving successful nutrition education will be given, including some examples of applications as attempted in Hong Kong. Research needs will also be described. In conclusion, successful nutrition education for older adults depends on positive needs-based messages. This is may be hard to do, as few good examples are available to illustrate these principles.

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Risk Factors of Malnutrition by Age in Hospitalized Older Adults (입원 노인의 연령별 영양불량 위험요인)

  • Kim, Eun Jung
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.1
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    • pp.77-84
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    • 2021
  • Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m2. Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.

Psychosocial Features Affecting Suicidal Ideation Among Human Immunodeficiency Virus-infected Older Adults

  • Kang, Cho Ryok;Yang, Sook Ja
    • Journal of Korean Public Health Nursing
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    • v.37 no.1
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    • pp.136-146
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    • 2023
  • This cross-sectional design study was undertaken to determine the factors associated with suicidal ideation in human immunodeficiency virus (HIV)-infected older adults. Data from a city-wide representative sample collected by the Seoul Metropolitan Government were used. The cross-sectional survey was conducted between February and March 2013. Participants selected and included in the analysis were HIV-infected adults living in Seoul, and aged 50 years and older. The overall adjusted model showed that being unemployed (adjusted odds ratio [aOR], 3.34; 95% confidence interval [CI], 1.16-9.57), a history of depression treatment (aOR, 4.61; 95% CI, 1.02-20.66), perceived belongingness (aOR, 0.63; 95% CI, 0.41-0.99), and psychological functioning (aOR, 0.85; 95% CI, 0.73-0.99) were significantly related to suicidal ideation. Psychosocial features were found to be strongly associated with suicidal ideation among HIV-infected older adults. The findings could be useful for HIV nursing consultants to identify HIV-infected older adults who are vulnerable to suicidal ideation. Comprehensive mental health services should be provided as coping resources for HIV-infected older adults who have suicidal ideation.

The Trajectory of Depressive Symptoms Across Years of Community Care Utilization Among Older Adults: A 14-Year Follow-up Study Using the 'Korean Welfare Panel Survey'

  • Il-Ho Kim;Cheong-Seok Kim;Min-Hyeok Jeong
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.6
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    • pp.495-503
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    • 2023
  • Objectives: While older adults using community care services are known to be vulnerable for depression, community care utilization (CCU) may help to improve the mental health of these elderly. To date, however, it is much less clear how CCU affects depressive symptoms in the elderly population. This study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea. Methods: Using the 2006-2019 Korean Welfare Panel Survey, this study is focused on elderly born in 1940 or earlier and selected 3281 persons for baseline interviews in 2006. This consisted of 35 800 person-year observations during a period of 14 years. Panel data analysis were employed to construct years of CCU. Results: After controlling for covariates, linear term of years using community care was negatively associated with depressive symptoms, but a quadratic term was positively significant. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased. The level of depressive symptoms at the 14th year of using community care remains significantly lower than the level at the outset of its utilization. Conclusions: This finding implies that CCU could be beneficial for improving mental health among older adults.

Changes in nutritional status of Korean older adults during COVID-19 Pandemic by household income and demographic factors -using the Korea National Health and Nutrition Examination Survey(2019-2020): a cross-sectional study (가구소득 및 인구학적 특성에 따른 코로나19 유행 전·후 한국 노인의 영양소 섭취변화에 대한 단면연구: 국민건강영양조사 제8기(2019-2020) 자료를 활용하여)

  • You-Sin Lee;Yoonna Lee
    • Korean Journal of Community Nutrition
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    • v.28 no.4
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    • pp.302-316
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    • 2023
  • Objectives: The study aim was to identify changes in the nutritional status of older adults during the COVID-19 pandemic according to household income and demographic characteristics. Methods: Study participants were 2,408 adults aged 65 and over who participated in the 2019-2020 Korea National Health and Nutrition Examination Survey (KNHANES). To examine changes in nutrient intake levels resulting from COVID-19, data of 2019 and of 2020 were compared. Study participants were divided into three groups based on household income level to compare these changes. The changes were compared according to household income level, age group, and household type. Results: Percentages of recommended intakes for energy, protein, and most micronutrients were the lowest for the low-income group of both males and females in 2020. The Mean Adequacy Ratio (MAR) score was the lowest for the low-income group in both years. When comparing nutrient density for 2019 and 2020 by income group, the male low-income group experienced a decrease in nutrient densities of vitamin A, thiamine, calcium, and iron. For the same group, a decreased percentage for energy intake from protein was noted. Fruit intake was lowest in the low-income group for both males and females. Low-income males had the lowest intake levels for meat, fish, eggs, and legumes in both 2019 and 2020 and the lowest milk and milk product intake levels in 2020. Older adults living alone or single older adults with children had lower MAR scores than those living with a spouse. Older adults living alone experienced decreases in energy and thiamine and iron intake levels in 2020 compared to their intake levels in 2019. Conclusions: Because of the COVID-19 pandemic, nutrition intake levels worsened for older adult males in the low-income group and older adults living alone. This finding shows the need for a more systematic nutritional support strategy for the vulnerable older adults population in national disaster situations.

Designing Intervention Arthritis Self-Management Program with Tai Chi for Older Adults with Osteoarthritis in Rural Korea

  • So, Aeyoung;Park, Sunah
    • International journal of advanced smart convergence
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    • v.7 no.2
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    • pp.55-66
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    • 2018
  • Osteoarthritis is one of the most common chronic degenerative disease and prevalent among women in rural area. A variety of self-management programs for arthritis patients have been developed and administered, however the effectiveness and adherence to the program including arthritis exercise are found to be low. The purpose of this study is to design intervention Arthritis Self-Management Program with Tai Chi (ASMP-TC) through identifying and analyzing attributes influencing adherence exercise behavior in Korean older adult women with arthritis in rural area. For this, the existing and relevant evidence on arthritis self-management including exercise intervention were investigated, and then this study describes well-designed arthritis self-management program to provide the credibility and validity necessary for its interventions. In addition, this study try to propose a self-management program model of Tai Chi exercise for rural older adults to improve adherence based on the primary health care facility, which is vulnerable area in Korea.

A Study of Depression in Female Seniors Living Alone: A Comparison Between the Young-old and the Old-old Adults (여성 독거노인의 우울에 관한 연구: 전기와 후기노인의 비교를 중심으로)

  • Jin-Seop Lim;Je-sun Kim
    • Journal of Industrial Convergence
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    • v.22 no.1
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    • pp.149-162
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    • 2024
  • This study is a longitudinal study of female older adults living alone, one of the most vulnerable groups in our society, to determine how their depression changes over time and what factors affect their depression. At the same time, considering that there is a large difference in age among the same older adults, this study divided the female older adults into the young-old and the old-old to see how the predictors of depression in each group differ from each other. The main findings are as follows First, depression among female older adults living alone appears to have a declining pattern over time. In the conditional model, factors affecting the initial level of the depression trajectory among women living alone were found to be associated with lower initial depression values among those living in metropolitan areas rather than non-metropolitan areas, better subjective health, and those who did not exercise. Next, we examined the factors affecting rate of change (slope) in depression among female living alone older adults and found that the higher the age, the larger the metropolitan area, the better the subjective health, the less socializing, and the more socializing, the greater the decrease in depression level. Finally, there were some differences in the pathways affecting the initial value and slope of depression among female older adults living alone between the early and late older adults. Specifically, the higher the initial level of participation in social activities, the greater the change in depression among the late older adults, while there was no significant relationship among the early older adults. In the early older adults, better initial subjective health was associated with a larger change in depression than in the late older adults. Only in the late older adults did those who regularly exercised in the early years have higher initial depression values than those who did not. Based on the results of the above analyses, suggestions were made to reduce depression among female older adults living alone.