Long-term Care Hospitals and Changing Elderly Care in South Korea

Author(s):  
Seonsam Na

Until recently in South Korea, the central dilemma facing children with ageing parents was how and by whom their parents should be cared for. In accordance with the norm of filial piety, the eldest son used to take responsibility. However, with the recent proliferation of long-term care hospitals, this arrangement is changing. These institutions, which play the combined role of rehabilitative hospital, long-term care centre, and nursing home, admit elderly people who do not require active medical intervention. The government’s promotion of these hospitals, centred on deregulation, ambiguity around their function, and the lack of alternative care facilities, has led to an expansion of the sector and consequently to the ‘nursing hom(e)fication’ of many of these institutions. While these hospitals ease the pressures associated with an ageing population, their mainstreaming has had an impact on healthcare, medicine, and the lives of elderly people. The hospital field has become commercialised, medical practice is being transformed, and the dignity of elderly people is being lost through hospitalisation. In this new care regime, filial piety itself is undergoing transformation—from an ideology underpinning the domestication of care, to the market idiom of service compliance. In this article, I introduce these hospitals and investigate how their growth has brought about a Korean style of elderly care commodification, revealing the undercurrents of healthcare privatisation and the neoliberalisation of welfare.

Author(s):  
Lanshu JIANG ◽  
Ling ZHOU ◽  
Ran REN

LANGUAGE NOTE | Document text in Chinese; abstract also in English.中國邁入老齡化國家之後,失能老人的長期照護將會成為未來養老問題中的難點。失能老人作為病患的權利需要靠社會的福利制度來得以維繫,這在目前中國福利制度仍未十分健全的情況下是很難實現的。本文將通過對中國儒家倫理觀的思考,吸取其精華,探索老齡化背景下符合中國國情的長期照護發展之路。According to the standard set by the United Nations, if more than 10% of the population of a society is over 60 years old, then that society qualifies as an aging society. This means that China has been an aging society since 2000. Currently, China has one hundred and forty-nine million people over 60 years old, of which more than thirty million require long-term care to various degrees. 8% of elderly rural Chinese are unable to afford institutional long-term care, even if such institutional care is available. Obviously, China faces grave challenges in providing long-term care for its ever-increasing elderly population.Unfortunately, Chinese bioethics has failed to conduct careful research on these challenges to develop appropriate Chinese public policy on long-term care. This essay offers a Confucian ethical approach to the issue and proposes a series of policy recommendations framed in terms of Confucian ethical concerns. As is well known, Confucian ethics places great emphasis on the virtue of filial piety (xiao) on the part of children, who are expected to respect and take care of their elderly parents. It is the Confucian view that elderly people should, insofar as is possible, live at home, with the assistance of their children, and lead their elderly lives among their children and grandchildren. Living in an institution with other elderly people is not considered a normal, much less ideal, human living environment. This essay argues that this Confucian value should be preserved in contemporary Chinese society. This requires proper policy formulation and governmental contributions. First, in moral education, the Confucian virtue of filial piety and familial interdependence, rather than individual independence, should be promoted. Second, the government should provide financial incentives and awards to children who choose to stay home to take care of their elderly parents or grandparents. Finally, based on the Confucian virtue of beneficence (ren), the government should offer special assistance to families with seriously disabled elderly members. People should also be encouraged to organize volunteer groups to offer help to needy families. In short, the Confucian moral principle of reciprocity (“do not impose on others what you would not want others to do to you”) suggests that if we do not want to be abandoned by our children and by society when we become old, it is high time for us to act and set appropriate long-term policies.DOWNLOAD HISTORY | This article has been downloaded 935 times in Digital Commons before migrating into this platform.


2015 ◽  
Vol 38 (2) ◽  
pp. 82-92
Author(s):  
Endija Rezgale-Straidoma ◽  
Līga Rasnača

The study deals with the deinstitutionalization of long-term care for elderly people in Latvia. The aim of this study is to identify the risks that elderly people, discharged from long-term care institutions, are likely to face. The research method of this case study is document analysis and a semi-structured interview. The research shows that some mismatch between the declared political aims and the current situation which was clarified through interviews exists. The identified risks have been grouped, analysed, conclusions drawn are provided in the paper.


2012 ◽  
Vol 33 (5) ◽  
pp. 871-887 ◽  
Author(s):  
JIN WOOK KIM ◽  
YOUNG JUN CHOI

ABSTRACTSouth Korea has been experiencing unprecedented socio-economic transformations in which an ageing population is widely regarded as a key challenge. As an unlikely consensus on state intervention in care has emerged since early 2000, South Korea has achieved rapid development of welfare state programmes. The introduction of long-term care insurance (LTCI) in 2008 is one of the important steps. However, it is still highly debatable whether the Korean welfare state has departed from its path of both developmentalism and Confucianism. This paper aims to analyse the nature of LTCI in South Korea and to examine whether its introduction could mean a divergence from these two important policy legacies. This research has reached an ambiguous conclusion. The regulatory role of the government and concerns about the costs of LTCI are regarded as a developmentalist legacy, whereas Confucian legacies seem to be withering away since LTCI shifts care responsibility from the family to the state. However, the study found that the state has difficulty in regulating the market and costs, and deeply embedded familialism seems difficult to overcome.


2011 ◽  
Vol 6 (1) ◽  
pp. 104
Author(s):  
Patrícia Peres Oliveira ◽  
Priscilla Sete de Carvalho Onofre ◽  
Paula Bertone Norberto

ABSTRACT Objective: to know the feelings of elderly people living in a long term care institution (ILP) with regard to the death of friends and relatives. Methodology: this is a descriptive and exploratory research with a qualitative approach, using the oral history method through two guiding questions: “Have you ever experienced the death of a friend, relative, or even some close colleague living in this institution? “and” How you face this situation?”. The data collection was carried out by means of recorded interviews, with the signing of Free and Informed Consent Term, help between January and March 2010, with twenty elderly people, from both sexes, aged between 72 and 89 years, living in an institution for elderly care in Sao Paulo city, as approved by the Research Ethics Committee of Universidade Paulista under CAAE 5380.0.000.251/09, obtaining a favorable opinion, under the Protocol 715/09. Results: from analyzing the interviews, four thematic focuses emerged: loss due to withdrawal from family relationships, new friendships, the existence after the death of friends and relatives, reflections on the possibility of one’s own death. Conclusions: it was possible to understand that the death of beloved people brings the elderly person closer to her/his own mortality, turning the grieving process more difficult, but separation is much more difficult to be interpreted because it is the loss of living persons. Therefore, it is essential that the health professionals and caregivers give support to the elderly people in their process of facing the suffering experienced. Descriptors: geriatric nursing; death; qualitative research. RESUMO Objetivo: conhecer os sentimentos dos idosos residentes em uma instituição de longa permanência (ILP) em relação à morte de amigos e familiares. Metodologia: trata-se de pesquisa descritiva e exploratória com abordagem qualitativa, utilizando o método da história oral a partir de duas questões norteadoras: “O senhor já vivenciou a morte de algum amigo, parente ou mesmo algum colega mais próximo residente nesta instituição? “e” “Como foi para o senhor enfrentar essa situação?” A coleta de dados foi realizada por meio de entrevistas gravadas, com assinatura de Termo de Consentimento Livre e Esclarecido, realizadas entre janeiro e março de 2010, com vinte idosos, de ambos os sexos, com idade entre 72 anos e 89 anos, residentes em uma instituição para idosos da cidade de São Paulo, conforme aprovação do Comitê de Ética em Pesquisa da Universidade Paulista sob o CAAE n. 5380.0.000.251/09, tendo obtido parecer favorável, sob o Protocolo nº 715/09. Resultados: a partir das análises das entrevistas emergiram quatro focos temáticos: a perda pela separação do convívio familiar, novas amizades, a existência após a morte dos amigos e familiares, reflexões sobre a possibilidade da própria morte. Conclusões: foi possível compreender que a morte de pessoas queridas aproxima o idoso de sua própria mortalidade, dificultando o processo de luto, mas a separação é muito mais difícil de ser interpretada por ser a perda de pessoas vivas. Portanto é fundamental que os profissionais de saúde e cuidadores deem suporte aos idosos em seu processo de enfrentamento do sofrimento vivenciado. Descritores: enfermagem geriátrica; morte; pesquisa qualitativa. RESUMEN Objetivo: conocer los sentimientos de los ancianos residentes en una institución de larga permanencia (ILP) en relación a la muerte de amigos y familiares. Metodología: esta es una investigación descriptiva y exploratoria con abordaje cualitativo, utilizando el método de la  historia oral, desde das preguntas orientadoras: “¿Usted ya vivenció la muerte de algún amigo, pariente o mismo algún colega más cercano residente en esta institución? “e” ¿Cómo fue para usted hacer frente a esa situación?”. La recogida de datos se realizó por medio de entrevistas grabadas, con firma de Término de Consentimiento Libre Y Esclarecido, realizadas entre enero y marzo de 2010, con veinte ancianos, de ambos sexos, con edades entre 72 y 89 años, residentes en una institución para ancianos en la ciudad de São Paulo, conforme aprobación del Comité de Ética en Investigación de la Universidade Paulista bajo el CAAE 5380.0.000.251/09, teniendo obtenido opinión favorable, bajo el Protocolo 715/09. Resultados: desde los análisis de las entrevistas surgieron cuatro focos temáticos: la pérdida por separación del convivio familiar, nuevas amistades, la existencia después de la muerte de amigos y familiares, reflexiones acerca de la posibilidad de la propia muerte. Conclusiones: fue posible comprender que la muerte de personas queridas aproxima el anciano de su propia mortalidad, dificultando el proceso de luto, pero la separación es mucho más difícil de ser interpretada por ser la pérdida de personas vivas. Por lo tanto, es fundamental que los profesionales de la salud y los cuidadores den soporte a los ancianos en su proceso de enfrentamiento del sufrimiento vivenciado. Descriptores: enfermería geriátrica; muerte; investigación cualitativa.


1982 ◽  
Vol 2 (3) ◽  
pp. 285-298 ◽  
Author(s):  
Ann D. M. Davies

ABSTRACTThe problems of introducing change in long-term care settings for elderly people are discussed in relation to social, psychological and organisational factors operating within the institution. It is argued that the poor maintenance and generalisation of many behavioural interventions is in part due to researchers adopting too narrow a framework. Four issues are discussed and illustrated: 1. The role of the researcher in relation to care staff. 2. Relationships with elderly patients. 3. Change as criticism. 4. Conflicting policies within the institution.


2011 ◽  
Vol 20 ◽  
pp. S121-S134 ◽  
Author(s):  
Heying Jenny Zhan ◽  
Zhanlian Feng ◽  
Zhiyu Chen ◽  
Xiaotian Feng

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