여성의 노부모 보살핌 경험에 관한 연구

이동옥 부산대학교 여성연구소 2011 여성학연구 Vol.21 No.1

This paper starts from the question, how the women who offered care labor for their aged parents interpret and give meaning to their experiences. The elderly care in Korean family has been regarded as the gender role embedded in the cultural context of the Confucian filial duty and thus the government has ignored the issue in the public sphere. But the recent increase of the aged people and working women and the visualization of elder abuse stimulated the necessity of the institutionalization of elderly care. Nevertheless, the family and especially women are not free from the responsibility for the elders. This research inquires into the women’s experiences through the in-depth interviews with the women who cared for elderly parents as daughters or as daughters-in-law. The interviewees were 10 people living in Seoul. Each participant had two or three interviews, for one or two hours per each interview. Their ages are various from the forties to the seventies. The reason why there was no age restriction on interviewees was because this research was interested in any possible change resulting from age difference in the care of elderly parents. According to the result of the research, daughters-in-law's responsibility for parents-in-law in the paternal family tends to have lessened relatively compared with the past. Nevertheless,they still feel that they are responsible for the care of the parents-in-law. Meanwhile, the research shows that the daughters who live with their elderly parents or have intimate relationship with them care for them from their own hearts. Nonetheless, the care for elderly parents was physically, mentally, and emotionally hard work. Women quit the job and experienced the cutting of the career because of the care for elderly parents. Even though women played the multiple roles such as housewives and mothers, their husbands did not support them. Since the elderly care is regarded as the troublesome, odd jobs, and the gendered role, women’s self-esteem was depreciated. Meanwhile, women understood the fact that aging and dying is the course of life through their care for their parents and accepted their time with elderly parents as the precious opportunity to feel empathy with them. The value of elderly care has been ignored in the feminist discourses. But the revaluation of elderly care services will be helpful as women's issue. Despite the institutionalization of elderly care, women's care for elderly parents does not decrease due to distrust of institution and the prejudice that the care of elderly parents are women's job. The idea that the care for elderly parents within family boundary is filial duty fixes women's role and hampers the institutionalization of elderly care. In order not to alienate Women's care for elderly parents, society should encourage men's participation and their emotional and physical support for elderly care. The institutionalization of elderly care in the public sphere should also reduce the economic burden and support the reliable elderly care. 본 논문은 여성들이 가족 내에서 노부모를 보살핀 경험을 어떻게 해석하고 의미를 부여하는가에서 출발한다. 한국에서 노인보살핌은 유교 효문화의 맥락에서 가족 내의 여성의 역할로서 인식되어 왔고 국가는 방임적인 자세를 취해 왔다. 현재 노인인구의 증가와 취업여성의 증가, 노인학대의 가시화 등으로 인해 노인보살핌의 제도화가 진행되고 있지만 가족, 특히 여성들은 노부모를 책임져야 한다는 의식에서 자유롭지 못하다. 이 연구는 며느리와 딸의 위치에서 노부모를 보살핀 여성들에게 심층면접을 실시함으로써 여성들의 경험을 살펴보았다. 심층면접은 현재 서울에 거주하는 10명의 연구참여자에게 2-3차에 걸쳐, 1회에 1-2시간씩 실시되었다. 연구참여자들의 연령은 40대-70대까지 다양하다. 연령을 제한하지 않은 이유는 연령간의 차이를 통해 노인보살핌의 책임에 대한 시대적 변화를 살펴보기 위한 것이다. 연구결과, 부계가족 내에서 시부모에 대한 며느리의 책임은 과거보다 줄어든 경향이 있지만, 여전히 며느리들은 의무감을 갖고 있었다. 반면에 친정과의 친밀한 관계를 유지하거나 부모와 함께 사는 딸들은, 부모에 대한 연민과 사랑으로 적극적으로 보살핌을 하고 있었다. 하지만 노인보살핌은 정서적, 신체적, 정신적으로 힘든 노동이었다. 여성들은 노부모를 보살피기 위해 직장을 그만두거나 경력 단절을 경험한다. 여성들은 가족 내에서 아내, 어머니 등의 다중적인 역할에도 불구하고 남편의 도움을 받지 못했다. 이와 같이, 노인보살핌은 여성의 역할로 인식되고 있었기 때문에 여성들은 자존감이 저하되었다. 반면에, 여성들은 노부모 보살핌을 통해서 나이듦과 죽음을 삶의 과정으로 수용하고, 아픈 노부모와 교감하면서 시간을 함께 보낼 수 있다고 해석한다. 노인보살핌의 가치는 여성주의의 논의에서 간과되어 왔지만, 가치의 재평가는 여성문제로서 노인보살핌을 해결하는 데에 도움이 된다. 노인보살핌의 제도화에도 불구하고, 시설과 유급노동자에 대한 불신과 노부모를 직접 보살피는 것이 효도라는 통념은 여성들의 부담을 경감시키지 못하고 있다. 가족의 틀 안에서만 노부모를 보살피는 것이 최선이라는 사고는 제도적 지원의 의미를 변형시키고 여성들의 역할을 고정시킨다. 노부모 보살핌이 여성들의소외된 노동이 되지 않기 위해서는 가족과 사회의 차원에서 정서적 지원과 남성들의 참여를 권장하는 한편, 제도적 차원에서 경제적 부담을 경감시키고 신뢰할만한 대체인력을 지원해야 한다.

노인돌봄체계의 개선방안에 관한 법적 고찰 - 재가(가정방문형)서비스를 중심으로 -

장봉석,박정연 전북대학교 부설법학연구소 2018 法學硏究 Vol.58 No.-

After the announcement of National Responsibility System for Dementia, Ministry of Health and Welfare is recently presenting new welfare policies, such as establishment of Social Services Institute, the Second Long-term Care Fundamental Plan and Community Care. For the successful implementation of these policies, study on improving the problems of current system has to be preceded. Therefore, this study intends to analyze the problems of current elderly care system and propose some improvement plans in terms of range of recipients, the contents of service, delivery system and financial aspect focusing on home care service. There are diverse home care services such as elderly care basic service, visiting care service, home care service for the elderly, long-term care service(esp. home care service) for the aged, elderly caring integrated service and community resources associated service under the current legal system, but it is imperative to set up an improvement plan due to the complexity, redundancy and abstruseness of these services. Problems of current home care service system for the elderly are overlapping of the range of the recipients between elderly caring basic service and elderly caring integrated service and overlapping of the contents of services between visiting care services under Welfare of the Aged Act and Act on Long-Term Care Insurance for the Aged. Also, there is a hierarchical problem of community resources associated service due to the overlapping and similarity between visiting care services. Furthermore, delivery system problem between theelderly caring basic service and elderly caring integrated service as well as the matter of regional unbalance in finance of home care service for the elderly has been raised. To solve these problems, first, under the dual system of preventive care and post care, related services should be integrated and adjusted focusing on recipients and the contents of service. Second, elderly caring basic service and home care service for the elderly should integrate focusing on home care service for the elderly, and it is appropriate to specify the special care for the senior citizens who live alone within the home care service for the elderly. Third, it is proper to eliminate the visiting care service under Welfare of the Aged Act upon consideration of the relationship with Long term care service for the elderly. Last, it is necessary to embrace the elderly caring integrated service into Long-term care service and establish new provision on community resources associated service. Elderly care service within the Community Care must reflect social, physical and emotional needs that the elderly has throughout all areas and the system should meet the needs. Through the prompt reorganization of the related legal system, home care service for the elderly ought to properly carry out its function and role within the social security area. 최근 보건복지부는 치매국가책임제 발표 이후 사회서비스원의 설립, 제2차 장기요양기본계획 및 커뮤니티 케어(Community Care) 등 새로운 복지정책들을 제시하고 있는바, 이러한 정책들이 성공을 거두기 위해서는 현행 관련제도의 문제점을 살펴보고 그 개선방안을 마련하기위한 연구가 선행되어야 한다. 본고는 이와 같은 문제의식 하에 특히 재가서비스를 중심으로 수급자 범위, 급여내용, 전달체계 및 재정의 측면에서 현행 노인돌봄체계의 문제점과 개선방안을 제시하고자 한다. 현행 재가서비스로는 「노인복지법」상 노인돌봄기본서비스·재가노인복지서비스로서의 방문요양서비스·재가노인지원서비스, 「노인장기요양보험법」상 재가급여, 「사회서비스이용권법」상 노인돌봄종합서비스 및 지역사회자원연계서비스가 있는데, 서비스의 중복성·복잡성·난해성으로 인해 혼선이 야기되고 있어 개선방안 마련이 시급하기 때문이다. 현행 재가노인돌봄체계의 문제점을 살펴보면, 먼저 수급자 범위에 있어서 노인돌봄기본서비스와 재가노인지원서비스 간의 중복, 「노인복지법」상 방문요양과 「노인장기요양보험법」상 방문요양서비스 간의 중복이 나타나고 있다. 또한 급여 내용에 있어서는 「노인복지법」상방문요양과 「노인장기요양보험법」상 방문요양서비스 간의 중복, 노인장기요양서비스와 노인돌봄종합서비스 간의 중복 및 급여의 유사성으로 인한 지역사회자원연계서비스의 위계 문제등이 제기된다. 나아가 노인돌봄기본서비스와 노인돌봄종합서비스의 전달체계 상 문제점과재가노인돌봄 재정에 있어서 지역적 불균형 문제도 제기된다. 이러한 문제점을 개선하기 위해서는, 첫째 사전예방적 돌봄과 사후적 돌봄이라는 이원적 체계 하에서 수급자 및 급여내용을 중심으로 관련 서비스를 통합·조정해야 한다. 둘째, 노인돌봄기본서비스와 재가노인지원서비스는 재가노인지원서비스를 중심으로 서비스를 통합하되, 독거노인에 대한 특별한 돌봄사업의 필요성은 재가노인지원서비스 내에서 구체화하는 것이 타당하다. 셋째, 「노인복지법」상 방문요양서비스는 노인장기요양서비스와 관계를 고려하여 삭제하는 것이 바람직하다. 마지막으로, 노인돌봄종합서비스를 장기요양서비스에 포섭하고 지역사회자원연계사업에 관한 명문 규정을 신설할 필요가 있다. 커뮤니티 케어에서의 노인돌봄은 노인의 사회적·신체적·정신적 기능 등 모든 영역에 걸쳐이들이 가진 문제나 욕구를 반영하고 그에 따른 대응체계를 갖추어야 한다. 관련 법제도의 신속한 정비를 통해 사회보장영역에서 재가노인돌봄서비스가 그 기능과 역할을 제대로 수행할수 있도록 해야 할 것이다.

고령자의 요양 중 사고에 대한 법적 책임

윤태영 한국경찰법학회 2019 경찰법연구 Vol.17 No.2

Recently, as more elderly people are going into the care facility for senior citizens, disputes are increasing between the elderly person and the facility. Senior citizens always have the possibility of the accident because of their bodily vulnerability. In addition, as the issue of human rights and self-reliant life of elderly people has become more emphasized, it has become much easier for accidents to occur. However, if the responsibility for accident prevention is strengthened too much, care facilities are tempted to imprison the elderly person. Therefore, it is necessary to clarify the standard for duty of care and responsibilities of those facilities. In this study, first, I research the elderly care accidents in comparison with the medical accidents. Legal rules of medical accidents are helpful to deal with the elderly care accidents because they have the similar responsibilities. Nevertheless, they should be differently conceptualized in the perspective of welfare, which is more emphasized in the area of the elderly care. It is not allowed to improve the elderly self-reliant life at the risk of the elderly safety. This is because the elderly care accidents may have arisen by uncontrollable causes. This research focuses on both the domestic and foreign cases dealt with the elderly care accidents and results in legal rules which are the most commonly applied in the case of the falling injury and the food swallowing disorder. Those legal rules provide that, in the case of falling injury, if care helpers negligently breach the duty of care for the elderly patient, they may be responsible for the injury. However, if the falling injury has happened during rehabilitation treatment, it is difficult to recognize negligence. Also, when deciding negligence in the case of swallowing disability, it is important to check if there was a proper response to the swallowing disability because it is not unusual for the elderly to have the swallowing disorder. For example, whether care helpers properly respond depends on how often they look at the elderly patient. 최근 고령자들이 노인복지시설에 입소하는 사례가 늘어남에 따라, 병약한 신체적 특성으로 인해 언제나 사고의 가능성이 내포되어 있는 고령자와 노인복지시설간의 사고에 따른 분쟁이 증가하고 있다. 더구나 최근 고령자의 인권문제가 부각되면서 자립적인 생활이 강조됨에 따라 사고가 발생하기 더 쉬운 상황으로 되었다고도 할 수 있다. 그렇다고 하여 사고 방지에 대한 책임을 지나치게 강화한다면 요양시설에서는 사고 방지를 위해 고령자를 보다 구속하려는 유혹에 빠진다. 따라서 요양을 담당하는 자의 책임범위와 주의의무를 명확하게 할 필요가 있다. 이에 본 연구에서는 먼저 요양 중 사고와 상당부분 유사한 점이 있는 의료사고에서의 책임과 비교연구를 해 보았다. 상당한 부분에서 의료사고에 관한 법리를 참고할만하지만 정확하게 말하면 의료와 달리 요양은 복지라는 점에서 다른 판단이 필요하다. 자립적인 일상생활을 도모한다는 명목으로 사고를 방치하는 것은 도저히 허용될 수 없지만, 고령자의 경우 불가항력에 의한 사고도 존재할 수밖에 없다는 점을 감안하여, 안전과 자립의 균형을 도모하는 것이 중요하다. 요양사고에 대한 법적 책임의 판단기준을 살펴보기 위하여, 국내외 판례를 조사 연구한 결과, 요양사고의 큰 비중을 차지하는 낙상과 음식물 삼킴 장애에서 중요한 판단기준이 도출되었다. 먼저 낙상의 경우 요양보호사가 돌보기를 게을리 하였을 경우에는 과실을 인정하였지만, 환자의 재활 등을 실시하는 과정에서 일어난 낙상 사고에 대해서는 과실이 인정되지 않았다. 한편 삼킴 장애에 있어서는 고령자의 특성상 자주 일어날 수밖에 없기 때문에 과실 판단에서 가장 중요한 것은 적절한 사태에 대한 대응이 있었는가 하는 점이었다. 따라서 얼마나 자주 돌아보았는가 하는 시간이 중요한 요소였다.

한국과 일본 노인당사자들의 가족돌봄 의식 비교

오영란,정태준 한국일본근대학회 2017 일본근대학연구 Vol.0 No.57

본 연구는 한국과 일본의 노인의 가족돌봄 인식을 노인당사자들을 대상으로 직접 비교 고찰하는 것에 목적이 있다. 그동안 한일양국에서는 돌봄의 사회화를 정책목표로 하면서 다양한 방식의 정책전개들이 이루어졌으나 그것이 당사자인 노인들에게 있어 적용과 활용은 어떠했는가에 대해 문제인식을 가지며 실제 노인당사자들이 요구하는 돌봄정책은 어떤 것이며 한일양국의 차이는 무엇인가를 고찰하고자 하였다. 이를 위한 연구방법은 한국의 노인복지관 이용자와 일본의 노인복지센터 이용자 307명을 대상으로 질문지를 통한 양적조사분석을 실시하였다. 주요결과는 첫째, 한, 일의 노인들의 가족돌봄인식은 가족의존보다는 돌봄전문직, 지역사회서비스, 시설이용을 통해 이루어져야 한다는 태도를 가지고 있었으며 특히 가족과 지역사회서비스가 혼합된 형태의 돌봄이었다. 둘째, 노인들은 가족돌봄에 대한 현금급여에 대해 공통적으로 선호하였으며 그 형태에 있어 일본은 노인당사자에게 제공하는 것으로 노인당사자의 자기결정권에 대해 선호하였고 한국은 부양가족에게 제공하는 것을 선호하여 차이를 보였다. 셋째, 전체적으로 한국과 일본의 차이는, 한국의 노인들이 가족돌봄에 대한 선호가 다소 높음을 확인할 수 있다. 이는 두가지 측면의 요인을 찾아볼 수 있는데 첫째는 한일 양국의 돌봄정책의 전개시기와 시간적 성숙의 차이가 작용한 것이라 할 수 있으며 둘째는 한일 양국의 노인들의 인식가운데 가족주의에 대한 인식차이로 해석할 수 있다. 결론적으로 제안하고자 하는 것은 보편적인 지역사회 돌봄서비스 제공과 이를 위한 인프라 정비를 정책적으로 보충하고 구성해가는 시도를 통해 노인들의 변화하는 돌봄사회화 인식에 대응할 수 있어야 한다는 것이다. The purpose of this study is to directly compare the perception of family care for the elderly people concerned in Korea and Japan. In the meantime, in both Korea and Japan, policies have been developed in various ways with the aim of socialization of care, but it has problem recognition as to how it applies and is implemented to the elderly people concerned. And this study attempts to explore what kind of care policies are required by the elderly people and what is the difference between the two countries. For this purpose, this study conducted a quantitative research analysis using questionnaires of 307 Korean elderly welfare center users and Japanese elderly welfare center users. From the main results, first, in Korea and Japan, the perception of family care for the elderly had to be made through caring profession, community service, and facility use rather than family dependency, and in particular it was a mixture of care of family and community services. Second, elderly people commonly preferred cash benefits for family care. And in terms of the form, Japan favored the self-determination of the elderly by providing it to the elderly, and Korea preferred to provide it to the dependents, which demonstrated a difference between them. Third, there is a difference between Korea and Japan as a whole, showing that the elderly people in Korea have a higher preference for family care. There are two main reasons for this. First, it was the application of the difference in the timing of development and the temporal maturity of the care policies of both Korea and Japan, and second, the perception of the elderly in Korea and Japan can be interpreted as the perception of familyism. In conclusion, what this study proposes is that, through the provision of universal community care services and the policy supplementation and construction of infrastructure for this, it should be able to cope with the perception of the elderly about the changing socialization of care.

청소년과 부모 세대의 노부모 부양인식에 대한 토착심리 탐구

박영신,박영자,남인순 한국문화및사회문제심리학회 2017 한국심리학회지: 문화 및 사회문제 Vol.23 No.3

The main purpose of this research is to investigate the qualitative nature of Korean adolescents and their parent's perception of elderly parents care. In addition, this research exams the quantitative differences between the two generations in term of their elderly parents care self-efficacy and attitude towards caring for their elderly parents. Further, an examination of the parental influence upon their children's elderly parents care self-efficacy and attitude towards caring for their elderly parents. There were 2,460 participants in this study, with 820 adolescents, and 820 fathers and 820 mothers. The results of the study were as follows: First, in terms the participants perceptions of “the most difficult aspect of caring for elderly parents”, the most representative response for adolescents was financial difficulties, while for parents differences in opinions. When it came to “the best aspect of caring for elderly parents” the most representative response for adolescents was harmonious family, while for parents good for children's upbringing. When it came to “actual acts (behavior) of elderly parents care” the most representative response for adolescents was living together with their elderly parents, while for parents looking after their elderly parents. When it came to “the best method of caring for their elderly parents” the most representative response for both adolescents and parents was providing a peace-of-mind for their elderly parents, followed by the second most frequent response of adolescents living together with their elderly parents, and for parents talking with their elderly parents. When it came to “how one feels when not caring for their elderly parents” the most representative response for both groups was a feeling of indebtedness. Second, for the quantitative analyses of the differences between the two generations, the parents showed a lower level of elderly parents care self-efficacy and a higher level of negative attitude towards caring for their elderly parents, when compared to the adolescents. Third, for the parental influence upon the adolescents' elderly parents care self-efficacy and attitude towards caring for their elderly parents, the only significant influence found was the mothers' elderly parents care self-efficacy. 이 연구의 주된 목적은 청소년과 부모 세대의 노부모 부양인식을 탐구하는데 있다. 더불어 세대 집단별 노부모부양효능감과 노부모 부양태도의 차이를 살펴보았다. 또한 부모가 청소년 자녀의 노부모부양효능감과 노부모 부양태도에 미치는 영향을 분석하고자 하였다. 최종 분석대상은 총 2,460명(청소년 820, 부 820, 모 820)이었다. 연구결과는 다음과 같다. 첫째, 노부모 부양할 때 어려움에 대해 청소년은 경제적 문제를, 부모는 의견 차이를 가장 대표적으로 제시하였다. 노부모를 부양할 때 좋은 점으로 청소년은 가정화목을, 부모는 자녀교육에 도움 됨을 가장 많이 응답하였다. 노부모 부양의 대표적 행동으로 청소년은 모시고 사는 것, 부모는 보살펴드림의 반응률이 가장 높았다. 노부모 부양의 좋은 방법으로 청소년과 부모 모두 마음 편하게 해 드림을 가장 많이 응답하였으나, 그 다음으로 청소년은 모시고 사는 것을, 부모는 대화함을 많이 응답하였다. 노부모를 부양하지 않았을 때 드는 마음으로는 청소년과 부모 모두 죄송함이 가장 대표적이었다. 둘째, 청소년과 부모 세대의 노부모 부양 관련 변인의 차이를 분석한 결과, 부모 집단이 청소년 집단보다 노부모부양효능감이 낮고, 노부모 부양에 대한 태도가 부정적이었다. 셋째, 청소년의 노부모부양효능감과 노부모 부양태도는 어머니의 노부모부양효능감의 영향을 받았다.

노인장기요양보험을 둘러싼 노인돌봄 정책변화의 쟁점 분석

문용필 ( Yongpil Moon ) 사단법인 아시아문화학술원 2021 인문사회 21 Vol.12 No.5

본 연구의 목적은 노인장기요양보험을 둘러싼 노인돌봄 정책변화의 쟁점을 분석하는 것이다. 이를 위해 2018~2021년에 시행된 4개의 노인돌봄 관련사업을 전달체계 측면에서 비교분석하였다. 분석결과는 다음과 같다. 먼저, 노인돌봄 사업들이 노인장기요양보험 중심 장기요양서비스에서 점차 지역사회 재가서비스로 재편되는 정책변화가 나타났고, 선진국의 노인돌봄 정책변화의 경향성이 유사함을 발견하였다. 둘째, 대상 측면에서 노인돌봄 관련사업은 지역사회 거주노인을 대상으로 독거노인, 장기요양노인뿐만 아니라 보건과 복지 등의 통합적 서비스가 필요한 일반노인층을 포함하는 특징이 있었다. 셋째, 서비스 측면에서 장기요양서비스뿐만 아니라 보건의료서비스, 주거서비스 등의 다양한 서비스까지 확대되었다. 넷째, 운영 측면에서 지방자치단체를 중심으로 운영되는 경향이 강하였고, 노인돌봄 관련기관과의 네트워킹이 이전보다 강조되었다. 이러한 연구 결과를 바탕으로 본 연구는 지역사회 거주노인을 위한 노인장기요양보험 장기요양서비스 및 관련서비스의 개선을 위한 정책제언을 제시하였다. The purpose of this study is to analyze issues of changes in care policy for the elderly surrounding long-term care insurance for the elderly. For this purpose, four elderly care-related projects implemented in 2018-2021 were compared in terms of delivery system. First, There was a tendency for elderly care policy to gradually change from long-term care services centered on long-term care insurance for the elderly to community social services. It was found that the tendency of changes in elderly care policies in developed countries was similar. Second, elderly care-related projects included not only the elderly living alone and the long-term care elderly, but also the general elderly who needed integrated services such as health and welfare for the elderly living in the community. Third, the elderly care-related projects expanded not only to long-term care services, but also to various services such as health care & medical services and housing services. Fourth, elderly care-related projects tended to be operated mainly by local governments, and networking with related organizations was emphasized. Based on these research results, this study presented policy suggestions for the elderly living in the community to improve long-term care services and related services for the elderly.

소비자의 노후 간병비 관련 인식과 노후 간병비 준비에 관한 연구

김지현,최현자 한국FP학회 2019 Financial Planning Review Vol.12 No.3

This study analyzed the consumers’ perception of the care costs for the elderly and their financial preparation, and identify what affects their financial preparations for care costs for the elderly. The data were collected from businessmen over 30 years of age by EMBRAIN, a market research agency. The analysis results and conclusions are as follows. First, with respect to the perception on the care costs for the elderly, the consumers generally did not perceive the fact they should pay for the patient share even if they received the benefit of the senile long-term care insurance system. An analysis of the care costs for the elderly related knowledge revealed a high simple knowledge score but poor scores for the related systems or supports. For the analysis of time and probability distances on the care costs for the elderly in the study subjects, they perceived the higher probability distance than the time distance. Lastly, the level of economic burden on the consumers’ care costs for the elderly was high, demonstrating the expense perceived as a burden. Regarding the financial preparation for care costs for the elderly, only 21.7% of the subjects prepared the care costs for the elderly by saving or investing W810,000 per month on average. Second, regarding the difference of the financial preparation for care costs for the elderly by the consumers’ characteristics, they showed significant differences in terms of gender, age, total household income, and the total asset amount for the difference as to whether to prepare the care costs for the elderly. In addition, an analysis of the financial preparation for care costs for the elderly by the consumer's perception on care costs for the elderly showed significant differences in the recognition of the expenditure scope, responsible scope, and psychological distances. Lastly, the results of the influential elements in the consumers’ financial preparation for care costs for the elderly showed that the elements that influence the preparation of their costs care for the elderly were recognition of the expenditure scope, responsible scope, time distance, gender, and total asset amount. 본 연구는 소비자의 노후 간병비 관련 인식과 노후 간병비 준비현황을 살펴보고, 노후 간병비 준비에 영향을 미치는 요인을 살펴보고자 하였다. 이를 위하여 30대 이상의 직장인 613명을 대상으로 설문조사를 실시하였으며, 연구결과는 다음과 같다. 첫째, 노후 간병비 관련 인식의 경우, 소비자들은 본인이 노후 간병비의 주된 책임자라고 인식하지만 실제 노후 간병비 지불은 국가의 보조나 지원을 기대하는 것으로 나타났다. 소비자들의 간병비 관련 지식을 분석한 결과 단순 지식 점수는 높았으나 관련 제도나 지원에 관한 지식은 낮았다. 노후 간병비 관련 시간적 거리감과 확률적 거리감을 분석한 결과 시간적 거리감은 비교적 간병비 지출시점을 가까운 미래로 인식하였고, 확률적 거리감은 높게 인식하고 있었다. 마지막으로 소비자들의 간병비에 대한 경제적 부담감 수준은 높게 나타나 간병비가 은퇴자금을 고갈시키는 부담되는 비용으로 인식하고 있는 것으로 나타났다. 더불어 전체 대상자 중 약 21.7%만 노후 간병비를 준비하고 있었고, 한 달에 평균 81만원씩 저축 또는 투자하고 있었다. 둘째, 소비자 특성에 따른 노후 간병비 관련 인식과 간병비 준비를 살펴본 결과, 소비자 특성에 따른 노후 간병비 준비의 차이는 성별, 연령, 총 가계소득, 총 자산에서 통계적으로 유의미한 차이를 보였고 노후 간병비 관련 인식에 따른 노후 간병비 준비의 차이는 지출범위, 책임범위, 시간적 거리감, 확률적 거리감에 따라 유의한 차이가 나타났다. 셋째, 소비자의 노후 간병비 준비에 영향을 미치는 요인에는 지출범위, 책임범위, 시간적 거리감, 성별, 총 가계소득이 통계적으로 유의미한 변수임을 알 수 있었다. 이를 통해 노후 간병비 준비를 증진시키기 위해서 소비자의 간병비 관련 인식, 심리적 거리감, 소비자의 사회․인구학적 특성, 재무적 특성을 종합적으로 고려하는 재무설계 또는 재무상담이 필요함을 알 수 있었다.

老人長期療養報障制度에 대한 比較法的 硏究

장두순 한국비교노동법학회 2009 노동법논총 Vol.16 No.-

In Korea, the number of the elderly has rapidly increased. In 2007, the percentage of the population aged 65 years or older has reached 9.9%. In this society of the old, the problem of the long-term care of the elderly is not only a problem for the individual family but for the society as a whole. In Germany and Japan, the long-term care insurance system has emerged as an answer to the problem of the rising medical costs of the elderly. Now, the Republic of Korea is trying to resolve the problem of the long-term care of the elderly by adopting a similar long-term care insurance scheme. The resulting recommendations for an improvement plan of the long-term care insurance of the elderly include: (1) Areas of a service supplementation. Firstly, it is difficult to enlarge caretaking facilities on short notice. Even if the numbers of the facilities are sufficient, new problems of the management of these facilities arise. To resolve these problems, it is necessary to increase the extent of the homecare service. Here, in order to prevent the waste of the insurance premiums, services not covered by the regulations should be paid by the family. Moreover, a national supplement policy for the elderly is needed, that supports the self-care community of the elderly. As in the case of Sweden, allowing specialized hospitals for the elderly to provide home-visit nursing care can be a solution for the shortage of nursing hospitals. Secondly, caretaking professional teaching programs must be improved. In the case of Germany and Japan, the training periods forthe caretakers are set at two to three years for a systematic education and the national licensing exam. In Korea, there are no definite provisions in the long-term care insurance law for the enforcement of regulations about the education of the caretakers. The government should make clear regulations concerning education periods and, especially, the period of the practical education. The organization of the exercise program should be licensed to caretaking hospital as well as to general hospitals. Thirdly, the "Family Long-term Care System" must be expanded. This system is only permitted in areas of the countryside that lack professional long-term caregivers and in the case of natural disasters. It is more economical to expand the Family Long-term Care System to lessen the expenses for the caretaker facility enlargement. Fourthly, the numbers of the management work force have to be raised. The supervisory system must be regulated in a way that clearly outlines the limitsof long-term care service. This means that a qualified management work force training system is needed. Fifthly, a volunteer system must be included in the long-term care service system. To foster a climate of volunteering services, a revision of the education law is needed so that related education programs can be newly introduced. (2) The objectives of the long-term care giving services should be enlarged. Firstly, the law of the objectives of the payment must be revised. Here, as beneficiaries, the disabled should be included. The disabled should be recipients of the long-term care giving service regardless of age. The financial resources for them should comefrom welfare budgets for the disabled. Secondly, the final entitlement evaluation should be done only by doctors; if the persons concerned are dissatisfied, a secondary evaluation should be made. The contents of the evaluation should be easy to be understood by common people. Thirdly, the concept of dementia must be defined. The improvement of the dementia symptoms is difficult judge. The law has no clear definitions of dementia, which will invite legal disputes. Fourthly, the scope of recipients of the elderly long-term care insuranceexcludes patients with severe symptoms. This will lead to objections by thepatients. Objective standards about recipients and payment regulation should be revealed (3) We should recheck the medical treatment service in the long-term insurance system. Firstly, we should recheck the effectiveness of the wireless paging project. We should establish a "mutual self-help system of the elderly". Especially, volunteer networking systems should be encouraged. Secondly, we should establish a voucher system and a preventive welfare system for the elderly. Thirdly, there are no provisions terminally ill patients. Care services for them must be included. Fourthly, we should prepare for payment systems and their control. Without proper control systems, there will be moral hazards with the imbursement of family medical treatment costs. (4) We should establish an objective entitlement level evaluation and control system. The decision process should be opened to the public by internet and public notice board. Firstly, level evaluations should be given after careful consideration in two stages. The supervision of service institutes and personal should be strengthened. Secondly, we should make multiple investigations for the preparation of reports of the medical situation. With recipients who receive high amounts of financial support, the medical certificates must be submitted to the authorities. Through this certification process, costs for those patients can be saved. (5) We should prepare sound financial planning for the long-term care of the elderly. Firstly, medical expenses for the aged and nursing expenses are increased like in Sweden. We should investigate the introduction ofa publicmedical public management, which unifies the welfare and medical services. Secondly, staying in long-term care hospitals is quite expensive. A self-supporter community, like in the United States, is recommendable to residents who live in the countryside and outskirts of the cities in Korea. In an industrialized country, staying at home is more common than staying at s hospital. Thirdly, we should introduce an insurance system for parents. In Korea, most of the old generation is not prepared for their declining years. Therefore, we should introduce an insurance system for parents financed by their sons and daughters. Fourthly, subdividing the levels of medical treatment is problematic. Presently, there are three levels of medical treatment. However, the gaps between each level are too large. Therefore, the financial situation of the insurance may change for the worse because of excessive payments. By subdividing the medical treatment levels, establishing preventive medical treatment systems may reduce medical payments. Fifthly, elderlyperson who applied for the long-termcare service should pay for their meals and room costs. This may prevent excessive payments by the long-termmedical treatment insurance. Only the poor people who receive livelihood expenses by the government need not pay for their meals in hospitals. Sixthly, for the financial stability, the retiring age should be extended. For this purpose, wage peak systems and job training systems for the elderly must be introduced. Seventhly, preventive measures against diseases of the elderly should be established. If one becomes sick, he will be a burden to his family and himself and medical costs will be increased. Therefore, we should establish a system of health support for the aged and support the aged who exercise through subsidies by the government. Eighthly, the present government tries to privatize the national health insurance. However, the privatization should be considered as a supplement for problematic fields of the public insurance sector. Private insurance should be made available along with national health insurance according to one's choice. In conclusion, the introduction of the long-time medical treatment insurance for the elderly is inevitable because of our progressing to an aging society. However, the financial maintenance of this system remains the core problem. For the prevention of moral hazards in the implementation of this system, we should establish various control systems.

저소득층 치매노인 가족의 부양부담과 서비스 욕구에 관한 연구

최연옥(Yeon Ok Choi) 대한노인정신의학회 2005 노인정신의학 Vol.9 No.2

The poverty families, who take care of the demented elderly, can suffer from the deficiency of social services for dementia and the condition and nature the families have. Therefore, This study examines the burden of the poverty caring for the demented elderly. This study focused on the three points : the level of care burden of the families, who take care of the demented elderly ; the needs of welfare services ; the differences of care burden and service demand on trait of the families and the demented elderly. In order to achieve them, the 250 families, who take care of the demented elderly at home, were sampled and the primary caregivers of family member interviewed. Then, the statistics of the 226 people were analyzed by SPSSWIN. The major findings of the study were as follows : First, the level of the care burden the families of the demented elderly have, participated in this research, is higher than ‘a little yes’. In a type of the care burden, the social & personal restriction is higher than the other types, including physical restriction, economical restriction, and reciprocal restriction. Second, some families had used service and had a low satisfaction, because of no various and adequate services. It shows that the services for the demented elderly and their families is not enough to use, that the services is not various for the families having many problem related the demented elderly. Third, there are many services needed by the families caring for the demented elderly : residential care facilities for the demented elderly ; day care service center ; short-term care services ; family counseling service ; services at home ; nursing services at home ; night care services ; family meeting. Fourth, the most difficult thing of caring is the economic burden of the families. The families are willing to take care of the demented elderly at home, if the government supports economically them and serves proper services to them. Finally, the lower income of the families is, the more time of caring the demented elderly in a day is, the lower vital functions of the demented elderly are, and the lower level of academic achievement, the higher level of care burden of the families is. According to the result, the level of the care burden can be affected by the family’s economic capacity, the vital function of the demented elderly, and the existence of service for the demented elderly. For the elderly welfare especially, the demented elderly and their poverty families, three opinions may be suggested. First, the service programs based on community should be developed to reduce the burdens-economic, psychological, medical burden, etc. - of the poverty families caring for the demented elderly. These programs may include preventive service, education programs of dementia, diagnosis services, family counseling, and medical service. Second, the national government and the local government must try to make policies to solve the temporary problems of the family having the demented elderly.

미국·일본 노인복지제도 경향을 통해 본 노인복지시설의 환경적 특성과 한국 노인요양시설에 대한 제언

윤소희(Yoon, So-Hee),김석태(Kim, Suk-Tae) 한국실내디자인학회 2014 한국실내디자인학회 학술대회논문집 Vol.2014 No.11

This aims to propose functions and characteristics of long-term elderly care insurance of long-term elderly care insurance and elderly facilities in Korea, by comparing elderly system and environmental characteristics of major countries that experienced aging society in order to understand the effect and ripple effect of elderly welfare system. The study was conducted in the following three steps, to compare elderly welfare system and facilities in major countries, regarding change of special structure of elderly care facilities following introduction of long-term elderly care insurance. First, for privacy and independence of elderlies, facilities will need to be built in a small unit and care rooms reduced to suit one or two users. This can lead to increase of the number of rooms as well as area of individual bedrooms. Also, introducing a group home system that combines unit spaces will emphasize the importance of individual elderly care. Second, local governments must make effort to support renovating and maintaining houses of elderlies and, when renovating elderly care facilities, make a long-term plan for systematic management. Third, integration of various facilities can be expected. As functions of care facilities develop, facilities can be combined or linked with other various facilities, which should take into account integration of medical institutions as well. Furthermore, hospice facilities should also be considered for such integration for patients who end their lives in the care facilities. Consequently specific standards and measures must be prepared according to characteristics of elderlies at facility, and, following revision of the long-term elderly care insurance law, many existing buildings are expanded, extended, repaired or renovated. Therefore, specific alternatives for standards need to be prepared regarding expansion, extension, repairing, and renovating of care facilities.