Section 1 Social Welfare and Elderly Welfare

1. Concept and Scope of Social Welfare

• National Basic Livelihood Security System : Minimum living security (maintenance) for

• Employment Insurance : Provides benefits necessary for living when a care worker is unemployed (unemployment benefits) as social insurance

• Basic Pension : Supports stable income base and living stability for seniors aged 65 and over

• National Health Insurance System : National disease and health promotion , health improvement

• Long-Term Care Insurance for the Elderly : Supports physical activities or household activities for those who have difficulty in daily life due to old age or geriatric diseases

• Aging society -> Aged society -> Super-aged society

• Super-aged society : 20% or more

Caution !! / Do not confuse “super-aged” and “ultra-aged”! Super-aged is correct!!

※ Exam Example ※

1. Aging society 2. Aged society 3. Aged society 4. Super-aged society 5. Ultra-aged society

2. Concept and Types of Elderly Welfare

▶ Principles of Elderly Welfare

• Principle of Independence - 1. Must have opportunities to work or earn income.

2. Must be able to live at home for as long as possible.

• Principle of Participation : Participation such as volunteer opportunities

• Principle of Self-Realization : Opportunities to develop potential

▶ Elderly Welfare Facilities

Elderly Residential Welfare Facilities
Nursing Home	Living for elderly residents
Elderly Group Home Family	Family-like residential conditions and meal provision
Elderly Welfare Housing	For sale or rent

Elderly Medical Welfare Facilities
Elderly Care Facility	Admission for geriatric diseases (10 or more people)
Elderly Care Group Home	9 or fewer people

Elderly Leisure Welfare Facilities
Elderly Welfare Center	Provides various information and services for seniors' cultural and hobby activities
Senior Center	Provides places for local seniors to autonomously engage in hobby activities and joint workshops
Elderly Classroom	Aims to provide healthy hobby activities and learning programs

Home-Based Elderly Welfare Facilities
Home Care	Targeted at seniors living at home
Home Bathing	Provides bathing through visits
Day/Night Care	Protection for a certain time period
Short-Term Care	Protection for a short period, certain period

Section 2 Long-Term Care Insurance System for the Elderly

1. Purpose of the System

Due to old age or geriatric diseases(dementia, stroke, Parkinson's disease, etc.), provides long-term care benefits such as physical activity or household activity support to seniors who have difficulty performing daily life independently to promote health and living stability in old age and reduce the burden on their families, thereby improving the quality of life of the people, which is the purpose of the system.

2. Insurer and Subscribers of the Project

• Insurer : National Health Insurance Corporation

• Subscribers : Citizens

• Supervised by the Minister of Health and Welfare

• Purpose : Support for household and physical activities of seniors who have difficulty in daily life. Health promotion and living stability

3. Recipients of Long-Term Care Benefits

● Recipients of long-term care insurance benefits for the elderly are 'those aged 65 and over' or 'those under 65 but with geriatric diseases (dementia, stroke, Parkinson's, Alzheimer's, etc.)' who have difficulty performing daily life independently for 6 months or more due to mobility issues or cognitive decline such as dementia. However, excluded if hospitalized

▶ Eligibility for long-term care insurance benefits for the elderly

- Tuberculosis making physical activity difficult for a 70-year-old man : Eligible for long-term care benefits

- Tuberculosis making physical activity difficult for a 60-year-old man : Not eligible for long-term care benefits

- Vascular dementia making physical activity difficult for a 40-year-old man : Eligible for long-term care benefits

- Seniors hospitalized are excluded from benefit recipients

4. Long-Term Care Recognition Application and Determination Procedure

A. Recognition Application

- Seniors aged 65 and over or those under 65 with geriatric diseases submit a long-term care recognition application form with a doctor's or Korean medicine doctor's opinion letter to the Corporation.

- The applicant, family or relatives or interested parties, social welfare dedicated public officials(consent of the applicant or family required), or persons designated by the mayor, county head, or district head can apply.

B. On-site Investigation

- Corporation employees who have completed prescribed training(social workers, nurses etc.) visit the applicant's residence to investigate items indicating physical and mental condition in the long-term care recognition survey.

C. Grade Determination

- The Corporation conducts a primary determination of the long-term care grade through a computer determination program based on survey results prepared according to the long-term care recognition survey form

- The Corporation submits the survey result report, doctor's opinion letter, etc. to the grade determination committee

- The Grade Determination Committee deliberates on the primary determination result according to grade determination standards prescribed by presidential decree and makes a final determination on long-term care recognition and long-term care grade.

D. Notification of Determination Result(Long-Term Care Insurance Act for the Elderly Article 17 Long-Term Care Recognition Certificate)

- Corporation : Provides the long-term care grade, types and contents of long-term care benefits contained in the long-term care recognition certificate and appropriate service contents, frequency, costs etc. contained in the individual long-term care utilization plan to the recipient or guardian and then educates on service utilization.

- Long-term care recognition validity period : Minimum 2 years or more.

▶ Long-Term Care Grades

Grade 1	95 points or more
Grade 2	75 points or more
Grade 3	60 points or more
Grade 4	51 points or more
Grade 5	45 points or more (dementia patients)
Cognitive Support Grade	Less than 45 points (dementia patients)

5. Contents of Long-Term Care Benefits

▶ Types of Home-Based Benefits

Benefit Type	Contents
Home Care	Long-term care workers visit the recipient's home etc. to support physical activities and household activities
Home Bathing	Long-term care workers use bathing equipment to visit the recipient's home etc. to provide bathing
Home Nursing	Nurses etc. who are long-term care workers provide nursing, medical assistance, consultation on care or oral hygiene etc. by visiting the recipient's home etc. according to the instructions of a doctor, Korean medicine doctor or dentist (hereinafter referred to as "home nursing instruction")
Day/Night Care	Protects the recipient in a long-term care institution for a certain period within the scope prescribed by the Minister of Health and Welfare ordinance and provides education and training etc. to support physical activities and maintain and improve mental and physical functions
Other Home-Based Benefits	Protects the recipient in a long-term care institution for a certain period within the scope prescribed by the Minister of Health and Welfare ordinance and provides education and training etc. to support physical activities and maintain and improve mental and physical functions
Other Home-Based Benefits	Provides tools necessary for the recipient's daily life, physical activity support and maintenance and improvement of cognitive functions or provides rehabilitation support etc. by visiting the home as long-term care benefits prescribed by presidential decree

1) Home-Based Benefits : Home care, home bathing, home nursing, day/night care, short-term care, other home-based benefits (welfare equipment)

•Advantages : Familiar environment, privacy respect, individual-centered life

•Disadvantages : Difficult to respond quickly to urgent situations

2) Facility Benefits : Receives services to support physical activities and maintain and improve mental and physical functions by being admitted to elderly care facilities, elderly care group homes etc. without living at home.

•Advantages : Comprehensive provision of medical, nursing, and care services

•Disadvantages : Difficult individual-centered life

3) Special Cash Benefits : Paid when home-based benefits and facility benefits cannot be received.

• Family Care Allowance : Cash benefits paid when substantial long-term care benefits equivalent to home care are received from family etc. due to regions where long-term care institutions are significantly lacking such as islands and remote areas, natural disasters, or reasons related to the recipient's physical, mental or personality characteristics.

5. Cost Claim and Payment of Long-Term Care Institutions

• Long-term care institutions claim long-term care benefit costs to the Corporation when providing home-based benefits or facility benefits to recipients.

• The Corporation reviews when claiming home-based benefit costs or facility benefit costs from long-term care institutions and pays the Corporation's share used for long-term care to the long-term care institutions in the current month (monthly).

6. Funding

Funding for operating the long-term care insurance system for the elderly : Composed of insurance premiums, national support, and partial individual contributions

A. Insurance Premiums

- The Corporation collects long-term care insurance premiums and health insurance premiums integrally, and after collection, long-term care insurance premiums and health insurance premiums are managed as separate accounts.

※ Integrated collection, separate accounts

B. National Support

- The state bears 20% of the expected premium revenue from the national treasury.

- The state and local governments bear the full amount of long-term care benefit costs for medical aid recipients, doctor's opinion letter issuance costs, home nursing instruction issuance costs among costs to be borne by the Corporation and management and operation costs.

◈ Funding

- Funding for operating the long-term care insurance system for the elderly : Composed of insurance premiums, national support, partial individual contributions

• Funding : Insurance premiums, national support ( 20% ) , individual contributions ( Facility benefits : 20% , Home-based benefits : 15% )

• Costs to be borne by the Corporation : Borne by the state and local governments

( Long-term care benefit costs for medical aid recipients, doctor's opinion letter issuance costs etc.)

• Local governments : Enact ordinances for improving treatment and status of care workers, protection from violence related to work etc.

C. Partial Individual Contributions:

- If benefit recipients use facility benefits, they bear 20%, and if they use home-based benefits, they bear 15%.

- Low-income groups, medical aid recipients etc. receive a reduction of 40~60% of the statutory individual contribution.

- National basic livelihood recipients have no individual contributions.

※ However, non-benefit items are fully borne by the individual.

7. Long-Term Care Service Utilization Support

▶ Documents sent by the National Health Insurance Corporation

• Long-Term Care Recognition Certificate : Long-term care grade, validity period, types and contents of available benefits

• Individual Long-Term Care Utilization Plan : Limit amount, individual contribution rate, benefit types and frequency, costs

Section 3 Care Work

1. Types and Contents of Care Work

• Physical Activity Support : Washing face, oral hygiene assistance, bathing, eating, toilet assistance

• Household and Daily Life : Personal activity support – Shopping, bank etc.

Daily Life Support - Cooking, cleaning, laundry

• Emotional Support and Communication : Life counseling, conversation partner, communication proxy (letters, phone)

• Cognitive Support : Cognitive stimulation activities

• Home Bathing : Home bathing ( 2 or more care workers )

2. Care Service Provision Principles and Compliance Matters

▶ Care Worker Service Provision Principles

- Respects the individual's life and must confirm the recipient's personality, habits, preferred services etc. from the recipient and family before starting service provision and does not engage in particularly disliked behaviors.

- Provides services while maximizing the recipient's abilities so that the recipient can achieve independent living as much as possible.

- After sufficiently explaining to the recipient before providing services, provides services if the recipient consents. However, if the recipient lacks cognitive ability such as dementia, obtains consent from the guardian.

- Must not disclose the recipient's personal information and secrets learned during service provision, must protect the recipient's privacy and guarantee free expression of opinions.

- Must provide services while observing the recipient's condition and must not provide services mechanically regardless of the recipient's condition or force the recipient to receive services.

- All services of care workers are provided only to recipients(Service contents: Physical activity support services, personal activity support services, emotional support services, home bathing services)

- If additional or changes to services beyond the planned services are needed due to changes in the recipient's condition etc. or if medical diagnosis etc. is deemed necessary, reports promptly to the facility director or management supervisor.

- If opinions conflict with the recipient or the recipient's family, avoids unnecessary friction and reports to the facility director or management supervisor.

- If unexpected accidents occur during service provision, must report promptly to the affiliated facility director, nurse etc..

ex) Falling and getting injured while assisting with walking, burns due to failure to control bath water temperature etc.

- Does not perform any medical acts including suction, nasogastric tube insertion, enema, catheterization, pressure ulcer management, medication (excluding oral and topical medications).

- If an emergency situation occurs to the recipient during service provision, performs emergency treatment according to emergency treatment priority and if emergency treatment cannot be performed or the situation does not allow reporting to a doctor, transfers the recipient to the nearest medical institution.

- Handles various unexpected situations that occur when providing services to dementia recipients after consulting with the facility director or management supervisor.

- Can perform emergency treatment according to priority in emergency situations -> Medical acts not allowed

- Acts possible for care workers : Oral medications (taken medications), topical medications (applied or sprayed medications)

▶ Prohibited Acts for Care Workers

• Elderly abuse

• Exemption and reduction of individual contributions

• Disclosure of secrets etc. Common sense prohibited acts

3. Role of Care Workers

1) Skilled Caregiver : Supports necessary services with knowledge and skills for skilled care services to alleviate the recipient's discomfort and helps the recipient.

2) Information Transmitter: Transmits information about the recipient's physical and psychological condition to family, facility director or management supervisor, nurse, medical staff at medical institutions and if necessary, transmits their instructions to the recipient and their family.

3) Observer : Observes changes in pulse, respiration, body temperature, blood pressure etc. and medication status, disease changes as well as psychological changes. That is, understands and observes the recipient's condition, medication intake etc.

4) Conversation Partner and Counselor : Uses efficient communication techniques to form relationships with recipients and provides necessary services to promote the recipient's physical, mental, and psychological well-being.

5) Motivator : Does not stop at providing physical activity support services or daily life support services but motivates and supports the recipient to demonstrate their abilities.

6) Advocate : Advocates and protects recipients who are abused, alienated, or discriminated against in homes, facilities, or communities from the recipient's perspective..

ex) Reporting suspected abuse, reporting sexual harassment to institution director

Elderly Welfare and Long-Term Care System Past Exam Questions

Chapter 2 Elderly Welfare and Long-Term Care System