Current Conditions and Worker Attitudes in End-of-Life Care for the Elderly in Korea

Abstract

Korea has led the way within Asia with its pioneering nursing insurance system. This study examines the current state of end-of-life for the elderly, along with future trends, based on surveys and interviews of managers and employees of institutions related to nursing and nursing insurance. Korea is seeing a gradual increase in its latter stage elderly population. It naturally follows that this puts pressure on dealing with end-of-life care, and this study revealed concern that the environment cannot keep pace with the concurrent increase in medical needs. Korea's system restricts end-of-life to hospital facilities, so facility staff lack experience and certain kinds of awareness. Workers' own attitudes toward life and death, as well as those toward caring for the sick, influence the quality of end-of-life care. It was found that these attitudes are significantly influenced by religious beliefs and work experience. Social workers had longer experience in caring for the infirm and a stronger tendency to be cognizant of which focuses on a patient's family. Results indicated that in the future, it will be necessary to consider how workers can best think about and approach end-of-life as a team. workers due to the rapidly ageing society; an increase in elderly people living alone resulting from factors such as the rise of nuclear families and increased social progress for women; and, a sharp rise in medical costs and the need for long term associated with an increase in chronic illnesses all became problems.(2) These led to the introduction of a system of long-term insurance for the elderly (hereafter referred to as care insurance) in July, 2008. There are a number of similarities between Japan and Korea in terms of the progression of their ageing societies and the decreases in the population of children. So, Korea's insurance was created with reference to Japan's nursing insurance system. The two countries have many issues in common, as they share a system of values based on Confucian culture and have accordingly developed which focuses on families. Fifteen years have passed since the introduction of insurance in Japan. In that time, the rapid increase in the later-stage elderly population and in the severity of related problems has continued, leading to the new issue of how to make changes in approaches to end-of-life care. A paper on terminal for the elderly in Korea was introduced during a seminar held on the Comparative Study in Ideal Terminal Care and Death by the International Longevity Center Japan.(3) However, this did not include any material related to current conditions or attitudes of staff in terminal facilities for the elderly. Korea is also exploring for solutions to prepare for its impending super-aging society. There is a need to shed light on current conditions and staff attitudes toward end-of-life in elderly facilities. With Korea having been the first in East Asia to introduce insurance, it is possible to think of Korea and Japan as having a common perspective on these issues. This study seeks to foster mutual understanding by examining issues the two countries have in common.