The population of South Korea is about 48 million without ethnic diversity, and the proportion of people aged 65 and over was 8.3% in 2003. This figure will double within 20 years to 15.1% in 2020. Demographic transition of the exponential rise in the ‘old-old’ population alerts Korean recognize the need for special care-provision for the elderly.
At the year of 2050, projected number of Korean elderly with dementia will reach 2 million, though it is just 0.3 million in 2003. A total of 788,000 persons, equivalent to 21% of Korean elderly need long-term care in 2001. At least 78,000 elderly needs institutional care. Number of dementia patients with disturbed instrumental activities of daily living was 186,000, who will seek institutional care sooner or later. Thanks to community mental health movement in public and private sector of psychiatry, psychogeriatric services have begun to develop rapidly since early 1990s. In 2002, there were 989 mental health related facilities in Korea, including 46 community mental health centers, 66 social rehabilitation facilities, 74 mental hospitals, 207 general hospitals with psychiatric outpatients, 541 psychiatric clinics and 55 nursing homes.
Home and institutional care programs are given for long-term care. Home help service and delivered meals, adult day care, short stay, respite care, and visiting nursing program have helped the elderly with disability. For institutional care, special units of dementia and stroke in nursing homes or dementia care hospital have been constructed all over the Korea.
There are several problems. At first, medical, psychiatric and social welfare services are separated, so as not to provide simultaneously. It originated from artificial distinction between ‘treatment’ and ‘care’. Secondly, subacute care facilities are too scanty. There exist only acute care and chronic care facilities. Differentiation of function in facilities is necessary, for example ‘hostel’ for mild cases and ‘nursing home’ for severe cases. Thirdly, public care facilities are too few (less than 10%). Most of them are private, leading to frequent conflict between consumers, government and suppliers. Fourthly, the elderly care facilities are deficient and not specialized. Even unauthorized freestanding care facilities take role as institutions. Fifthly, government does not go much further from ‘Family support first, public support next’ policy. However, Korean government has increased the expenditure for the elderly medical care and social welfare, though not sufficient. It is actively considering adoption of Long-term Care Insurance System that have adopted in Germany and Japan. National pension benefit is eligible for all the elderly in 2003, which will improve quality of life for Korean elderly.
Korea is rapidly aging, but is not being prepared for upcoming tide of ageing. Both the number and the proportion of the elderly with mental disorder will increase substantially. Therefore, health policies to meet the unmet needs of the elderly Korean population are urgently needed.
Back to S062 Challenges in the Delivery of Psychogeriatric Services
Back to The Eleventh International Congress