치매노인의 증가가 치매환자 본인뿐만 아니라 공식적·비공식적 돌봄제공자에게도 장기간 신체·정서·경제·일상생활에서의 어려움을 초래하고 국가재정에도 부담을 가중시키고 있다. 이에 본 보고서에서는 현행 치매관리정책이 치매노인과 공식적·비공식적 돌봄제공자의 욕구를 포괄하고 있는지 다각도에서 진단·점검하고, 이용자의 욕구를 충족시켜 줄 수 있는 중장기적인 정책방안을 모색하였다. 연구결과, 1) 치매노인에게 연속적이고 통합적인 사례관리와 일상생활지원, 2) 비공식적인 돌봄제공자에게 치매교육, 상담, 자조모임, 정보제공 등 복합적인 서비스 제공, 3) 공식적 돌봄제공자에게 전문적인 치매지식교육, 노동자로서의 권익 보호, 처우·인식 개선이 필요하다는 정책적 제언을 하였다.
Dementia torments the patients suffering from it and burdens their caregivers physically, emotionally, and economically. Eventually, the life of the entire family can be devastated by it. As Korean society has been aging rapidly, it is expected that the number of demented older adults will surge to be more than 3 million by 2050. Consequently, the burden of South Korea due to dementia will increase. Since the South Korean government declared war on dementia and announced ‘the First Comprehensive Dementia Management Plan’ in 2008, the policy for the patients with dementia has been expanded rapidly. Although the policies and services for the older adults with dementia have been improved greatly owing to the efforts of the South Korean government, there are still many parts to be supplemented in the future because new policies have been introduced and changed in a very short period of time. It is necessary to closely examine the current situation (e.g., whether the current dementia management program has been provided to demented older adults people and their caregivers without a blind area) to provide effective and customized dementia management program. It is also needed to closely diagnose and evaluate whether the current dementia management program has been provided in the customized fashion to resolve various difficulties and desires of demented older adults and their caregivers officially and unofficially. The objectives of this study were to closely examine the situations that the demented older adults and their diverse caregivers could experience in the progress of dementia, identify their difficulties and needs, and seek ways to provide appropriate tools satisfying their needs in each stage of dementia. In order to achieve these objectives, this study evaluated the dementia management policies (i.e., long-term care system, older adults care basic and integrated services, and national and local dementia center projects) for the early, intermediate, and terminal stages of dementia. Moreover, this study summarized the major dementia policies of other countries and international organizations (i.e., WHO and OECD). This study also analyzed the daily life, caring needs, and caring benefits according to the dementia status of the demented older adults and their psychological behavioral abnormalities. Additionally, this study examined the difficulties of dementia caregiving, care provision, and care demand of family members, caregivers, and institutional staffs, who officially and unofficially cared the demented older adults, and their relationship by the stages of dementia. This study aimed to identify new mid- and long-term tasks and suggest ways to improve the dementia management policy of South Korea so the policy can embrace all needs of users.
목차
Abstract 1 요 약 5 제1장 서론 11 제1절 연구의 배경 및 목적 13 제2절 연구의 분석틀 15 제3절 연구의 내용 및 방법 18 제2장 치매돌봄정책 분석 21 제1절 치매관리법과 치매관리종합계획 23 제2절 치매돌봄정책 개요 30 제3절 치매돌봄정책 분석 42 제4절 소결 55 제3장 치매돌봄정책 해외 사례 57 제1절 국제기구 59 제2절 영국 66 제3절 일본 69 제4절 소결 78 제4장 치매검진: 실태, 어려움, 정책적 요구 81 제1절 치매검진 실태 84 제2절 치매검진의 어려움과 정책적 요구 110 제3절 소결 116 제5장 치매 돌봄: 실태, 어려움, 정책적 요구 119 제1절 치매노인과 배우자의 돌봄 요구 및 돌봄 수혜 121 제2절 비공식적 돌봄제공자의 어려움과 정책적 요구 140 제3절 공식적 돌봄제공자의 어려움과 정책적 요구 162 제4절 소결 171 제6장 결론 및 정책적 제언 173 제1절 결론 175 제2절 정책적 제언 177 참고문헌 181 부 록 185