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Yoon, Moon, Kim, and Kim: Nutritional Assessment and Management in Long-term Care Insurance's Home Visit Care Service
Original Article
Korean Journal of Community Nutrition

Korean Journal of Community Nutrition 2013; 18(2): 142-153.

Published online: 30 April 2013

DOI: https://doi.org/10.5720/kjcn.2013.18.2.142

Nutritional Assessment and Management in Long-term Care Insurance's Home Visit Care Service

Mi-Ock Yoon, Hyun-Kyung Moon, Seo-Yeon Kim, Bok-Hee Kim1

Department of Food and Nutrition, Dankook University, Gyeonggi, Korea.

1Department of Food and Nutrition, Chosun University, Kwangju, Korea.

Corresponding author: Hyun-Kyung Moon, Department of Food and Nutrition, Dankook University, 152 Jukjeon-ro, Suji-gu, Yongin-si, Gyeonggi-do 448-701, Korea. Tel: (031) 8005-3173, Fax: (031) 8021-7200, moonhk52@dankook.ac.kr

Received 30 May 2012       Revised 31 January 2013       Accepted 27 March 2013

Copyright © 2013 The Korean Society of Community Nutrition

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from 5th to 21st of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

Keywords: Long-Term Care Insurance, nutritional status, assessment, nutrition management, In-Home Service, MNA (Mini Nutrition Assessment)

Figures and Tables

Table 1
General characteristics of the subjects
kjcn-18-142-i001

1) Level: Level 1 = Requires help in all aspects of daily life (score > 95, n = 9); Level 2 = Requires help in most parts of daily life (75 ≤ score < 95, n = 28); Level 3 = Requires help in part of daily life (55 ≤ score > 75, n = 166)

2) By chi-square tests

3) N (%)

4) BMI: Body Mass Index = body weight(kg)/height (m)2 (Underweight: BMI < 18.5, Normal: 18.5 ≤ BMI < 23.0, Overweight: 23.0 ≤ BMI < 25.0, Obesity: BMI ≥ 25.0)

Table 2
Disease types and number of elderly with the diet therapy of the subjects
kjcn-18-142-i002

1) Number of disease holder within number of elderly

2) Number of diet therapy within number of disease holder

3) p-values were derived by chi-square tests between prevalence of level 1+2 group and level 3group. but Both were not significant.

4) N (%)

5) Number of disease holder (people with more than one disease counted as one person) with diet therapy

Table 3
Age and anthropometry of the subjects by the long-term care level
kjcn-18-142-i003

1) p-values were calculated using the t-test comparing between the level 1+2 group and level 3 group

2) Mean ± SD

Table 4
Diet related variables of the subjects by the long-term care level
kjcn-18-142-i004

1) By chi-square tests

2) N (%)

Table 5
Comparison of MNA score of the subjects by the long-term care level
kjcn-18-142-i005

1) By t-test

2) Mean ± SD

Table 6
MNA assesment of the subjects by the long-term care level
kjcn-18-142-i006

1) By chi-square test

2) N (%)

MNA: Mini Nutritional Assessment

Table 7
Correlations between MNA score and Individual risk factors for malnutrition of the subjects by the long-term care level
kjcn-18-142-i007

1) by Pearson's correlation test: Age, BMI, MAC, CC, Intake problems, Weight loss during last 3 months; by Spearman's correlation test: Housemate, Disease types

2) Loss of appetite, digestive problems, chewing of swallowing difficulties

MNA: Mini Nutritional Assessment

BMI: Body Mass Index = body weight(kg)/height (m)2

MAC: Mid-arm circumference

CC: Calf-circumference

Notes

This research was supported by grant from Ministry of Health & Welfare (MW-2010-111-6011-00)

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