Senior Employment and Community-based Integrated Care System​

South Korea is projected to enter a super-aged society by 2026, with one out of every five individuals aged 65 or above (KOSIS, 2019). Globally, the ageing process is progressing rapidly, accompanied by an increase in the elderly population and extended life expectancy, which are projected to lead to a significant surge in demand for caregiving services. In response, the government and various organizations have implemented diverse policies to support senior caregiving, and have established a social infrastructure for “care”. One option to prepare for the anticipated increase in demand for caregiving services is through community care. Also known as integrated community caregiving, community care aims to transform a hospital-centric caregiving system into a community-based service model, expanding the choices available to service recipients. It focuses on assisting residents in need, such as older individuals and those with disabilities. With South Korea on the brink of a super-aged society by 2026, efforts are under way to establish a community-centered caregiving system for the older population.

Among the older population, a particularly vulnerable group is those living alone. Older individuals living alone within the community often face socio-economic disadvantages and health challenges. The Korean Statistical Information Service reveals that three out of four older individuals lack financial provision for retirement, with 62% living below the poverty line. Furthermore, their isolation places them at risk of social marginalization, devoid of contact with family members and lacking the support of siblings or children. 96% of older individuals living alone have multiple chronic conditions, the absence of family assistance for health management exacerbating their plight (KOSIS, 2019). Addressing these critical concerns, Jeonju City has launched the “Integrated Care Supports, Health Keeper” project, leveraging retrained retired workers as caregiving professionals to efficiently support and enhance the safety and health management of older households.

In 2020, Jeonju City launched the Integrated Care Supporters Program, utilizing retired senior workforce to fill a gap in the integrated care business. With the additional aim of improving the welfare of older persons through income preservation, Jeonju City annually selects older citizens who can act as healthcare advocates for older persons living alone in the community, appointing them as "health keepers". Recruitment is conducted by the Jeonju Medical Welfare Social Cooperative. There are three stages of evaluation: physical fitness measurement, functional assessment, and face-to-face interview. The selected applicants work as health guardians in groups of two. They are usually 60 years or older, and mainly retired professionals such as nurses and welfare workers.

In 2023, the recruitment of Health Keepers showed a competition ratio of 9:1, following a ratio of 2:1 in 2022. A total of 131 Health Keepers have received theoretical and practical training and are currently providing care services to approximately 500 beneficiaries. Alongside the theoretical and practical training, they also undergo soft skill training to emphasize the significance of caregiving and kindness and promote the attitudes expected of Health Keepers, enhancing their pride as dedicated professional personnel.

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Older citizen experiencing VR cognitive enhancement program (Source: Jeonju City Hall)

The specific roles of Health Keepers and the impact of their work can be observed through case studies. For instance, Health Keeper A noticed that the body of one of her beneficiaries was leaning to the right. She immediately contacted the hospital in charge of the integrated care safety net and was advised that this symptom could be a precursor to a stroke. By promptly communicating with the integrated care center, Health Keeper A was able to take proper action to avert an emergency. In the case of Health Keeper B, a sudden behavior change in an older care recipient was observed, and appropriate action was taken. Subsequently, the recipient was diagnosed with dementia and prescribed regular medication, as well as assigned to cognitive rehabilitation programs (Jeonju City Hall, 2022). These cases demonstrate how integrated care supporters, specifically the Health Keepers, can contribute effectively to creating a high-quality healthcare safety net in the community.  

In 2022, Jeonju City conducted a satisfaction survey for the Integrated Care Supporter Program. The survey results showed that over 97.3% of respondents expressed a high level of satisfaction, with many stating they were “extremely satisfied”. Particularly, 92% of the respondents indicated that they received significant assistance in terms of both physical and emotional well-being. The Health Keepers themselves also showed high satisfaction levels in various areas, including self-satisfaction with their work and financial support. Based on these positive responses, Jeonju’s Integrated Care Supporters program is being rolled out nationwide to expand social engagement opportunities for older persons and promote integrational connections within the community (Jeonju City Hall, 2022).

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2022 Integrated Care Supporters Program Satisfaction Analysis Results (Source: Jeonju City Hall)

Jeonju’s Integrated Care program plays a crucial role in promoting the rights of older persons. Through regular home visits, it ensures the safety and health of older individuals while providing care services, thereby contributing to older people’s ability to lead dignified lives. Additionally, this program strengthens the connections among community members. By facilitating communication and interaction between older beneficiaries and Health Keepers, it fosters social networks and creates an inclusive environment where older individuals are embraced as part of society. Furthermore, the program is significant for pursuing the value of mutual growth. It provides opportunities for local authorities to expand their capabilities by utilizing the knowledge and experience of a healthy retired workforce in programs such as “Older Person Care by Older Person”. Therefore, Jeonju’s Integrated Care program can be seen as a best practice that supports the sustainable enhancement of the rights of older persons in various aspects, including the right to health, housing, social participation, and economic well-being.

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Haeri Kang (haerikang@asemgac.org)