노년기 가족돌봄의 위기와 지원방안 연구

Family caregiving in an aging society: Evaluation of the current family support system and policy implications

Ⅰ. 연구개요 □ 연구의 배경 및 목적 ○ 압축적 고령화(compressed aging), 가족형태 및 돌봄에 대한 급격한 가치관변화 등을 경험하고 있는 한국에서는 노인돌봄이 주요한 사회ㆍ정책적 이슈로 대두되고 있음 ○ 한편, 과도한 돌봄부담으로 인해 가족돌봄자들이 요보호노인을 학대, 유기 및 살해하거나 자살하는 등 극단적인 선택을 하는 현상도 적지 않게 나타나고 있음. 돌봄과 간병의 부담은 가족에게 심각한 무기력을 초래하는 문제로 지적된 바 있으며 이는 극단적인 생계형 사건ㆍ사고의 핵심적인 원인이 되는 것으로 나타남(이현주외, 2013) ○ 그럼에도 불구하고 한국에서는 가족돌봄자를 직접적으로 지원하는 정책 및 서비스가 발달되지 않았고, 관련 논의도 중요한 사회ㆍ정책적 이슈로 부각되지 않고 있음 ○ 이에 본 연구는 노년기 가족원을 돌보는 가족구성원을 위한 정책의 방향성을 점검하고, 이들의 삶의 질을 향상시킬 수 있는 국내외 지원정책을 검토하여 효과적인 가족정책과제를 수립하는데 필요한 기초자료를 제공하고자 함 □ 주요 연구 방법 ○ 본 연구는 배우자 돌봄자의 돌봄부담 및 정책지원 욕구를 파악하기 위한 2차자료 분석과 국내외 가족돌봄자 지원 정책을 검토하여 정책적 시사점을 도출하였음. 이와 함께, 현재 가족돌봄자 지원 프로그램을 수행중인 현장전문가와 학계 전문가 자문회의를 통해 정책개선 방안을 모색하였음. 마지막 으로, 한ㆍ일 심포지엄 개최를 통해 양국 간 노인돌봄 및 가족돌봄자 지원방안에 대한 이슈를 논의하였음

Due to compressed aging and significant changes in both living arrangements and family values, elderly care has emerged as a crucial social and political issue in South Korea. In addition, caregiver demographics are diverse in terms of age, family relationship with the frail elderly, and labor force participation. Likewise, the number of cases of elder abuse and murder by family caregivers is steadily increasing due to the caregiving burden. The purpose of this study is to evaluate the family support systems currently in place for families, who comprise the major caregivers for the frail elderly in Korea, in terms of how effectively they support family caregivers. In this study, we analyzed the caregiving burden among female spousal caregivers (N=300), providers of a significant proportion of elderly caregiving, with respect to age, household composition, and health status. We then examined public policies and non-governmental programs supporting family caregivers in Korea, Germany, Japan, and the United States. The findings from this study are as follows: First of all, spousal caregivers experience a substantial caregiving burden, but have limited access to both public (e.g., national long-term care insurance) and non-governmental support systems (e.g., educational programs for caregivers). Secondly, although various support systems have been established for frail older adults, the service needs of caregiving families have not yet been explicitly recognized in Korea. In contrast, other countries that faced similar issues earlier than has Korea, such as Germany and the United States, have enacted laws and rulings that have increased support services for caregiving families, and non-governmental organizations in these countries provide evidence-based caregiver training programs. Such services include, but are not limited to, provision of information about available services, assistance to caregivers in gaining access to services, individual counseling, support groups, and caregiver training. As the South Korean population is rapidly aging and the number of elderly members of society with impairments is expected to grow significantly, family caregivers are at an increasing risk of degraded mental and physical health. Efforts should be made to develop more comprehensive caregiver service networks and provide adequate support programs. Policy recommendations are as follows: First of all, public policy should acknowledge the service needs of caregiving families and implement family caregiver support programs designed to alleviate their caregiving burden. Secondly, evidence-based caregiver training programs tailored to meet the varied needs of family caregivers in terms of resources, care intensity, phases of caregiving work, and labor force participation should be developed. Lastly, collaboration and coordination among formal and informal networks, public and private entities, and local and state systems should be promoted as a means to establish a comprehensive caregiver service network.