[Shadow of Care Work] "Inadequate Training and Dementia Misunderstanding"... Unqualified Care Workers Leave Elderly Bruised

②Inadequate Expertise of Care Workers Threatens Elderly Safety
Lack of Practical Training Raises Doubts About Professionalism
Verbal and Physical Abuse Controversies in Elderly Care Process

Since entering an aging society, the demand for care workers has surged, prompting the nursing care industry and the government to put their utmost effort into securing personnel. The government estimates that approximately 750,000 care workers will be needed by 2027, which is about 10% (around 75,000) short compared to last year's supply of personnel.

The government has sought solutions by setting lower qualification requirements than overseas. However, due to sloppy personnel management and education systems focused only on filling quotas, care workers lacking professionalism are entering the field, raising concerns about the safety of the elderly.

Lack of Practical Training Hours... Leading to Insufficient Professionalism

According to statistics from the National Health Insurance Service, the number of care workers actively working in the field at the beginning of last year was 609,221. Compared to 361,568 workers in 2017, this represents a 1.7-fold increase over five years.

However, the nursing care industry is skeptical whether all the care workers who have entered the field in large numbers over recent years possess sufficient professionalism. The government stipulates that applicants for the care worker certification must complete a standard education course of 320 hours, of which only 80 hours are practical training.

This is far below the qualification requirements of major foreign countries. Japan and Germany require care workers to complete 1,800 hours and 2,100 hours of specialized education, respectively.

Due to the short practical training hours, care workers are deployed with insufficient understanding of the field. This sometimes leads to situations where, during care for dementia patients, unexpected incidents cause psychological shock, resulting in physical abuse or verbal assault on the elderly. A lack of understanding of elderly diseases leads to abuse.

According to statistics on elder abuse from the Ministry of Health and Welfare, among the elder abuse victims recorded in 2022, 1,767 were suspected or diagnosed with dementia, accounting for 26% of all abuse cases (6,807 cases).

Kwon Tae-yeop, president of the Korea Senior Welfare Association, stated, "Dementia patients often exhibit worsened symptoms after sunset or display stubbornness beyond imagination," adding, "Care workers who have not received training on how to handle dementia patients sometimes cry in shock or react angrily and hit or flee when faced with inappropriate behavior from dementia patients, which frequently occurs in the field."

It is also pointed out as a problem that care worker training institutions are issuing certifications without proper education. In 2022, two care worker training centers located in Gyeongnam were criminally charged for forging attendance signatures and informing students that they could complete the course without attending classes.

The Ministry of Health and Welfare recognized the controversy over forged attendance records and false attendance at care worker training facilities and conducted joint inspections of eight cities and provinces and 17 training institutions in the first half of last year. As a result, two institutions had their designations canceled, and one received a warning. Starting this year, an electronic attendance system will be introduced at all training facilities to prevent such incidents.

Sloppy Personnel Allocation... One Care Worker Caring for Over Ten Elderly

Along with the lack of professionalism, the lax personnel allocation system is also identified as a major cause of elder abuse. Since a small number of workers care for dozens of elderly people, burnout among care workers intensifies, leading to neglect or abuse of the elderly.

Care workers on the ground have complained that it is common to care for more than ten elderly people alone during night shifts. According to the current Elderly Welfare Act, nursing facilities must assign one care worker per 2.3 residents. However, this refers to the overall ratio of residents to care workers, not the standard for constant care personnel, so when colleagues take leave or only a few workers are assigned during night shifts, the workload increases.

[Image source=Yonhap News]

Lee (54), a care worker who has been working at a senior nursing facility in Seoul for three years, said, "Because of the three-shift system, there were nights when I worked alone and cared for elderly people in six rooms simultaneously," adding, "When changing diapers, it is difficult to monitor what is happening in other rooms, and if a fall accident occurs during this time, guardians report it as neglect and abuse."

Burnout caused by physical fatigue can lead to emotional and physical abuse of the elderly. A survey by the Korea Institute for Health and Social Affairs of 1,432 care workers on the causes of elder abuse in facilities found that 14.2% cited personnel shortages and difficulties in personnel allocation as causes. Stress was also identified as a cause of abuse by 8.4% of respondents.

President Kwon pointed out, "In the long term, the personnel allocation standard should be adjusted to a 2:1 ratio," emphasizing, "Because there are not enough people, the quality of service inevitably declines, and neglect and abuse due to abandonment actually occur because of personnel shortages."