In 2025, South Korea entered a super-aged society. The number that caught the attention of the reporting team was '53.9%'. Among registered persons with disabilities in South Korea, 53.9% are aged 65 and older. This shows that aging and disability are not unrelated. The reporting team analyzed health statistics of the elderly population and met with persons with disabilities, caregivers, and medical staff to amplify their voices. The lives of elderly persons with disabilities serve as a signal urging a bold transition in our society's healthcare and welfare paradigm. [Editor’s note]
“Grandma, do you make sure to eat every meal? Do you have any discomfort walking when you go to the hospital?”
On February 4th, an unprecedented heavy snow caused snow to pile up in a certain apartment in Suwan-dong, Gwangsan-gu, Gwangju. Jeong Geun-young, head of the customized welfare team at the Suwan-dong administrative welfare center (social worker), took out a piece of paper and a pen from her pocket to check the care situation of 90-year-old Choi Soon-hee (pseudonym).
The paper was filled with 15 items related to care services: temporary housing, home visit bathing, meal support, oral education visits, escort support, home visiting nursing, personalized exercise visits, AI check-in calls, deep cleaning, pest control.
Choi decided to receive temporary housing, escort support, and meal support (side dish service) from these service items. It is said that a neighbor living in the same apartment was worried about Choi's situation and requested care from the administrative welfare center.
Gwangju City launched the 'Gwangju Integrated Care' service in April 2023. Anyone can request help with a single phone call, whether they are a family member or a neighbor, through the 'Care Call (1660-2642)', and civil servants will first assess whether care is needed through 'mandatory visits'. The aim is to provide universal care that overcomes the limitations of the 'application principle' and 'selective principle' of the Korean welfare system.
The annual support limit per person is 1.5 million won. An additional support of up to 1.5 million won is possible in emergency situations. Support is fully provided to those with a median income of 90% or below, and those above 90% are responsible for all expenses.
To ensure implementation, Gwangju City restructured the city-district organization to establish a 'dedicated department' (with 44 personnel) and designated 336 care managers in 96 districts. Additionally, 59 private care service agencies (840 personnel) were selected. An 'information system' that assists the collaboration process between the administration and private sectors was also opened on July 1st of last year.
South Korea, unfriendly to an aging society, view in interactive content
Desperate elderly rescue cases abound
The public officials met that day noted, “We frequently encounter elderly people in situations beyond imagination.”
There are cases like an elderly person who cannot even go to the bathroom due to back pain and urinates in bed out of shame for asking for help, and an 80-year-old elderly person who lived buried under a pile of trash while eating rotten food. In most of these cases, neighbors discover them by submitting complaints to the administrative welfare center through the care call.
The head of the team said, “One grandfather, who had cut ties with his children, was living while eating expired food without knowing he had dementia, but after a long persuasion from public officials, he began treatment at the hospital, which remains the most memorable case.”
Gwangju City supported 8,595 people out of 10,639 cases received over the past year (from Jan. 1, 2024, to Dec. 31, 2024). Among the support recipients, the elderly made up an overwhelming proportion (82.2%). Additionally, the proportion of single-person households was the highest at 73.5%, followed by two-person households at 21.9% and three-person households at 4.6%.
Biggest hit item is side dish delivery
Kim Jae-seok (pseudonym, 70), who suffers from lower limb disability, finds it difficult to move freely even within his house, spending most of his day sitting in the living room. It is even burdensome to go to the kitchen, so he solves his meals by placing bowls and cooking utensils on the floor. He even has to keep the front door open because he struggles to lock it.
Mr. Kim received a helping hand through the 'integrated care' mandatory visit service. As meal assistance was the most urgent, he began by receiving meal support (side dish service). The visiting public officials, upon seeing that the bathroom light was off, immediately facilitated a repair service.
What is the most challenging aspect for elderly or disabled individuals with mobility difficulties? Surprisingly, it is said to be the task of eating three meals a day. Among the integrated care services in Gwangju, side dish service is one of the most popular items.
Earlier, Choi from Suwan-dong also stated, “With discomfort in my back and legs, it takes over 20 minutes to get to the market,” and chose the side dish service first. At that time, the head of the team explained, “In Suwan-dong, side dishes are delivered to the front door twice a week on Tuesdays and Fridays.”
Public officials swamped by surging care demand
Kim Kyung-myeong, head of the Gwangju care policy team, was holding a Jeju mandarin box and an integrated care calendar. He noted it was a small gift for the administrative welfare center public officials.
He remarked, “Gwangju has five districts, including Gwangsan-gu, Buk-gu, Seo-gu, Nam-gu, and Dong-gu, and if the public officials in each district welfare center had not cooperated, integrated care would not have succeeded,” adding, “I always feel grateful to the public officials of the Dong administrative welfare center who navigate the field.”
Due to the explosive surge in demand for care, public officials at the administrative welfare center have become overwhelmingly busy. As the number of citizens seeking services increases, there are many cases where one person visits households instead of the original two-person team.
Public officials were also managing to fit care specialization training schedules into their busy agendas. At the city level, activities are conducted monthly to enhance the expertise of social workers, nurses, and care public officials at administrative welfare centers.
The head of the team explained, “Since public officials directly visit homes to assess the care situation and provide services, we are conducting regular training.”
Gwangju City also holds an annual awards ceremony for excellent integrated care case competitions in collaboration with the Korean Health and Welfare Human Resources Institute and the Gwangju Social Services Foundation. The aim is to discover and disseminate integrated care cases to encourage public officials and enhance field execution capacity.
Kim Gi-suk, assistant deputy director, stated, “Vivid care cases serve as a guide for policy implementation,” adding, “They also have a promotional effect in informing citizens about policies.”
100 billion won annual budget and personnel投入...“Need for consultation with the main departments”
Gwangju City is creating a wave of 'integrated care' through bold attempts and investments. The passage of the Integrated Care Act (concerning the integrated support of local care, including medical care and nursing) in February last year acted as a catalyst, leading local governments nationwide to visit Gwangju City for reference in regional care policies.
The problem lies in the enormous budget and personnel input. About 1,000 personnel (380 from administration, 837 from private sector) have been投入 in Gwangju's care services. This year, the types of care services have increased to 26 (13 from the seven major areas of Gwangju + care, and 13 specialized by local government), with an average of over 70 complaints received per day.
Gwangju City’s greatest concern is ensuring continuous budget allocation due to the rapid increase in demand for care. In the first year of integrated care in 2023, Gwangju City allocated a budget of 10.2 billion won, increasing to 10.7 billion won the following year. As care demand increases, the needed budget is expected to rise significantly.
The head of the team mentioned, “Gwangju City spends about 10 billion won annually on care services, and for this to be sustainable in the future, cooperation from the relevant ministries, including the Ministry of Strategy and Finance, the Ministry of the Interior and Safety, and the Ministry of Health and Welfare, is essential,” adding, “The roles of managing and training social workers, nurses, and others should also fall under the responsibilities of the relevant ministries.”
South Korea, unfriendly to an aging society, view in interactive content