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Poles belong to societies that are aging faster and faster. This is, on the one hand, the result of the constantly decreasing number of births, and on the other - the achievements of medicine, thanks to which we live longer and longer. It is predicted that in 2035 a quarter of Poles will be over 65. We talk to Dr. Aleksandra Słabik-Ledóchowska, deputy director for treatment at the Independent Public Clinical Hospital. Witold Orłowski in Warsaw.
PolSenior research from 2011 clearly showed that both the he alth and material condition of Polish seniors is not good. The problem of aging populations affects all countries. Demographic analyzes are the basis for the development of geriatric care. It happens very slowly in Poland. Why? Do we not understand the needs of this group of people and believe that we will always be young? We discuss the problems of seniors with Aleksandra Słabik-Ledóchowska, MD, PhD, deputy director for treatment at the Independent Public Clinical Hospital. Witold Orłowski in Warsaw.
- There is a shortage of paediatricians in our country, but no one denies that they are needed. There are actually no geriatricians. Maybe they are redundant?
DR N. MED. ALEKSANDRA SŁABIK-LEDÓCHOWSKA: Aging is a normal, long-lasting and irreversible physiological process. Geriatrics deals with the physiological and pathological aspects of human aging and the clinical problems of the elderly. There are more and more seniors in Poland, but geriatricians and geriatric beds can be counted on their fingers. Currently, 6.5 million people in Poland are over 60 years old, which is 17 percent. population. Eurostat data show that in 2022 there will already be 9.5 million people over 60. And one more information from my backyard: last year, as much as 65 percent in our hospital. medical benefits concerned people over 60 years of age. A similar tendency is in other hospitals. Old and sick people are admitted to internal medicine departments, as there are only a few geriatric departments. And you have to remember that a senior, like a small child, requires specialist care.
- Statistics show that we have nothing to brag about compared to Europe.
A.S-L .: In terms of geriatric care, we are ranked first in Europethe end. Index of the number of geriatricians per 10 thousand. people over 65 years of age in Poland is 0.2, while in the Czech Republic - 1, in Belgium - 1.5, in Great Britain - 3.1, and in Sweden - 4.6.
In Poland we have just over 200 geriatricians, but only half practice in their speci alty.
In other words, we have just over 200 geriatricians, but only half of them practice in their speci alty. There are only 37 inpatient geriatric wards in the country with 782 beds. There are no rehabilitation departments, and rehabilitation undertaken early enough may extend the period of a senior's independence and postpone the moment when help and care will be needed. In our country, geriatricians are replaced by specialists in family medicine or internal medicine. In district clinics, the care of primary care physicians (POZ) does not always work for seniors, because, as I have already mentioned, these people require multi-profile care. He does not criticize his colleagues from POZ, they are overloaded with an excess of administrative duties, in addition, they have limited competences, they cannot commission diagnostic or, more importantly, preventive tests that seniors need. The PolSenior survey published in 2011 shows that 43 percent. Poles over 65 suffer from at least 3 diseases from various groups of diseases, e.g. hypertension, diabetes and arthrosis.
A.S-L .: Indeed, seniors suffer from many diseases, which in medical statistics are called multiple diseases.
Medical care for seniors is expensive because it requires many specialist consultations, sometimes tests, but above all an interdisciplinary approach to the patient.
They visit many specialists and receive prescriptions for medications. Not always at the next doctor, they will tell you about a visit to the previous one and received medications. It is rare for us to deal with a person who only has diabetes or high blood pressure. Our pupils also have many unrecognized diseases. We admit a patient with pneumonia, and it turns out that we still need to treat diabetes, bedsores - ailments that had not been thought of before. This further complicates the he alth situation of these people, but also our work. And to put it bluntly - it makes medical care for seniors expensive, requires many specialist consultations, sometimes research, but above all an interdisciplinary approach to the patient.
- But even if we could afford hospital facilitiestreatment, it will not solve the problem.
A.S-L .: Of course, staying in a hospital ward is not everything. After leaving the hospital, many seniors also need care at home because they are dependent or disabled. There is no properly organized network of diverse facilities operating in the place of residence that would provide such care. You cannot always count on family and children. It is common to bring old parents to the hospital before long weekends, holidays or vacations. It is not uncommon that, after hospitalization, the patient has nowhere to return, because the family does not want to pick up the patient from the hospital, and people wait for many months to find a place in a nursing home. Creating full-profile geriatric care is not easy. It requires knowledge, commitment, money and good intentions.
- Where should I start?
A.S-L .: Many seniors attribute their ailments to the aging of the body and simply do not heal themselves. Others wait in long lines to see specialists, wasting their nerves and time. An ideal solution would be a geriatrician who comprehensively deals with the he alth of the senior. He has knowledge of internal medicine, neurology, diabetology, cardiology, psychiatry, knows the specificity of diseases in old age, and these may be slightly different than in younger people. He can remedy not only he alth problems, but also mental ones. He will listen patiently and will not underestimate, for example, concerns related to retirement.
- Does the Polish senior citizen have a chance to improve medical care?
A.S-L .: I hope the situation will improve. In our hospital, we are already working on transforming a part of the internal medicine ward into a geriatric ward. In addition, which is not mentioned too often, a wave of training courses in the field of geriatrics has started all over Poland. Since 2012, the Department of Nurses and Midwives of the Ministry of He alth, in partnership with the Medical Center of Postgraduate Education, has been implementing a system project called "Support for the system of continuing education of medical personnel in the field of geriatric care". The project is co-financed by the European Social Fund under the Human Capital Operational Program. I hope that the ministerial project of training 2,000 primary care physicians, 2,000 Nurses, a thousand physiotherapists and 200 medical caregivers and environmental therapists in the field of geriatric care will improve the situation of elderly people.
ImportantPolish Autumn of Life
Here are some data collected in 2011 in the PolSenior survey.
- Almost 30 percent the subjects have constant symptoms of depression thatis not diagnosed or treated.
- Almost every third seniors suffer from cataract, every 14th and every 50th suffer from glaucoma diagnosed with macular degeneration (AMD).
- Every third person over 65 hears worse.
- 28 percent seniors have mild to moderate dementia.
- Almost every twentieth person has significantly impaired cognitive functions, which make it impossible to function independently.
- Almost a quarter of respondents experienced a fall in the last year. Every second senior woman who falls over suffers many injuries - from minor contusions, fracture limbs, to fracture of the neck of the femur.
- Over 75 percent seniors suffer from hypertension.
- Nearly 45 percent older people have diabetes.
- Every fifth senior living alone, despite 93 percent. has living children. Only 8 percent. of respondents live with a son or daughter, and less than one in 100 with grandchildren.
- 60 percent of seniors claim that they do not need systematic care from their family or other people.
- Only 17 percent respondents do not have to save, others live very frugally - they buy the cheapest food and do not buy new clothes.