Dr. Zofia Szweda-Lewandowska of the Warsaw School of Economics discusses the situation of the elderly and their caregivers in Poland.
Congestive heart failure (CHF) is the fi nal stage in several heart diseases. The diagnosis of CHF in older patients is a challenge. Preserved left ventricular systolic function is a characteristic type of CHF in seniors. The purpose of the study was to characterize elderly patients with CHF and to highlight specific features of the conditions in seniors. The most common etiology of HF in this group of patients is hypertension and coronary heart disease. In seniors atypical presentations of chronic heart failure is much more common than in younger patients. Malnutrition, limitations of exercise and sedentary lifestyles or comorbid diseases have an influence on asymptomatic, early stage of HF. Th ere are better outcomes of treatment in obese individuals. It is called the obesity paradox. Open communication with a patient and his/her family may improve their response to therapy. When heart failure becomes an incurable disease and aggressive treatment is ineffective, palliative care should be considered in end-of-life heart failure patients. The goal of treatment in the remaining moments of life last moments of life should be maximizing the patient’s comfort.
The authoress wishes to discuss the idea of engaging senior citizens into the maintenance and care of historical park and garden complexes. The article illustrates the possible mutual benefits of the cooperation between the caretakers of these complexes and organized groups of senior citizens, who whose participation would be based on a form of voluntary help, through a foundation, or based on monetary compensation. Such a cooperation could lead to an improvement of the condition of historical gardens, in addition to providing beneficial effects to the physical and mental he alth of older people.