Returning the farmer with cardiac disease to work

Abstract

Farming as an occupation still requires much physical work although today the drudgery is neither necessary nor remunerative. The requirement of hard work acts as a selecting factor, discouraging the unfit from entering the vocation. The activity of farming appears to have a prophylactic effect on the manifestation of coronary heart disease. However, the nature of the farm business makes the impairment of the farmer in the acute stages of heart disease a serious threat not only to the man but also to the future of the business. The farmer commonly owns all or part of his farm; he has many alternatives which permit him to live usefully with his heart disease. These alternatives range from changing work methods, the size of business being unaltered, through obtaining more labor to retiring. The complexity of the alternatives makes decision-making difficult. However, once the acute stages of the disease are overcome, the farmer may obtain help in planning his farm from the agricultural extension service; there are also sources of credit which can provide capital for mechanization to aid in overcoming the physical impairment. The physician has a real opportunity in rehabilitation of this highly motivated group of patients. Apart from his medical skills, the physician's success will depend upon some understanding of the stresses of farm work and means for their reduction. The instructions to the farmer in the area of work must be specific. Compliance will often be better if the family is well informed. Acceptance by the community of the fact that most farmers with cardiac disease are able to work within limits is essential to satisfactory rehabilitation. Most people consider the physician as the main source of information in this area. Therefore, community education on health and disease is another responsibility of the physician trying to rehabilitate cardiac patients who are farmers.