Older People In Poland Research Articles

Palliative care and the growing health needs of older people in Poland

Palliative care and the growing health needs of older people in Poland

The activities of older people when healthy aging policy and funding is limited. The institutional and financial dimensions of health promotion for older people in Poland

The presented country profile, based on several national reports, legal acts, international databases, scientific articles and pilot research performed with the use of health care sector templates, outlines the major institutional, organisational and financing challenges for health promotion in Poland, and specifically, health promotion for older adults. Despite the numerous legislative and organisational changes in the health care sector since 1989 and the strengthening of the public health institutions in Poland, the country lacks a long-term, sustainable policy perspective in the public health area. The traditionally higher priority attached to curative care than to public health actions is one of the major reasons for the shortcomings of public health policy and the insufficient resources for health promotion and primary prevention in general, and health promotion for older adults specifically. However, there are also many weaknesses at the organisational level. One of the most important is the weak cooperation between the different levels of territorial self-government, the central government and other institutions when undertaking health promotion actions, which results in the development of both under- and overprovision of health promotion interventions for different population groups and at different geographical locations. Few self-government associations try to improve the cooperation and experience exchange in this field. However there is a need for a greater coordination and information exchange concerning plans and financial possibilities as well as for more competent health educators with better communication skills, less bureaucratic burdens, and better financial conditions.

Older People, Ageing and Old Age in the Light of Some Public Opinion Surveys in Poland

This paper is based on the analysis of surveys led by Central Statistical Office of Poland and Public Opinion Research Center. The article consists of four parts. In the first one, the outcomes of the research related to the boundaries of old age, both spiritual and physical, have been described. The second part brings forward the opinions of Poles about ageing, the frequency with which Poles reflect upon their own old age, concerns related to old age. The third part is a description of attitudes towards older people in Poland. The indicated parts are preceded by a short demographic characterisation of the demographic situation in Poland (data from CSO, Eurostat and UN) and social characterisation of an average Pole aged above 60 years.

Assessment of health, functioning and disability of a population aged 60-70 in south-eastern Poland using the WHO Disability Assessment Schedule (WHODAS 2.0).

There is a growing number of older people in Poland. This phenomenon results in the need to assess their problems related with functioning in everyday life. This is the first study conducted in Polish society which evaluates the prevalence of disability and limitations in functioning by means of WHODAS 2.0 questionnaire. Evaluation of the health, functioning and disability of people aged 60-70 years living in south-eastern Poland. The researched material was a randomly- selected sample of 1,000 inhabitants of south-eastern Poland. The study was conducted by use of direct interviews applying the WHODAS 2.0. For the purpose of statistical analysis, measures of descriptive statistics and non-parametric tests of significance were used. Limitations in functioning were reported by 67.00% of participants aged 60-70 years, including 46.20% with a mild disability, 14.50% - moderate, 6.30% - significant and extremely large disability. The highest level of disability occurred in areas related to participation in social life (mean = 20.77), performing activities of daily living (mean = 17.42) and mobility (mean = 17.23). A significantly higher level of disability (p <0.0001)was observed among unmarried people, the elderly and those with a greater number of chronic diseases. Higher level of physical activity was associated with lower disability level in the studied population (p<0.009). Regarding the studied population, it was found that many health problems become worse over the years. The state of health that deteriorates with age causes limitations in daily functioning, which lead to disability, activity limitations and participation in everyday life. The progressive ageing of the Polish population will cause an increasing demand for medical care and on the social services.

Aktywizacja społeczna osób starszych w Polsce

Tematyka aktywizacji osób starszych poruszana jest głównie w raportach oraz programach mających na celu zapobieganie wykluczeniu seniorów. W literaturze naukowej częściej prowadzone są badania dotyczące aktywności społecznej osób starszych.W pierwszej części niniejszego opracowania przedstawione zostaną wybrane sposoby oraz formy aktywizacji społecznej osób starszych, które stosowane są w Polsce. Będą to: kluby seniora, Uniwersytety Trzeciego Wieku, organizacje samopomocowe, wolontariaty, Społeczne Banki Czasu, organizacje kulturowe oraz Rady Seniorów. W drugiej części omówione zostaną rządowe formy wspierania aktywności osób starszych. Natomiast w ostatniej wybrane działania aktywizujące seniorów w Łodzi.

O „gettoizacji” aktywności kulturalnej seniorów

The article discusses the problem of the so-called “ghettoization” of senior’s cultural activity. It consists in the fact that cultural institutions while creating an offer direct it exclusively to some specific age groups like children or seniors. Participants are therefore separated and this creates “age ghetto.” In the first part of the article the author, by referring to researches, characterizes cultural activities of older people in Poland and then focuses on the determinants of “ghettoization” of cultural activity of seniors. Finally, the author indicates the risk connected with separating various age groups and the need to balance “fenced” offers which are designed “exclusively” for seniors through more intergenerational offers.

FUNCTIONAL HEALTH ASSESSMENT AS THE DETERMINANT OF SOCIAL CARE MANAGEMENT

The aim of this study is to assess the functional state of health for elderly residents in Poland. The analysis has been using the data from the survey “Social Diagnosis” carried out in 2013, in Poland. The research concentrates on subjective measures, used to assess the population’s state of health, based both on mortality and disability studies, while disability is defined as reduced ability to carry out daily activities. The authors have evaluated the health status of the elderly in Poland in 2013, using measures of health function (ADL) and activity restrictions (IADL). The results show, that functional health of older people in Poland is significantly correlated with age and sex of respondents. The interpretation and the conceptualization of desirable directions of changes should lead to active life style’s promoting, adjusted, accordingly, to health state and age. It also provides important information for social care managers, by defining needed form of interventions. Key words: healthy aging, social care management, Life expectancy without self-care activity restrictions (ADL), Life expectancy without instrumental activity restrictions (IADL)

Nutritional status and quality of life in different populations of older people in Poland.

To estimate the potential association of three distinct nutritional status measures (body mass index (BMI), calf circumference (CC) and the Mini Nutritional Assessment (MNA)) with health-related quality of life (HRQL) assessed with Euroqol 5D questionnaire in different populations of elderly people in Poland. The study group was comprised of 1003 community-dwelling subjects from the urban environment, 890 subjects from the rural environment and 879 subjects from an institutional environment (nursing homes). Bivariate and multivariate associations were identified between nutritional status measures and HRQL adjusted for demographic and social variables, health status, physical function and mental status. Nutrition status indices (BMI, CC and MNA) were generally higher in the urban than in the rural environment and clearly worse in institutionalised elderly. In both community-dwelling groups, BMI and CC were negatively related to several Euroqol scores. In institutional residents, of opposite relationships were observed: higher values of these variables were connected with less frequent reporting of problems in Euroqol. In all the three groups, associations between HRQL scores and MNA were very similar: higher values of MNA were significantly connected with less frequent reporting of problems in Euroqol. BMI and CC, as overweight/obesity measures, are independent predictors of lower HRQL in urban and rural community-dwelling seniors and higher HRQL in institutionalised elderly. Poor nutritional state as measured by MNA is a similar determinant of well-being in all the three environments. This different relationship of popular overweight/obesity measures to HRQL should be taken into account while designing care for older people.

Uczenie się jako strategia pozytywnego starzenia się

This paper presents the problem of older people’s learning regarded as a positive aging strategy, according to the positive aging concept by Robert D. Hill. The growing population of older people in Poland generates the need to seek new solutions on how to deal with the subjective and social aging and the old age. In Poland, despite the fact that some good activities have been already emerging, there are still no system solutions in the area of : social welfare, health care, labor activity, cultural and educational activities targeted at the elderly, especially the oldest. What dominates is the economic perspective of looking at the problems of an aging society. The media promotes youth and consumerist lifestyles that are not conducive to positive perceptions of aging and older people. Learning is treated as a strategic action taken for positive aging. It includes three important components: the essence of learning in old age, the relations between positive aging and learning, and learning in the case of illness and long-term care. The older people’s learning in addition to the invaluable benefits for the person, increases the social productivity and expands social capital of the older generation.

Secondary prevention of stroke in elderly people in Poland—Results of PolSenior study

Background and purposeThe purpose of the study was to evaluate the frequency of use of oral antiplatelet (OAP) and anticoagulant (OAC) drugs as secondary stroke prevention among older people in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors. Material and methodsThe study group consisted of 426 subjects with a history of a previous stroke (mean age of 81.5±8.2 years), participants of multicentre, population-based PolSenior study. ResultsAmong the study group, 261 people (61.3%) used at least one drug as a secondary prevention. OAPs were regularly used by 237 people (55.6%), and OACs—by 25 people (5.9%). The most often used drug was acetylsalicylic acid. Ticlopidine was more frequently used than clopidogrel, and acenocoumarol was used more often than warfarin. Among all of the concomitant cardiovascular risk factors, congestive heart failure was mostly associated with OAP treatment, and a history of atrial fibrillation—with OAC treatment. Use of drugs did not depend on age, sex, place of residence (rural or urban), level of education and personal income, but it was associated with the region where the respondents lived. ConclusionsSecondary cardiovascular preventive therapy in Poland is used too rarely in older people after stroke, and it especially concerns anticoagulant therapy in those with a history of atrial fibrillation. Structured educational programmes should be developed in Poland to improve usage of secondary preventive therapy in the elderly.

Validation of the modified mini nutritional assessment short-forms in different populations of older people in Poland.

To assess the usefulness in different populations of elderly people in Poland of both modified versions of Mini Nutritional Assessment Short-Forms (MNA-SFs) with a three-category scoring classification: one using BMI (MNA-SF-BMI) and another using calf circumference (MNA-SF-CC). A group of 932 community-dwelling subjects from the urban environment, 812 subjects from the rural environment and 859 subjects from an institutional environment (nursing homes). Agreement between both MNA-SFs and the MNA full form. MNA-SF-BMI correctly classified 84.12%, 82.51% and 81.84% of subjects from urban, rural and institutional environment, respectively. For MNA-SF-CC those values were 82.4%, 71.8% and 76.6%, respectively. The sensitivity and specificity of MNA-SF-BMI and MNA-SF-CC against full MNA in screening for "at risk/malnutrition" and "malnutrition" were generally very high, except for relatively lower sensitivity (74.1%) when screening for "malnutrition" with MNA-SF-CC in nursing homes. Both MNA-SFs can be recommended as screening tools in assessing the nutritional state of the community-dwelling and institutionalised elderly in Poland. The full version of the MNA confirmed the results of MNA-SFs in this group. The "classic" MNA-SF using BMI was found to perform better than the MNA-SF-CC. The MNA-SF-CC should be used only when measuring BMI is not possible. While using MNA-SF-CC in nursing homes, a higher MNA-SF-CC cut-point of eleven should be rather used in this population to screen for "at risk/malnutrition".

Challenging Marginalization at the Universities of the Third Age in Poland

Older people in Poland often describe and experience old age as a time in the life course marked by discrimination and marginalization. In this postsocialist context, a still-dominant Cold-War logic links older people to the devalued socialist past and younger people to the present and future of the Polish nation-state. Contemporary media portray old age as defined by physical and mental decline and social isolation. The most visible challenge to such temporal, bodily, and social exclusion occurs through Universities of the Third Age, where older people learn new skills, cultivate hobbies, and explicitly theorize growing old as a positive phase of life. Drawing on twenty months of ethnographic research, this article traces key sociocultural, political-economic, and historical factors that contribute to discrimination against and empowerment of older people in Poland. By analyzing national politics and media representations of old age together with ethnographic data from Universities of the Third Age, this article highlights the practices through which older Poles feel themselves to be transformed in old age—and asks who may be excluded from such practices—thus contributing to gerontological discussions of “active aging” and anthropological understandings of sociality in late life.

Oral anticoagulant and antiplatelet drugs used in prevention of cardiovascular events in elderly people in Poland.

BackgroundIn Poland, the prevalence of cardiovascular diseases is increasing. This might be associated with the constantly growing proportion of elderly people and inappropriate cardiovascular prevention. This study aimed to evaluate the frequency of use of oral antiplatelet (OAP) and oral anticoagulant (OAC) drugs among older people in Poland and to assess their association with cardiovascular risk factors.MethodsThe study was based on data collected during the implementation of a multicentre, publicly funded research project called PolSenior.ResultsThe study group consisted of 4,979 people with the average age of 79.35 ± 8.69 years. Among them, 1,787 people (35.9%) used at least one drug in the prevention of cardiovascular diseases. OAPs were used regularly by 1,648 (33.1%) elderly people and OACs were used by 165 elderly people (3.3%). Acetylsalicylic acid was used by 32.2% of elderly people. Use of drugs significantly depended on age (p < 0.01), sex (p < 0.01), place of residence (p < 0.001), level of education (p < 0.0001) and personal income (p < 0.0001). Among all the respondents treated with OAPs, therapy was applied as secondary cardiovascular prevention in 717 respondents (43.5%), and as primary prevention in 705 respondents (42.8%). Among the respondents treated with OACs, 117 (71%) elderly people had a history of atrial fibrillation. Secondary cardiovascular prevention should be considered in a further 482 respondents (15.1% of untreated elderly people), and primary cardiovascular prevention in 1,447 respondents (45.3%).ConclusionsOur study is the first to determine the frequency of use of OAP and OAC drugs among elderly people in Poland in relation to cardiovascular risk factors. The most commonly used drug for cardiovascular prevention is acetylsalicylic acid, but it appears that it is used too rarely in high-risk patients. Educational programs should be developed among general practitioners concerning current recommendations for pharmacological cardiovascular prevention.

The current state and challenges for the future of health promotion in Polish older people

Still in its early stages, much work remains to be done in terms of the health promotion of older people in Poland. The aim of this paper is to present the current state of health promotion in older people in Poland on the basis of research conducted within the framework of the healthPROelderly project, presenting the state of health promotion in older people after 1989, and to provide practical recommendations for future interventions. (1) Content analysis of scientific and popular publications; (2) document analysis of policy papers; (3) review of existing Polish health promotion programs; (4) program case studies; (5) SWOT analysis of the state of health promotion in Poland. In the past 10 years, in terms of planning and realization, efforts aimed at health promotion in older people were only sporadically realized. There were no macrostructural programs targeting this age group nor was this an element of national health policy. Only a small number of health promotion programs targeting older people were found. There should be a renewed focus on health promotion, as opposed to preventing disease. Health promotion campaigns should target those with a decreased awareness of their health needs, with improvement in health status being based on increasing this awareness. In an effort to develop more health-conscious attitudes and behaviors in older age, health promotion initiatives should also be marketed to pre-retirement aged individuals.

Between Family and State: Ageing in Poland and Norway

ABSTRACTA comparative analysis of the life circumstances of older people in Poland and Norway is presented. It examines differences and similarities in attitudes to both family- and state-provided care, for those living in their own homes. In more prosperous Norway, public services are more frequent, elderly people are more independent and play a more active role in the labour market. In Poland formal care is seen as the last resort, with the responsibility for supporting elderly people placed firmly with the family. State services are directed towards those without families. The Norwegian system places no legal obligation on families, which results in a higher proportion living in institutions.