Older and Wiser – The Aging Workforce
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Dr C.T.C. Kenny FAFOEM Specialist Occupational Physician Waitemata District Health Board, Auckland Courtenay.kenny@waitematadhb.govt.nz (P33, Friday 28, Ilott Theatre, 12.00)
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Older and Wiser – The Aging Workforce
- 1. Dr C.T.C.Kenny, FAFOEM Specialist Occupational Physician Waitemata District Health Board
Notas del editor
- As you will by now be aware, not only in New Zealand but internationally we have both a difficulty and an opportunity with regard to the population generally and the workforce specifically; the average age of both is steadily increasing, leading inexorably towards a situation where fewer people are providing the goods and services for the community and financial support for an increasing cohort of older people.
- The marked increased in birth rates following the Second World War and the relative economic stability during that period led to the so-called ‘Baby Boomer’ generation (those born in the period 1945-1965), and this group is now beginning to enter the traditional retirement age (approximately 65). The ‘older worker’ is variably defined in research and descriptive studies as those aged anywhere from 50, 55 or 65 years onwards, but generally refers to those in the latter part of the traditional working life.
- There has been a trend for employers to preferentially release older workers when downsizing, or replace older workers leaving with younger employees. This age discrimination will not be socially or economically acceptable in the future.
- The EEO Commissioner stated that ‘New Zealand will need more people aged from 55 onwards to stay in paid work at a time when retirement and early retirement is popular’. Older people were often the last to be considered for jobs or suffer ‘covert’ discrimination’, despite NZ having one of the highest workforce participation rates for the 55-64 year age group, with workers older than 55 years making up approximately 17% of the workforce.
- There are several reasons for this steady trend in the labour force composition, in addition to the effect of the ‘baby boomer’ generation. As a result of other sociological and economic factors, people tend to be less well-prepared financially for retirement, including changes to the availability, structures and level of income replacement of superannuation and other retirement schemes (pension plans), the failure of investment companies, sharemarket volatility and falling investor confidence. There has also been a steady increase in life expectancy, and certainly in developed countries an overall improvement in the management of many health conditions, and an improvement in the under 5 year child death rate.
- The 1990 Global Burden of Disease survey used projections of socio-economic development to model future patterns of mortality and illness for the period to 2030. These predictions included continuing increase in life expectancy, a lowered death rate for children less than five years of age, and an increase in the number of deaths from non-communicable disease such as heart disease and cancer. By 2030, it is predicted that the three leading causing of illness and disability will be HIV/AIDS, depression and ischaemic heart disease. [1]
- Although in recent years there has been some decline in chronic disability rates for those in the general population aged over 65 years, there is nevertheless a gradually increasing prevalence of chronic and degenerative health conditions (e.g. arthritis, hypertension and presbycusis) in the population the older workforce which has at least the potential to limit some aspects of work capability. While many chronic conditions are not necessarily debilitating and can be alleviated with medication, disability aids and/or exercise, other can significantly limit an individual’s ability to perform certain tasks of daily living. There is an increasing prevalence of obesity and associated conditions, since the older a person becomes, the more likely they are to gain excess weight and the more likely that any obesity will be associated with complications. In the US, and in many other Western countries, percentage of adults with healthy weight has been declining and obesity has been increasing, most notably among older men.
- Low income is strongly associated with activity limitations; the lower the income the greater the probability of an activity limitation. Differences such as these suggest that older persons most in need of continued employment may be the least physically capable of remaining at work.
- Although the overall sickness absence rate for younger and older workers is similar, in one study older workers were more likely than younger to miss work and their overall lost-time rate was higher. The sickness absence rate for illnesses and injuries (not necessarily WRI) is higher for older than for younger workers but older workers are generally less likely to be absent for other reasons (family obligations, social, etc). The US Bureau of Labour figures showed that the median number of days away from work for non-fatal occupational injuries and illnesses involving absence was double in workers 55 years of age and over compared with the younger group. Restricted work days and hospital days associated with episodes of injuries at work tended to be substantially higher for older workers.
- Older workers are more likely to sustain injuries that require longer convalescence/ rehabilitation and work absences of long duration are more common among older workers. The issue is complicated by the higher prevalence of medical co-morbidities among this older group, which can make treatment for specific injury conditions more prolonged and with poorer outcomes in terms of restoration of function and return to work.
- Overall there has been shown to be a greater severity of work-related injuries in older workers, and these are often more costly to treat and compensate Among those workers presenting to an emergency department with an industrial musculoskeletal injury, workers over age 65 years are most likely to present with a fracture or dislocation, an injury resulting from a fall to the ground from the same level, and to require hospitalization. However, injury rates among older workers may be lower because of experience, maturity, judgement.
- The overall likelihood of poorer health with advancing age increases the risks of employees losing employment for health reasons (including premature medical retirement) and increases the potential difficulty in gaining employment. Economic forces can influence the number of new employees that may be taken on by an employer such a the difficult that may result in attracting newly trained/ qualified employees by an industry in decline. This may allow opportunities for older workers (depending upon salary requirements). In addition, retirement rates and ages may vary across different occupations and professions depending upon working conditions, and the relative health of particular sectors.
- With aging comes an inevitable reduction in stature that affects both men and women, and these and other changes in anthropometric factors can affect workplace posture and performance, including those in posture sensitive roles (such as computer keyboard work) or undertaking physically demanding work. Reduced physical capacity (e.g. strength, endurance, co-ordination) among older workers
- Deterioration in physical health is often cited as one disadvantage of employing older workers, believing that these physical health issues lead to increased absenteeism and higher injury rates. Such physical parameters are also sometimes claimed to be related to lowered productivity in older workers, compared to their younger counterparts However, these beliefs are not supported by research literature. Clearly, o lder people differ from younger people in terms of physiological parameters, with age-related changes apparent in vision, hearing, bone mass and density, skeletal muscle, lung function, skin integrity, metabolism, motor function and immunity.
- However, performance shortfalls associated with age may not manifest until work demands exceed physical ability or when the system is stressed. While age-related changes occur at a greater rate with advancing age, most biological functions do show a wider variation than in younger people. Further, the physical condition of the individual can mitigate age-related decreases in factors such as motor function and cardio-respiratory function. It may be that older people who maintain a high degree of physical fitness may perform better than sedentary or unfit younger workers.
- MSK symptoms and injuries are increasingly common in older workers, but the situation is complicated because in this older group non-specific ‘muscular aches and pains’ are common, MSK tissues are less tolerant of load leading to discomfort and/or injury, there may be significantly reduced muscular tone and strength, and reduced skeletal flexibility. Further, depression and emotional distress can commonly (50%) be associated with somatic symptoms (including MSK pain) and muscle pains may be adverse effects of a number of medications (particularly cholesterol-lowering drugs). Physical work activities, including those movements, loads and postures which may be well within an individual’s physical capabilities, may be intermittently associated with discomfort or other symptoms, leading to concern about injury and physical capacity.
- Many falls in older persons are contributed to by diminished sensory input , which is one of the leading causes of injury among all older adults, regardless of work status. Much of the literature, however, focuses on extrinsic, environmental sources of falls such as surface traction (such as water on floors), physical hazards (such as electric cables and worn carpet), and footwear. Besides diminished vision and hearing, older adults also experience depressed autonomic reflexes, which predisposes them to postural hypotension, syncopal episodes, potentially falls. Concomitant medication usage, particularly antihypertensive medications, may compound this risk. Older workers also may have aging-related decreases in sensory and motor nerve conduction.
- It is well-established that cognitive function declines with age. However, while response speed, working memory and selective attention deteriorates with age, particularly on difficult tasks, individuals can develop adaptive strategies to compensate for this decline. Researchers explain that there is a range of variables that mediate any relationship between age and job performance, including knowledge, skills, abilities, personality characteristics, motivation, environmental factors and others. Specific intervention strategies are available to minimise the effect of any such decline, and intellectual decline in older age is not necessarily irreversible. Further, the intensive and sustained cognitive functioning tested formally in the clinic is rarely required in the work-place Further, age has been found to account for only a small percentage of the variance in an individual’s cognitive, perceptual and psychomotor abilities after controlling for type of occupation, experience and education.
- There is debate as to whether older workers will be more prone than younger workers to the effects of work-related stress , because of the increasingly complex nature of the work environment and for which they could be considered to unaccustomed. However, stress-related effects may occur among workers regardless of age and for a variety of reasons. Work-related stress result from ‘an accumulation of minor insults and hassles, as well as the threat or onset of significant exposure to uncontrollable harm’. Such stressors may result from the nature of the job, workload, time pressures, or exposure to adverse physical environmental conditions.
- Further, the organisational and social environment of the workplace may generate stressors, including through conflict with co-workers, threats to job security, low job autonomy and low support from management. The association between ageing and the stress and coping process is complex, as evidence from the wide individual variation in the type of stressors, the interpretation of different situations as stressful or otherwise, the emotional and physiological reactions experienced, and the individual’s coping abilities.
- Within the nursing workforce, researchers reported sources of job dissatisfaction potentially leading to stress responses include high physical demand, rostering problems, unrealistic workloads, mandatory overtime, and lack of management response to workplace concerns. Another study Other researchers reported nursing work environment issues to include increased administration, increased severity of patient illness (acuity), government/regulatory body requirements, nursing staff turnover, need for second-language skills, voluntary overtime and time pressures. [1]
- Recent literature reviews provide no evidence for a reliable relationship between ageing and work performance but differences will exist depending upon age bracket, educational level and type of occupation. The overall findings of 100 research investigations showed no significant differences in work performance of older and younger workers. Warr found that, overall, older workers are considered to be less adaptable and slower at gaining new skills and knowledge than younger workers. On the other hand, they are seen to demonstrate higher consistency and better quality in their work, as well as being more effective with respect to reliability, conscientiousness and sound decision making when compared to younger workers. There have also been anecdotal information suggesting that older workers having greater difficulty learning new techniques and technological skills. One of the most frequently cited adverse characteristic regarding older workers is difficulty in adjusting to change and technology However, the research evidence suggests that older employees are quite able to learn new skills and keep up with younger workers. One researcher believes that there is sufficient evidence which shows older people enjoy the challenge of learning new skills, new technology and change, and cites the increasing and prolonged use of the Internet by people over 55 years. It is true that older people may be slower in new learning situations, although this may be partially explained by differences in learning styles, practice, or motivation. People training older people need to be aware of the importance of adopting an approach that embraces the different learning styles of older people.
- Decrements in hearing have the potential to impact upon both work and non-work activities, including difficulties in voice communication, hearing auditory signals and alarms, and isolation from the workplace social environment. In general older people experience a reduction in visual functions , including the range of accommodation, a loss of contrast sensitivity, decreases in dark adaptation, declines in colour sensitivity, and greater problems with glare. These changes have the potential to interfere with direct communication and recognition, reading signs, driving, and with computer and document work.
- The older worker may in many situations be more valuable to an employer than a younger worker, irrespective of any relationship between age and work performance. A range of positive attributes is associated with older workers. One researcher reports knowledge, skills, experience, reliability, stability, loyalty, strong work ethic, responsibility, people/customer care skills, motivation and initiative. It is noted that companies with older workforces have experienced higher profits, lower turnover/higher retention and lower absenteeism. Other qualities, according to another researcher, include discipline, punctuality, commitment to quality and personal maturity. According to findings from the Work and Age Survey (EEO Trust), the main perceived strength of older people in New Zealand is reliability. Other reports of older workers’ strengths include good customer service skills, communication skills, commitment to careers, skills in training people, initiative, able to create a good atmosphere and technology skills. However, younger people did not rate the strengths of older people in the workplace as highly as older people rated themselves.
- Crossan points out that the skills and experience that have been accumulated by older workers can translate into efficiency and “the ability to deal with problems quickly and effectively”. They can pass on the benefits of their experience to younger workers, which promotes greater overall efficiency. The older employee therefore may have many positive attributes and be able to offer significant benefits to the employer. First and foremost, the older worker may have a high level of relevant skills and experience, relating to the specific workplace or to the sector generally. While an employer may choose to take a new and perhaps recently qualified/trained employee over an existing older employee or other older candidate, for reasons of cost (salary) or to seek an injection of new ideas, the benefits of this approach may well be outweighed by the loss of experience, loss of corporate and sector knowledge, and loss of ability for teaching and mentoring which the experienced worker may be able to provide.
- There are a number of possible reasons for a tendency away from premature retirement in New Zealand, including; compulsory retirement was outlawed in February 1999 surcharges on extra income earned while receiving superannuation were removed the age of eligibility to receive superannuation changed economic necessity improvements in health treatment a positive outlook and desire to keep active the nature of work is changing, reflected in a shift away from manual labour. (Statistics New Zealand).
- The EEO Trust (2006) survey also examined which work conditions would encourage current workers to keep working beyond their expected retirement age. Quality part-time work (66%) and flexible working hours (64%) were cited as the two main work conditions that would be influential in the decision to remain in work. Extended leave and return to work was also cited by 53% of current workers. Less likely to be influential in the retirement decision but still cited by a significant minority were higher pay (42%) and being able to work from home (47%). Other conditions that may encourage currently employed respondents to continue working were: - challenging, interesting, varied work - the ability to make a difference - having your experience needed and valued - less stress.
- Recruitment processes which include; advertisements specifically asking for school-leavers or people with little experience application forms requesting date of birth and an employment history selection procedures that re-enforce stereotypes about older workers Employers often consider that older workers: are over-qualified are too experienced do not fit with the corporate image or expectation Other barriers include; advertising in media with which older workers may be unfamiliar or inexperienced (Internet/blogs/youth publications) inequality in training and development opportunities inappropriate assumptions, including that older workers; can’t learn new skills can’t cope with challenging tasks/projects can’t meet high performance targets don’t want or need professional development opportunities Failure to offer or to assess the value of workplace accommodations for older workers.
- Workplace accommodations are likely to become an important strategy for employers who want to retain experienced older workers. However, despite the prediction that a large number of older workers will stay in the workforce during the coming decades, employers report that they are not preparing for the impact of this demographic shift. One 2003 survey in the US identified that the majority of survey respondents had made no special provisions or benefits in their organisations with older workers in mind, and that the increasing age of the workforce had only had a marginal impact on their organisation’s recruiting, retention and management policies/practices.
- 2001 saw the launch of the New Zealand Positive Ageing Strategy in which positive ageing goals were set within a framework encompassing income, health, housing, transport, ageing in place, cultural diversity, rural, attitudes, employment and opportunities. In relation to the workforce, these goals included facilitating positive attitudes to ageing and older people, the elimination of ageism and the promotion of flexible work options, and increasing opportunities for personal growth and community participation. Suggested issues included addressing future recruitment and workforce management, recruitment and retention, flexible working arrangements, career planning and development, and health issues
- Finding older/experienced employees Advertising in appropriate media Networking through communities and organisations frequented by older workers/retirees, including churches, sports’ clubs (golf), seniors groups, special interest groups/newsletters, reunions, professional journals Encouraging greater female participation in the workforce, including through policies which are supportive of wider family commitments and needs.
- Physical work environment Improved design of patient areas to optimise ergonomics and minimise unnecessary standing and walking (flooring, lighting, layout, etc) Improved/high quality lighting, particularly in offices, stairways, paths Hand rails and guardrails, including in stairways and thoroughfares Reduced heavy and/or awkward lifting (particularly in non-manual work) Mechanical devices to assist with manual handling Need for modifications to working hours and activities (alternative or restricted work) Older workers not necessarily expected to perform all physical aspects of specific jobs; provision of mechanical assistance or assistance from more able-bodied or stronger workers
- Optimise physical and psychological health Providing opportunities for physical exercise to minimise the functional loss associated with ageing Early diagnosis and clinical management (or referral for clinical management) of health conditions with adverse implications for work fitness Implementation of wellness programmes (health promotion) On-site/subsidized health club/gymnasium membership Stress reduction/relaxation training
- Additional benefits Access to employer provided/funded health care Subsidised health/medical insurance Creche/childcare on-site Travel/recreation subsidies
- Occupational health services Role of occupational health practitioners in managing the ageing workforce, including ….
- Other Policies which encourage increased birth rate Policies which assist in attracting national and international recruits, including immigration, salary and remuneration package, job satisfaction Encourage increased participation in specific occupations (e.g. nursing, physiotherapy, etc) although need to guard against tendency to decrease entry standards