Keeping older persons at work is becoming increasingly important but require better understanding on the age-related physical and psychological changes associated with ageing process and its potential impact on health, safety and health promotion of older workers. Findings from a systematic review to understand the ageing process of older workers concluded that:
- Age-related physical and psychological changes can reduce the workability of older persons but with large variation between individuals and improvements can be made by physical and mental activity.
- The reduced speed commonly associated with ageing can be compensated with improved accuracy and better knowledge and experience
- Although the risk of chronic illness increases with age, this can be accommodated so that the people affected can still work.
- It’s important to ensure that job demands do not outstrip ability and any recovery time required – this should be built into job design.
An organisation’s health and well-being provision can cater for employees of all ages especially older workers. These could range from basic to full medical cover, work-related stress support such as counselling, and support for returning to work after an illness. Organisations should also consider offering disability benefits to give employees reassurance that they will be looked after should they encounter a disability. Employers are gradually realising it’s in their best interests to cater for the over-65s if they want to retain precious talent for the future. The key is to offer a variety of benefits that fit in with the organisations overall strategy and budget, and to communicate these benefits to workers so they can choose the right ones for them [1].
The scope of tasks involved in conducting social care work put the carers at various physical and mental health risks which include risks related to communicable disease such as skin diseases (scabies, tuberculosis and HIV), chronic diseases particularly back pain from lifting and moving dependent and bed-ridden residents and also mental torture from the residents themselves and their family members. Detailed admission screening and acknowledgement of the associated risks to the workers involved is necessary to ensure the workers are protected against the harmful infectious diseases which may not only harm the workers but also their family members. Here are some of the experiences shared by the carers especially among the older social carers during the interview in Malaysia;
“It was once happened here, where we received an HIV patient. But we were never informed about the status of the resident.. and we were conducting the duty and tasks as usual without precautions. We only found out of he being an HIV patient the day when he died. It was really shocking and frightening thinking about the risks we were exposed to..”
“The most common is back pain, because we have been lifting elderly people manually. If we do it wrongly, we’ll get injured. Sometimes the physiotherapy services which available in some centres are not only for the residents but also being utilised by workers with chronic back pain…The conduction and completion of the care tasks are also become harder and more challenging with increase age due changes associated with ageing process as previously mentioned.”
“It is a fun job to do but very challenging at the same time. At the very beginning, it was really fun. But after a while, when we are getting older, we can’t complete the tasks like we used to.. longer time needed to complete the tasks, because of less energy and we are getting weaker..”
“When we started this career, we were very healthy, young and full of energy. But when we are getting older, we are expose to many risks, particularly to our health. We have to look after elderly, lifting and bathing them but yet we are also getting old.. it is a risk to our health…Verbal abuse and mental torture particularly from demented patients and family members are also common.”
“As carers, we’ve tried our best to perform the tasks given to us, but the family members are always complaining and never satisfied. But at the same time they never willing to look after their old parents or grandparents.. it really hurts and feel unappreciated..” (Malaysian care workers)
We also asked care workers what their concerns are in terms of managing their own health and well-being within the context of work. By far, the biggest challenges are managing work pressures and having to complete an increasing amount of tasks within a short space in time. There is a wealth of evidence that workplace pressure can have an impact on both mental and physical health. Pressure, for example, can lead to workers sensing an imbalance between the effort they put into work (e.g. having to complete a task in a short space of time) and the reward that they receive for hard work (e.g. being paid a living wage or getting satisfaction from work) [12] If the imbalance is too great and the worker doesn’t feel they have an escape (and for older workers, early retirement is seen as an escape), work starts to erode good health. Care workers explained how work pressures are impacting on their health. First, pressure leads to stress especially when they feel that they have little say over how their work is carried out. One care worker described her normal work routine,
“You’ve now got the next six customers ringing the bell. You haven’t got over the fact that you’ve just had two hassles, you’re dealing with the next six ringers, in which time you’ve got somebody on the floor, next to somebody shouting for their tea break.” (UK care worker)
Second, some care workers are sacrificing personal time like forgoing lunch breaks or working unpaid hours. Many care workers have chosen their careers because they want to help others, so the pressure to get work completed even if it eats into personal time can be overwhelming. As one care worker described,
“There is maybe someone doing an 80-hour week, but it’s not 80 hours of work time. They are maybe getting paid for 40 hours but they are out for 80. That was happening on a regular basis.” (UK care worker)
Finally, work pressure might lead to care workers making sacrifices which impact on their own health and welfare. This can be particularly true of home care workers who must budget into their work routines not only time with clients but also travel between visits. Slight delays between meetings can lead to pressures to reach their next clients in short spaces of time,
“Social care workers are working in unhealthy working environments. … We’ve had so many car accidents in the last 30 years, our staff are just pumping, and pumping to get that call time. I think it needs to go to an hourly slot or a two hourly slot even.” (UK care manager)
Older workers participating in work beyond the normal retirement age indicated several preconditions and motives for staying in the work force. Accordingly, the health, work characteristics, skills and knowledge, social factors, financial factors and purpose in life can be applied to working beyond retirement age [2].
Among good practices that should be considered in managing older workers’ health and safety in the workplace include;
a. Jobs should be made to suit a range of individuals and not just the strong or fit persons. An objective assessment of job requirements will help to assess the physical job demands. In order to deal with age-related changes and their impact on work, several considerations need to be made;
i. Work–rest schedule: Adequate recovery time between tasks
ii. Risk assessments and risk reduction measures: Including the musculoskeletal, cardiovascular and respiratory systems, vision and hearing
b. Consideration for shift work;
i. Limiting night work, or stopping it entirely, for workers aged over 45–50
ii. Giving older workers priority to transfer to day work
iii. Giving older workers their choice of preferred shift where possible
iv. Reducing workload
v. Shortening working hours and increasing rest periods
vi. Arranging more frequent health checks
vii. Giving effective counselling on coping strategies such as sleep, diet, stress management and exercise.
c. Measures to overcome the likelihood of hearing and visual problems – warning system, hearing aid provision and more readable materials
d. Maintaining and updating the workplace skills of all workers is important and helps to stimulate their mental processes.
The physical and mental demands associated with social care work may put older persons at risk of physical and mental illnesses. The nature of the tasks involved in caring for an older adult can be a form of stress and influence the carers’ daily lives and health. Previous studies have reported that resilience and social support play an important role in reducing physical and psychological burden in carers. However, with the increase in demand in the sector and higher turnover rate among the workers, there is a future need to employ older workers as social carers, which make the tasks are even more challenging to be performed. Several adjustments and considerations are needed to be taken seriously to promote involvement of older people in the social care sectors, which include:
a. Reduce physical ability among older workers can put them more at risks of occupational related injury and inability to perform the tasks according to demands within the allocated time. This problem can be addressed and improved by;
i. Introduction of assistive device to ease and facilitate the physical work such as lifting the bedridden residents
ii. Shorter shift hours and increase the number of carers to residents’ ratio
iii. Revision the scope of jobs – To come up with lists or categories of social care tasks that can be done by older persons which require thorough and comprehensive screening of residents’ condition prior to admission to the residential care.
iv. Training to improve skills
v. Provision of critical allowance in view of the higher likelihood of occupational related injury among older workers
b. Older persons are frequently associated with sensitive and easily disturbed emotions and having older persons to become carer of another older persons can be very challenging. Periodic counselling and motivational activities may be necessary to ensure good mental health status of older social care workers.
[1] Haymes, R. (2014). Late retirement means businesses need better benefits for an ageing workforce. The Guardian. Available at https://www.theguardian.com/sustainable-business/late-retirement-ageing-workforce-business-benefits.
[2] Sewdas, R., de Wind, A., van der Zwaan, L. G., van der Borg, W. E., Steenbeek, R., van der Beek, A. J., & Boot, C. R. (2017). Why older workers work beyond the retirement age: a qualitative study. BMC public health, 17(1), 672.
