Judy Jankovics - Injury treatment - FOCUS SESSION: The Ageing Worker: Facts, Myths and Strategies...
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Transcript of Judy Jankovics - Injury treatment - FOCUS SESSION: The Ageing Worker: Facts, Myths and Strategies...
THE AGEING WORKER: FACTS, MYTHS AND STRATEGIES FOR MANAGEMENT
Presented by:
Judy Jankovics
Training and Corporate Health Specialist
Content • What is “Ageing”?
• Trends in the Australian workforce
• Facts and Myths about ageing
• What happens when we age
- Physical and psychological changes
- Impact on safety & performance at work
- Risk factors and prevention
• Strategies for managing RTW for an older worker:
- Case Studies
- Considerations and accommodations
• Injury prevention strategies for the organisation:
- Preparing for the future
- Getting the best out of your older workers
What is “Old Age”?
• Recognised in literature as being > 65 years of age
• The excuse / reason given for:
- stiff and painful joints
- dry and itchy skin
- sleep that is un-refreshing
- poor energy levels
- reduced strength
What is “Ageing”? Ageing is a lifelong process – a biological sequence of events that begin at birth and end in death
Many theories:
• Genetic error, wear and tear: result of events that occur randomly and accumulate over time
• Programmed ageing: predetermined by genetics
Commonly accepted that ageing process best explained by the interaction of several mechanisms depending on lifestyle, family history and genetics.
Biological vs Chronological Age • Biological (functional) age is a measure of a
person’s ability, body composition and degree of morbidity.
• Chronological age = actual age
• The gap between biological and chronological age widens as we age
Ageing Across America Pop Quiz • How accurate are your attitudes towards an
understanding of older people?
Facts about older workers:
• They sustain fewer injuries and accidents although
they take longer to recover and RTW if injured
• They are not more absent although they do
take more absence for “genuine” health reasons
• They demonstrate various desirable personality
characteristics: they are more conscientious,
emotionally reliable, stable and agreeable.
*Unum CMO report on ‘inconvenient truths’ about the ageing workforce
Occup Health, 2008, 60(12): 35-36
Australian Ageing Workforce Stats • Population is ageing: longevity increasing and
fertility declining
• People in workforce aged >55 years will increase from 15% in 2009 to 21% by 2050
• 2009 to 2050: 45% growth for 55-59 yr olds; 65% for 60-64 yr olds and >200% for >65 yr olds
What happens when we age?
Loss of Skeletal Muscle Mass
• Part of normal ageing process
• Proportion of body fat generally increases while lean body mass decreases
• Therefore: may escape detection on physical appearance, BMI
Risk factors for Loss of Muscle Mass
• Physical inactivity
• Reduced protein intake
The Implications of Loss of Muscle Mass
• muscle strength (esp. legs) impaired postural stability risk of trips and falls
• muscle power / speed of contraction force generated and response time
• Consider the additional impact of obesity!
Remember: Loss of strength does not necessarily translate to an inability to perform inherent job requirements!
• Older workers may just be working closer to their maximum than younger workers
• Experienced compensations
Changes to other soft tissues (Joints, ligaments, tendons and discs)
• Ligaments, tendons and joints become more rigid in movement likelihood of tears
• Joint cartilage wears down, lubricating joint fluid reduces slower +/- painful movements (degeneration or osteoarthritis)
• Discs become dehydrated,
thin out and/or bulge +/-
osteophyte formation
non specific low back
pain, nerve impingement
and loss of function
Modifiable Risk Factors for Osteoarthritis
• Obesity
• Joint trauma or injury
• Repetitive joint loading tasks
• Joint misalignment
Osteoarthritis is not necessarily present with ageing
The Implications of Soft Tissue Changes
• likelihood of more serious injury
• recovery time following injury
• If you look for something you will find it!!!
• Incident, aggravation or pre-existing condition??
Remember: Nature vs Nurture !!
The older we get, the more different we become!
Loss of Bone Mass (Osteoporosis)
• Bone mass constantly undergoes re-modelling throughout life ie cyclic resorption and renewal
• Ageing resorption and mineral deposition after 40-50 years of age
• Bones become brittle and more likely to fracture
Osteoporosis risk factors • Women 4 x > men
• Reduced calcium intake
• Vitamin D deficiency
• Diet and activity levels
• Factors throughout life
- peak bone mass at 20-30yrs
- affected by diet, calcium
intake, exercise levels and
genetics
• Smoking
Neurological Changes
Chronic Health Conditions
Heart Disease
• Ageing is an independent risk factor for heart disease & stroke (men > women until age 55)
• Ageing arteriosclerosis, stiffer arteries, valves and vessel walls
• systolic blood pressure
• Compromised venous blood return postural hypotension
Main Risk Factors for Heart Disease
• NOT related to ageing
• Modifiable
• Lifestyle choices
2. Type II Diabetes
• Related to insulin resistance
in the cells
• Can go undetected for years
• incidence in older population
Effects of prolonged blood glucose elevation:
• risk of heart disease
• Cataracts and damage to retina
• Foot problems due to poor circulation and nerve damage
• Kidney impairment
• Impaired recovery from injury
Risk Factors for Type II Diabetes
• Overweight and obesity
(esp. abd)
• Waist circumference:
- men > 102cm
- women > 88cm
• Poor diet
• Physical inactivity
• Family history / genetics
• Over 55 years of age
Psychological Changes
Adjustment Disorder: Significant consideration for later in life
Symptoms Include:
• Increased vulnerability to depressive episodes
• Prevalence of triggers for generalised anxiety
Risk factors:
• Change & maladaptive change response
• Ageism
• Trauma, grief & loss
• Challenges to resilience and purposeful ADLS
• Loss of family support, social isolation
Life Balance Challenges with Ageing
• Big Picture - your life journey
Mini Picture -
making each day
meaningful
Balance
Purposeful Work
Mastery in Work & Hobbies
Commitment to Health & Wellbeing
Engagement with Family/
Friends
Functional Happiness &
Pleasure Connection to
Community
Pursuit of Meaning &
Purpose
Exploring Creativity
Pursuit of Learning
Self Actualisation
& Control
The Psychology of “Happiness”
Act:
• Physical activity: walk, garden, dance
• Cognitive activity: read, study, cross words
• Social activity: interact with people, friends
Belong:
• Group participation / join in
• Community events
• Family and friends, partner
Commit:
• Take up / volunteer for a cause
• Learn a new, challenging skill
Psychological Changes
Cognitive Processing
• Greatest 30 and 40 years, decline in 50s / early 60s
• Quality of reasoning and problem-solving remains the same but the speed of mental processing may slow
• Language and the ability to process complex problems improves with age!
Decision Making:
• Come to the same conclusions as younger workers but tend to rely more on prior knowledge and consider more alternatives
You CAN teach an old dog new tricks!!
Strategies for Managing RTW for an
Older Worker Case Study 1: “Sam”
• 68 year old male
• Sustained a lower back strain while working as a
machine operator
• Difficulties experienced with RTW due to the
prolonged standing, repeated bending and
lifting required for pre-injury duties
• History of similar claims in the past with protracted
RTW
Strategies for Managing RTW for an
Older Worker Case Study 1: “Sam”
• What can you do to achieve a successful RTW?
• How would you manage this worker if he
presented with a final certificate for a return to
PIDs today?
• What could you do to try and prevent further
recurrences?
Strategies for Managing RTW for an
Older Worker Case Study 2: “Jack”
• 64 year old male • Sustained a work-related knee injury while
working as a cleaner in a hospital > 3 years ago
• Morbidly obese (BMI 42)
• Work capacity of 4 hours x 3 days, limited standing and walking ability (after several exacerbations)
• Extreme shortness of breath and flushing observed during workplace assessment
• Failed attempt at RTW in driving role due to behavioural difficulties
Strategies for Managing RTW for an
Older Worker Case Study 2: “Jack”
• What are the barriers to RTW / work capacity?
• What can you do to manage this?
• What should the employer have done?
Considerations & Accommodations:
• Identify personal risk factors as early as possible
• Allow more time for gradual RTW
• Consider stage of life / priorities
• Use government and community services where appropriate
• Modify the workplace to extend work longevity:
- raise / lower working heights
- equipment provision
• Change nature of PID / redeploy to more suitable role
• PREVENTION!!!
Injury Prevention Strategies for the
Organisation
“ Need to adopt workplace strategies that build
upon the strengths and protect against the
vulnerabilities of workers as they age”
(Silverstein 2008)
Assessment and Analysis:
Current Workforce:
• Workforce demographics
• Areas of skills and experience
• Make predictions about future age of workforce and any training or up-skilling needs
• Review illness and injury statistics with regard to ageing factor
• Review opportunity for progression of job roles to more “suitable” tasks as workers age
May direct recruitment selection, opportunities for flexible work arrangements, social engagement
Assessment & Analysis
Further Assessment:
• Health status
• Policy review
• Employee focus groups, surveys
• Risk assessment
• Workplace assessment
Interventions / Implementations • Job dictionaries / review of job descriptions
Education / Training:
- Manual handling, H&W,
Courses
• Workplace modifications
• H&W environment
• Fitness for work Ax
• RTW planning for non
work-related conditions
• Onsite physio
• Flexible work arrangements (gradual retirement)
Aim: Healthy Ageing Workforce
Questions