The Aging Workforce: Strength is the new Vital Sign

Alan K. Novick, MD

Rehabilitation Medical Director

Memorial Rehabilitation Institute

Disclosures

I have no financial disclosures

ObjectivesBecome familiar with the statistics of the current and expected future workforce

Understand the benefits and disadvantages of an older worker

Understand the physical/medical changes with advancing age and the implications for injuries and recovery with those changes

Develop a knowledge of potential injury and rehabilitation programs specifically for the aging employee

Aging Society

AgeVariations in physical and cognitive capacities within different age groups

We all age differently

Jack Lalanne

Age 95– Exercises two

hours/day– 90 min weights– 30 min walking or

swimming

“If man made it, don’t eat it”

“If it tastes good, spit it out”

Baby Boomers

Born mid 1946-mid 1964

Began turning 65 in 2011

Aging Population

United States Aging Population: >65 years old

43.1 million in 2012

83.7 million in 2050

Estimated 21% total U.S. population in 2030– 1 out of every 5 people

Higher in minorities– 39.1% in 2050– 20.7% in 2012

Aging Population

Aging Population

Aging WorkforceWorkers >55 y.o. – projected to increase by 12 million from 2008-

2018– Make up 25% of workforce

65 y.o. no longer “normal” retirement age– 80% of baby boomers plan to work after

retirement age

Aging Workforce

Aging Workforce

Age 55-64– 1992- 11.8%– 2002: 14.3%– 2012: 20.9%– Projected 2022: 25.6%

Aging Workforce: Reasons

Reduced value of retirement portfolios

Improved health

Increased Life expectancies

Highly engaged in work/ Job satisfaction– Committed to organization

Aging Workforce: Reasons

From AARP Survey Staying Ahead of the Curve 2005

Aging Workforce: Reasons

Aging Workforce: AdvantagesEngaged employees – Use less health care– Take fewer sick days– More productive– Longer tenure– Create stronger customer relationships

Fewer accidents– Less risk taking behavior– More supervisory roles– Injuries more severe

Avoids “Brain drain”

Aging Workforce: DisadvantagesHigher compensation/wages

Increased cost of healthcare

Increased expense of training older workers in new technologies

Resistance to change

Outdated skills

Less mobile– Community roots– Home ownership

More disability

More sever injuries– Pre-existing conditions

Incidence of Disability

Age Disability

18-24 4.5%

45-54 20%

>65 42%

Functional Limitations

Functional Limitations

Aging: Common EffectsVision– Decreased acuity

Nearsightedness increases after age 40

Medical ailments increase after age 50– Macular degeneration– Cataracts– Glaucoma

– Eyes lose ability to change shape

Unable to focus quickly

Impaired night vision

Decreased ability to distinguish – Colors– motion perception – Contrast

– Dry Eyes

Aging: Common Effects

Hearing– Decreased– Tinnitus– Loss of high frequencies

30% over 65 y.o.

Cognitive Abilities– Mental process slower

Decreased response time

Fewer mistakes but decisions take longer– Impaired short term memory– Medications may also impact cognition

Aging: Common EffectsPhysical Ability– Decreased joint ROM– Bone mass decreases– Muscles

Decrease mass

Decrease elasticity/muscles stiffer

– Slower response time– Strength decreased– Manual dexterity/fine motor skills decline

Aging: Common Effects

Slips and falls– Contributing factors

Impaired vision

Impaired postural stability

Decreased muscle elasticity causes shorter stride length

Decreased strength

– 16% of fatalities in age 55-64

Aging: Common Effects

Medical Conditions– Hypertension– Coronary Artery

Disease– Diabetes– Arthritis– Obesity– Osteoporosis– COPD– Depression

Hypertension

Rate per 100 of Civilian, Noninstitutionalized Population with Diagnosed Diabetes, by Age,

United States, 1980–2011

Diabetes

Coronary Artery Disease

Complications of Coronary Artery Disease

Memory

Depression

Lost Work Days

Aging Workforce

More severe injuries

Slower recovery

More lost days

Apportionment concerns– Impairment from injury

or age related disease

Injury Prevention: Vision

– Modify environmentProvide sufficient lighting

Use bright or contrasting colors on ramps, stairs and uneven surfaces

Use pastel colors in areas requiring high level of concentration

– Modify equipment and tasksUse magnifiers to improve seeing small objects

Use equipment with audio or tactile cues

Limit driving to daylight hours

Injury Prevention: Hearing

Modify environment– Reduce noise levels

Relocate or replace excessively noisy equipment

Consider noise levels in room design– Sound absorbing materials

Modify/Utilize appropriate equipment– Use visual or tactile feedback for controls that are

hard to hear– Ensure alarms are audible/ use light warning systems– Provide communication systems with volume controls– Utilize hearing aides– Utilize protective gear

Injury Prevention: Cognition

Minimize complexity of tasks

Automate processes when possible

Lengthen time requirements between steps in tasks

Reduce need for multitasking

Allow for increase decision-making time

Eliminate clutter/distractions

Provide training– Use frequent and short hands-on refreshers– Provide opportunities to practice– Limit to no more than 3 critical issues to be learned

per session

Injury Prevention: Physical Ability

Job Modification– Reduce heavy lifts

Utilize handling aids (carts, dollies, etc)

Multi-person lifts

– Ergonomic changes

Address Employee issues– Review proper lifting techniques– Strength training, maintain flexibilty and

balance exercises

Hursh, Lui, and Pransky (2006): prevention strategies to minimize declines in work performance resulting from age-related physical, cognitive, or sensory

disabilities: Employer Strategies for Responding to an Aging Workforce

Individualized ergonomic design for older workers

Job analysis examining specific functions that result in increased injury

Assistive technology devices to increase, maintain, or improve the functional capacity of a worker

Job accommodations involving changes to the work site or work process

Hursh, Lui, and Pransky (2006): Employer Strategies for Responding to an Aging Workforce

Training initiatives to upgrade and maintain skills– multiple, shorter training sessions– mixed training formats (i.e., tell-show-do, direct/immediate

application of new skills to current job)– small group training formats– extra time and slower pace– distraction-free practice of new skill– link new learning to current work– early error correction, self-paced/directed learning– training environments that minimize noise or provide other

accommodations for hearing/vision impaired

Wellness and integrated health promotion– smoking cessation– Exercise– weight management

Conclusion