An age-old problem

For years many older workers have suffered ageism in the workplace. But this
country’s changing demographics mean employers are going to have to learn to
appreciate the contribution they can make. OH personnel can play a pivotal role
in busting age stereotypes and ensuring a harmonious working relationship, By
Nic Paton

We are all getting older. According to career consultancy DBM by 2008 the
number of people aged 45 years or older will increase from 33 per cent to 44
per cent of the workforce, as the baby boomer generation of the 1960s starts to
approach retirement age.

By comparison, fewer young people are coming into the workforce to take
their place. Those aged 24 to 44 will drop from 51 per cent to 41 per cent. And
by 2012, more people will be leaving the workforce than entering it. By 2030 it
is estimated that the UK population will have 19 million people aged 60 and
over.

Thanks to medical advances, life expectancy is longer than it has ever been.
According to the Employers’ Forum on Age (EFA), women can now expect to live
until 80 on average and men to 75. Life expectancy is growing at a rate of two
years per decade. Yet, against this, the growing pensions crisis in this
country means that more and more people who had hoped to retire at 65 or even
earlier are having to stay on in the workplace for longer.

And, on top of all that, in four years time legislation will come into
force, outlawing age discrimination.

These changes are set to create new challenges for occupational health
nurses. The way OH nurses work, and critically, their role in the workplace as
advocates of good health among employees and employers, is likely to evolve as
the make-up of the workforce changes.

How old is old?

When it comes to discussing age in the workforce, it is important to define
whether you are talking about workers under 65 or over 65, suggests Dr David
Matthews, occupational physician at Bupa Wellness.

A recent conference organised by the health provider came to the consensus
that while current trends have been for more and more people to take early
retirement, it is likely this is going to reverse in years to come. Increasing
numbers of people will have to keep on working up to retirement age and beyond
simply because society will not be able to afford to keep them in retirement
any more.

"We will need a population that is able to work in some capacity to a
much greater age. So there will be a greater incentive for people to remain
active, and health promotion activities will become much more relevant,"
he suggests.

Older workers need special consideration

Providing for older workers should, in principle, be no different to
providing for workers with disabilities or other special needs, argues Sam
Mercer, campaigns director at the EFA.

Issues include looking at the physical nature of any work and where any
stressors, such as excessive lifting, might lie. "Just because you are
getting older does not automatically mean you are disabled. The focus has to be
on ability rather than age," she says.

Just as everyone is different, so everyone ages differently. While older
people are generally less physically active and potentially more prone to
physical injury than younger workers, a young person might be just as at risk
of suffering from a bad back. They might also be significantly less healthy
than an older person who has looked after him or herself for many years.

But it is worth looking at where older people can be affected differently.
In general physical strength declines with age from a peak at between 20 and 30
years. Ageing also affects people’s mental abilities, and the ability to
process information can decline with age. Their eyesight may not be as good and
older workers may also find it harder to learn new skills and technologies.

Benefits offered by older people

On the plus side, older people will probably have more experience of life
and the workplace than their younger counterparts and may have developed better
coping mechanisms. The stereotype that older workers are inflexible, take more
time off sick, have poor technical skills and cost more simply because of
higher salary and pension costs, does not stand up to scrutiny, says the forum.

Indeed, older workers are often likely to be more committed and take less
time off sick than their younger counterparts, making it all the more important
that their health is being screened and monitored effectively.

"An older worker is often more reliable and has less short-term
absence, but there is a greater likelihood of long-term absence when they do go
off. There are also going to be issues with medical conditions that are more
common in older age, such degenerative musculoskeletal conditions,
cardiovascular disease, malignant diseases and diabetes," says Dr
Matthews.

OH professionals will need to keep a close look at issues such as manual
handling and shift working, as well as their criteria for ill-health
retirement. "After 50, the ability to do night work is significantly
decreased," he explains. Extra training may be needed in areas such as
manual handling and workstation assessment, he adds. Many older workers will be
looking to remain in the workplace on a part-time or flexible basis, which is
another area that will need to be tackled.

Retail sector

One industry that has pioneered getting older people back into the
workforce, and so has experience of dealing with their health needs, is the
retail sector. Companies such as B&Q, Sainsbury’s, Asda, Tesco and John
Lewis have all encouraged older people to work in their stores, and have seen
their skills, experience and manner become increasingly popular with shoppers.

From an OH perspective, it is vital that older workers know what the demands
are of the job they are going into, suggests Margot Marment, senior OH nurse at
John Lewis’ Brent Cross store in North London.

They need to realise that the job may be physically demanding, as a job in
retail sometimes can be, and the OH department needs to be aware of what their
health needs are likely to be. "We tend to make sure they have a very
clear job description and ensure they have a workplace visit," she says.

The role of OH

The relationship between the line manager and OH nurse is a vital one, both
in ensuring the manager knows what to expect from the worker, and vice versa,
and in keeping good channels of communication open. "People often come to
us with underlying chronic conditions, so we do a lot of modifications and look
at the tasks they are doing," she explains. But all return-to-work
programmes must be geared to individual needs, she adds.

When it comes to health promotion, subjects such breast awareness, back
pain, diabetes, heart conditions and chiropody are all high on the list when
you have a working population that has many people aged over 45 within it.

For employers, the advantage of having an occupational health team to do all
this cannot be understated, says Marment. OH nurses have the knowledge and
understanding of the working environment, and the sort of equipment required,
she says.

They also have the ability to reassure managers that a person, however old
or young, is fit to do the job required of them. "We often find older
people are more reliable, and their attendance is often much better. But the
more established an OH department is, the more effective it is," she says.

Yet, at the same time as the workforce is ageing, and so requiring greater
access to the sorts of services OH departments provide, so provision of OH in
this country is being reduced.

A study by the Institute of Occupational Health for the Health & Safety
Executive, published in June, found that just one in seven workers in the UK
now has access to comprehensive occupational health support. This compares with
50 per cent, or 12 million workers, in 1990. And around 40 per cent of employers
spent under £1,000 a year on occupational health (see box).

The trend towards a more mobile workforce, with workers less likely to stay
in one place for more than a few years at a time, has exacerbated this
situation, with firms arguing there was less point in paying for a service to
look after someone for just a couple of years, say.

Lack of trust

Managers have still got much to do to gain the trust of older employees when
it comes to managing their health. A study published in July by the Industrial
Society Learning and Development found that the older the employees were, the
less well managed they thought they were. Just two out of five employees felt
they were getting sufficient help to manage their stress levels at work, with
older workers the most critical of their managers’ skills.

The forthcoming legislation on age discrimination, scheduled for 2006, is
bound to concentrate many employers’ mind who are likely to turn to their OH
departments for advice, suggests Simon Pickvance, senior OH nurse at the
Sheffield OH Advisory Service.

"When people are looking at the priorities within OH in the workplace,
working with people with disabilities has slipped down the agenda but working
with older people is now going up the priority list," he says.

Most workers aged over 50 have some form of disability as covered by the
Disability Discrimination Act, he argues, meaning employers already need to
keep a close watch on how they treat their older workers and ensure they are
protecting their health.

The changes facing OH are not just demographic ones but also the result of
the changing nature of the labour market, he asserts. Skills shortages in heavy
industry are encouraging more people who had perhaps taken early retirement to
return to the workplace.

Common workplace health issues can also present themselves differently in
different generations. Take stress, for instance. An older worker might find
dealing with a new technology or adjusting to change much more stressful than a
younger colleague, argues Pickvance.

Tackling the health of older workers will mean employers have to look at the
issues from various viewpoints. Indeed, a conference on the ageing workforce in
Finland in 1999 concluded that addressing the needs of an ageing workforce
required a co-ordinated approach, combining education, health, training, social
protection and equal opportunities.

OH will play a pivotal role in ensuring older workers are fit and capable of
doing a specific role and helping to destroy, rather than reinforce, age
stereotypes, argues Bupa’s Dr Matthews.

Given the right tools, OH nurses have the potential to act as a bridge
between the older worker and management, giving managers the confidence to
employ older workers in the first place and giving older workers the confidence
to know they are up to the job.

"OH nurses will play a major role in changing perceptions. But at the
moment we are not particularly well equipped to do that," adds Pickvance.

The ageing workforce: facts and figures

– There are currently just under 6
million people aged between 50 and the state pension age in employment, an
employment rate of 68 per cent

– The employment rate for men aged 50-64 is 70.3 per cent and
for women aged 50-59 is 64.9 per cent

– Since 1997 the employment rate of older people has risen
faster than that of the working age population as a whole

– The average length of time in current employment is much
higher for older workers (13 years compared with seven years for those aged
25-49). Older workers are more likely to work part-time and/or be self-employed

– There are around 19 million people aged 50 and over in the
UK, accounting for 40 per cent of the adult population. By 2020 it is predicted
this population will have increased by a further 3 million

– Older people in general have fewer qualifications than their
younger counterparts and are more than twice as likely to have no formal
qualifications

Source: Department for Work and Pensions

Occupational health provision

According to the Health & Safety
Executive, only around 30,000 organisations make use of comprehensive OH
support – defined as one that encompasses hazard definition, risk management
and information provision, and having the ability to modify work activities,
provide training, measure workplace hazards and monitor trends.

Around 44 per cent of large organisations, but only 2 per cent
of very small companies use this kind of provision.

But some 15 per cent of firms make use of more basic OH
support, offering hazard definition, risk management and training.

The main reason for having occupational health support is a
concern for the health, safety and wellbeing of employees. A fear of litigation
and worries about the cost of dealing with absence if there is no occupational
health service are other deciding factors.

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