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Ageing, Work & Health
Professor Amanda GriffithsPhD MSc PGCE CPsychol (Occ, Health) AFBPsS AcSS
RCN Health & Safety Conference:Health and Safety in the Changing World of Work
RCN HQ, Cavendish Square, London, 14th October 2011
© University of Nottingham
Institute of Work, Health & Organisations
• Research - promoting ‘healthy people, healthy work & healthy organisations’
• Teaching – Innovative PG courses to equip students with knowledge & skills to ‘make a difference’
• WHO Collaborating Centre in Occupational Health
• Applied psychologists
Aims• To update you on three topics – literature
reviews & empirical research projects – and implications for practice
– older workers' changing profiles of skills & abilities
– work characteristics experienced as 'stressful' by older workers
– gender specific issue - women’s experience of working through the menopause
Age of Nursing Population
• Patient demands increasing as general population ages
• 12% RCN membership age 55+ yrs• Average age (42) increased by 9 yrs
since 1987 RCN Workforce Survey 2009
• Not enough new entrants to replace expected number of retirees
• Retaining older nursing workforce critical (as well as increasing number of new entrants) RCN ‘Who will care?’ 2011
PART I
OLDER WORKERS – CHANGING SKILLS & ABILITIES
Introduction
• Limited amount of research addressing factors of real interest to employers
• The real question – how can employers design & manage work to suit an age diverse workforce? – maximise job satisfaction?– capitalise on knowledge and skills?– boost health?
Physical Abilities
• Muscle strength, sight, hearing
• Illness, Sickness absence
• Injuries & accidents
• Implications– flexible work patterns– age appropriate equipment
NB – Physical Activity KEY
Cognitive Abilities
• Verbal abilities– decline after 80
• Information processing– declines after 25
• Reasoning, numeracy, memory– improve from 25– level off in mid 40s– modest declines after late 50s
Variety is Normal
• Large variation – some 50 yr olds better than 30 yr olds
• Predictors of cognitive decline ?– cardiovascular fitness– intellectual activity
• Decline in basic ‘abilities’ does not equate to decline in work performance
Why Not?
• ‘Ability’ research based on artificial tasks that push people to limits of ability – not real work
• Experience compensates
• Know the system
• Teamwork / engaging support
Implications for Practice - Key Role of Line
Managers• Stereotypical attitudes impact on
performance
• Knowledgeable, sympathetic & flexible (line) management predicts continued success
• Importance role for training & continued professional development
• Consult older workers
Attitudes & Personality• More
– job satisfaction– organisational commitment– conscientious– reliable– stable– agreeable
• Less – turnover– open to change
Conclusions
• Age diversity natural & confers advantages
• Trade-off between reaction time & considered approach
• OWs’ unique contribution - experience
PART II
AGE & WORK-RELATED STRESS
Background to Review
• The ageing population has made extending paid working life a priority for government policy
• How can employers act to reduce work incapacity & early exit from labour force ?
• Which working conditions cause stress & mental ill-health in older workers? Systematic literature review for TAEN (Griffiths et al, 2009)
• Reports of work-related stress, anxiety & depression inverse-U shaped : – become more common in mid-life workers (50-55) – decrease towards retirement (55/60+)
Mapping Stress & Age
• Why do smaller numbers of workers in their 60s report stress? :– unhealthy workers take ill-health retirement– workers change jobs they find stressful– workers voluntarily retire early from jobs they find
stressful– senior workers have more ‘control’ at work (=less
stress)– older workers have developed coping strategies– health reporting bias – report of health tends to be in
comparison with others of the same age (so older people report more positively about objective health states than younger people)
– are older workers ‘healthy survivors’ ?
Other Considerations• Health effects of work can take years to
appear
• Health effects of work extend into retirement• Physical health declines with age but work-
related stress can contribute independently to– cardiovascular disease – musculoskeletal disorders – altered immune system & inflammatory processes– disturbed sleeping patterns
• Changes in priorities– caring & domestic responsibilities, chronic health
conditions, other interests• Women report more work-related stress
Improving Work• Increase control & support • Increase flexibility
– working hours, rest breaks, flexi-time, job shares– special leave arrangements (work-life balance)– part-time work (gradual retirement), transfer to less
demanding jobs, consultancy options• Choice about level /type of work undertaken• Day/early shifts preferable• Offer job training - fast changing world of work• Adapt work to suit changing strengths• Promote age aware/tolerant culture – educate
managers about age, work & health• Recognise contribution of older workers• Health promotion (eg. physical exercise)• Conclusion - consult older workers - make work
more flexible, interesting & attractive
“Investments in the quality of people’s ‘third age’ – life after retirement –
should be made during working life, not just afterwards”
Nurses• Skills & experience to be valued• Healthy inter-generational culture • good relationships at work• Career expectations respected• Flexible retirement options• Suitable equipment/technology• Access to OH support• Flexible working options (eg for carers)
RCN ‘Who will care?: Protecting employment for older nurses’. RCN 2011
PART III
OLDER WOMEN WORKERS & HEALTH - THE MENOPAUSE
Women at Work
• 47% of labour force (ONS 2010)
• 45% of all employees over 50
• 3.5 million women
• Issues specific to older women’s occupational health receive little attention (Payne & Doyal, 2006)
• Older women workers report more work-related stress
(HSE LFS SWI, 2009; Griffiths et al, 2009)
Older Women & Stress I
• More prepared to report stress?
• Greater domestic responsibilities
• Multiple roles > physical & emotional strain > poorer mental health
• Different physiological response to stressful situations
• Lack of support at work more harmful for women
Older Women & Stress II
• Employed in different occupations from men and under different working conditions– poorly paid, low status, little opportunity for
control > more stressful
• Hormonal changes associated with ageing – the menopause
Menopause Research: Aims
• What problems does the menopause present for working women?
• How do they cope with it?
• Advice for women, employers & healthcare practitioners
• Women very pleased to participate
• Organisations less so – many reasons
Questionnaire - Content
• Menopausal status algorithm (McKinlay et al)• HRT use, alternative treatments • Effect of symptoms on work• Effect of work on symptoms • Work characteristics (line manager, work
environment)• Hot flushes • Coping strategies & sources of support (general,
work-specific)• Disclosure to managers & co-workers, Absence• Suggestions - what would make things better at
work?
Menopausal Status
43%
30%
8%
18%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Menopausal Status
Perc
enta
ge o
f W
om
en
Perimenopause
Natural Menopause
Surgical Menopause
Hormone Use
Perceived Impact of Symptoms on Work
Symptoms %
Poor concentration 51
Tiredness, poor memory 51
Feeling low/depressed 42
Lowered confidence 39
Sleep disturbances 37
Irritability 36
Hot flushes 35
Job Performance Negatively Affected by Menopausal
Symptoms
14%
26%
18%
31%
11%
0%
5%
10%
15%
20%
25%
30%
35%
J ob Performance Negatively Affected byMenopausal Symptoms
Perc
en
tag
e o
f W
om
en
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
Difficulty Managing Work Overall
4%
1%
47%
37%
11%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
How Difficult it is to Manage Work Overall
Perc
en
tag
e o
f W
om
en
Not at All
Somewhat Difficult
Fairly Difficult
Very Difficult
Extremely Difficult
Work Situations Making Coping with Hot Flushes
More Difficult%
Working in hot/unventilated environment 75
Formal meetings & presentations 67
Doing high visibility work 48
Learning new things/procedures 46
Tasks requiring attention to fine detail 39
Working in a shared office 38
Working to a deadline 35
Disclosure to Line Manager
30%
70%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Disclosure to Line Manager
Perc
en
tag
e o
f W
om
en
Yes
No
Physical, Organisational & Psychosocial Adjustments at Work
%
Greater awareness among managers of menopause as a possible OH issue
75
Flexible working hours 63
Formal info/advice about the menopause & how to cope at work from my employer
58
Better ventilation/air conditioning /temperature in my usual work environment
55
Informal support for women going through the menopause
52
Allowing working at home 49
A rest area 40
The Menopause: Implications for Practice
• Guidance for managers published: includes -
• What is the menopause?
• What can managers do to support women?– be aware of the menopause as a possible source of
difficulty for working women– create a culture where employees feel able to disclose
health problems– allow flexible working hours as far as possible– set up informal and formal systems for providing
support and information (eg. contact point, websites)
• PLUS – illustrative quotes, & sources of further information
Conclusions• Older workers can provide a valuable contribution to
tomorrow's workforce. However, successful and healthy ageing involves maintaining physical fitness, having supportive managers and colleagues, keeping up to date with training, and having flexibility in working practices.
• Protecting tomorrow’s older workers, as well as today’s, would be likely to pay dividends, particularly since it is now becoming clear that working conditions can impact on health and well-being after retirement.
• Although usually a 'taboo' topic, some women experience considerable challenges whilst working through menopausal transition: a few simple steps will enable managers to support them.
Resources• RCN ‘Who will care?: Protecting employment for older nurses’.
RCN 2011• http://www.rcn.org.uk/__data/assets/pdf_file/0008/395378/003
849.pdf
• Ageing, Work-related Stress and Health. Age Concern & TAEN - The Age & Employment Network 2009 http://www.taen.org.uk/uploads/resources/24455_TAEN_Work_Related_Stress_32pg.pdf
• Work and the Menopause: A Guide for Managers. BOHRF 2010• http://
www.bohrf.org.uk/downloads/Work_and_the_Menopause-A_Guide_for_Managers.pdf
• Healthtalkonline• http://www.healthtalkonline.org/Later_life/menopause
• Older workers’ strengths and weaknesses: Fact and fiction reviewed. In UNUM CMO Report – Age Old Concerns 2008
