Disability and the Aging Work Force Flashcards
Why is the [workforce] population aging? - 3 general reasons LiME
- Life expectancy increases and fertility declines
- Medical advancement
- Education and research (ex: smoking)
explain how medical advancements have extended life
With the advancement in medicine, we have been able to perform surgeries, provide immunization (prophylaxis), and drugs to extend and improve the quality of life.
explain how education and research has extended life
(give example)
Research has brought much to light in terms of healthy living. There used to be a smoking section in restauraunts. As a society we have learned more about the detrimental effects of smoking. Soldiers during WWII would receive cigarettes in their daily rations, whereas now we receive protein shakes. Can’t smoke in the aircraft, what?
How much has life expectancy increased since 1950?
11 years
What is the current life expectancy in the US?
78 years old
Explain how birth rates over the years have contributed to a shift in our population towards older age
Post world war II birth rates increased dramatically. Economy was better, more optimistic outlook on the future.. Now that large population (baby boomers) is aging.
Also, GI Bill to return to school and improve skills. Oral contraceptives became available in the 60s. This reduced birth rates after the baby boom, so there were less younger folks born in comparison since then .
(I think)
What were 3 policies that discouraged older adults to continue working in the past?
- There was Mandatory Retirement Policies
- Defined Benefits were common
- Delayed receipt: workers could delay receipt of social security benefits in exhange for a 3% reward.
- If workers wanted to continue to work while delying SS benefits, companies penalized workers for staying past a certain age by not giving them company benefits either. It was often not worthwhile to continue working and yet not receive company or social security benefits.
Together these created a disincentive to continue working past a certain age, and provided a means to live without working.
What is mandatory retirement policy?
when and how did it change over time?
Why was it in place?
In the past, workers were Required to leave thier job at a certain age (1978 went from 65 to 70, then in 1986 completely eliminated for vast majority).
Perhaps due to decline in health, employers thought that older workers were risky to emply (could have accidents, etc)
What are 5 reasons older adults are now starting to retire later (or work into retirment)?
- Delayed Retirement Credit, the reward for delayed recipt of social security benefits was increased from 3 % to 8% per year of delay (better incentive to work longer into life)
- Defined Benefits (DB) continue to penalize workers who stay on the job too long, but DB plans are becoming less common as Defined Contribution (DC) plans grow. Unlike DB plans, DC plans are by their very nature age-neutral (tax deferred savings accounts). In 1988 only 26 percent of people had primary DC plans, by 2006 it was 67%. DC plans do not decline if an employee decides to work another year. Once we got to the 1980s, employers realized how expensive this was for the company to maintain defined benefits. The companies could not afford to pay for defined benefits as people lived longer.
- Life expectancy at age 65 has increased by four years and are predicted to rise another two years by 2050
- In general workers have less physically demanding jobs and this trend is expected to continue because of rise of technology. Technology has also increased job flexibility, can work where and when they want.
- Decline in company provision of post-retirment health benefits, so older adults stay at work to get insurance benefits. Fewer firms provide it, and when they do, the retiree pays more of the premium.
- Side note: Increases in healthcare cost are presumably related to aging, but research has shown that increases in healthcare cost may be due to inefficiencies in the healthcare system
What are 5 reasons that older adults are more commonly finding that they must or want to delay retirment?
Why do we care?
We care because we need to show empathy and understand how this could be a shock or dissapointment to our patients. We need to be prepared to help them maintain or improve function so they can continue to be successful workers.
- Some older adults have limited resources and continue to work because they cannot afford retirement (Defined Benefits aren’t what they used to be)
- Some older adults on the higher end of the socioeconomic scale choose to continue to work because they enjoy their jobs
- Some continue to work to stay mentally and physically active (2 most common reason in Merrill Lynch 2006 study), while
- others needed to continue working for healthcare benefits.
- Maybe did not begin planning for retirement until they were in their 40s or life circumstances. Someone becomes ill, medical bills, losing a high paying job.
T/F: there appears to be considerable scope for policy makers to improve the effectiveness of healthcare
True
What can be done at a policy level to help the aging workforce? (general)
Develop policies and programmes to enable older and disabled citizens to live independently longer
What is the European Employment Strategy?
European Employment Strategy is to increase Seniors rate of employment by 50%
Which countries are meeting the European Employment Stratagy goal?
European Employment Strategy is to increase Seniors rate of employment by 50%
- Countries meeting this goal: Nordic Countries, the UK, and Portugal
Overall, in the european union, what fraction of older adults are still working (and what age range is this number for)?
Overall in EU, ⅓ of people ages 55-64 are still working
T/F: there is is a shift in attitude toward aging working, and a recognition of the value of the experience older workers bring to their companies
true
Shift in attitude toward aging working; recognition of experience
What is Active Aging? (4 points)
- Term developed by WHO in the late 1990s
- Inclusive term for “healthy aging”
- Life for the aging is bigger than healthcare
- Shifts focus away from “needs” focus to human rights focus
What are 5 human rights and aging, and UN principals?
C– DIPS
Human Rights and aging and UN Principles:
- Care
- Dignity
- Independence
- Participation
- Self-fulfillment
What does “active” refer to in Active Aging?
“Active” refers to continuing participation in social, economic, cultural, spiritual and civic affairs.
Active Aging: What is the WHO dictum?
WHO dictum “years have been added to life now we must add life to years.”
What was commonly done in the past when unemployment was high that affected older adults?
what has experience shown about this?
When unemployment was high, there was often a tendency to reduce the number of older workers as a way to create jobs for younger people.
However, experience has shown the use of early retirement to free up new jobs for the unemployed has not been an effective solution
Employment trends: What has been the overall trend of employed aging population over the last century?
●Steady decline in employed aging population over last century
how did employment change for men age 65 in the late 1800s to 1990?
Men over age 65 employed dropped from 75% in late 1800s to 16% in 1990
Employment Trends: Which trend changed for both men and women at the end of the 1990s?
The trend of a steady decline in employed aging population.
Instead of declining it started increasing by the end of the 1990s
Employment Trends:
T/F: it is projected by the dept of labor that there will be an increase in only male workers over 65
False
●Projected by Dept. of Labor: an increase in workers over 65 for both genders
Where do we find our aging population employed?
Moving into sedentary jobs
Those with disabilities are often found in manual, temporary, part-time, or volunteer
Those with Disabilities are found in retail, manufacturing, Health and Community Services
Three things about Work, aging, and disability
- how does degree of severity relate to representation in workforce?
- What happens to labor participation when a person has more than one impairment?
- Are disabled workers likely to ask for accommodations from employer?
- ●Degree of severity of disability directly proportional to representation in workforce.
- ●Labor participation rates drop by almost 50% when a person has more than one impairment (could be hearing loss, chronic pain, difficulty holding/gripping things)
- ●Disabled workers not likely to ask for accommodations from their employer
How does the degree of disability severity relate to representation of older adults in the workforce?
●Degree of severity to disability is directly proportional to representation in workforce.
How much does labor participation rates drop when a person has more than one impairment?
●Labor participation rates drop by almost 50% when a person has more than one impairment
What are three common impairments that may affect an older adult’s ability to work?
Impairments could be
- hearing loss,
- chronic pain,
- difficulty holding/gripping things
T/F: disabled workers are not likely to ask for accommodations from their employer
True
What does it mean for us as physical therapists that our older patients may be working in more sedentary roles?
As pts age it is important for them to stay active to avoid disability. A challenge for us: we want to enable them to work (most in sedentary jobs) yet we want them to stay active.
If an older person with disabilities comes to you and mentions that they want to be able to go back to voulunteering, what might we want to especially keep in mind when treating them?
(corrected)
If we have a person coming to you with disabilities, they might have a goal to just maintain their volunteer job. This might not seem that significant to us, but it could be huge for them.
(corrected: the wrong thing pasted in when I originally made the card - Sara)
What do older adults often do instead of ask employer for accommodations?
What is a hypothesis related to this?
what is this an example of?
May seek part time employment instead of full time employment.
May stay unemployed instead of asking for accomodations (self selection)
Self-Selection Hypothesis
- Self selecting employment to evade asking employers for accommodations
This is an example of Self-Imposed Barriers to working.
What is something that the self-selection hypothesis explains?
•Explanation for greater representation of those employed with only one impairment
Three things to know about Discrimination and Aging
- tech and accommodation availability
- what percentage of workers were provided with an accommodation when restrictions were reported by employees?
- two conditions that were least likely to receive any type of accommodation
- •Wide variety of assistive technology and accommodations are available to those with disabilities, but few employers offer accessibility.
- •When restrictions were reported by employees, only 12% were provided an accommodation.
- •Those with hearing loss or blackout were least likely to receive any type of accommodation
Do employers offer accessibility to aging workers?
What might be available for them to offer?
•Wide variety of assistive technology and accommodations are available to those with disabilities,
but few employers offer accessibility.
When restrictions at work were reported by older adults, what percent were provided an accomodation by their employer?
•When restrictions were reported by employees, only 12% were provided an accommodation.
What were two conditions that were least likely to receive any type of accommodation?
•Those with hearing loss or blackout were least likely to receive any type of accommodation
when working with an individual pt, what are some things we can do to help get around discrimination against aged workers
We are here to help enable people, so we might be the ones to help people work around these discrimination difficulties.
What is a law that helps protect older workers, and what ages does it cover?
When was it passed?
●Age Discrimination in Employment Act (ADEA) passed in 1967
●Some protection for people over 40
What is a law that helps protect disabled workers, and when was it passed?
●Americans with Disabilities Act passed in 1990
How many workers in the US are age 55 or over according to AARP?
1 in 5
How many workers say they have seen or experienced age discrimination in the workplace?
64%
according to AARP
What percentage of adults believe age discrimination begins among workers in their 50s?
58%
according to AARP
We are not lawyers but . . .
we have access to resources and should be aware of them to help our pts.
Resources include things like knowledge of the Age Discrimination in Employment Act and Americans with disabilities Act.
What is something that helps older adults reduce barriers to continue working?
•People who remain healthy as they age face fewer barriers to continue working.
remaining healthy and continuing to work helps offset the cost of what three things?
•Help to offset the rising costs in
- •pensions
- •income security schemes
- •medical and social care costs
What are two (-) societal trends that are increasing in the aged and disabled?
- Increased interests in euthanasia
- Increased rate of suicide in aging and disabled
What are two types of things that society at large should think about, considering the increase interest in euthenasia and increased rate of suicide in the aging and disabled?
- Moral, religious and legal implications of these phenomena
- Increased need to develop emotional, psychological, and economic support
What are some psychological implications of aging in today’s world?
•Living Longer considered paradoxical due to “frequency of questionable attributes”
- •Frequency of chronic illness
- •Physical and psychological weakness
- •Alienation and isolation
- •Depression
- •Loss of independence
- •Lowering of social and economic status
Living Longer considered paradoxical due to “frequency of questionable attributes”: What are 6 factors that go into this idea?
- •Frequency of chronic illness
- •Physical and psychological weakness
- •Alienation and isolation
- •Depression
- •Loss of independence
- •Lowering of social and economic status
Why should you care about any of this? (5)
- PT may be first person the pt may complain to about age or disability discrimination
- Aging population is moving in sedentary jobs- how can we help them adjust and maintain employment?
- Understand the societal and psychological changes that may affect our aging patients
- Be able to understand and empathize with the changes our patients have experienced
- We can affect change and development of helpful programs at a city, state or federal level (we are advocates for our pts)
**the bold was emphasized in class (possibly by Dr. Worst)
What are some changes that occur as we age? (8)
- Decreased Aerobic Fitness
- Decreased Muscle Strength
- Decreased Balance
- Decreased reaction speed
- Decreased hearing
- Decreased flexibility
- Slower mentation
- Vision Changes
Changes with Aging: Explain Decreased Aerobic Fitness (3)
•Decreased Aerobic Fitness
- 1% decrease per year after age 20
- ½ peak levels by age 80
- UNLESS you’re active!
- Active healthy adults only lose 7%
***Aerobic fitness is max o2 uptake during incremental exercise
Changes with Aging: Explain Decreased Muscle Strength (4)
•Decreased Muscle Strength
- 0.3-0.5% loss in muscle mass per year after age 30
- Decrease in number and size of muscle fibers
- Increase in adipose tissue within the muscle
- UNLESS you strength train 2X a week
What is the leading cause of older adult injury?
Falls are the leading cause of older adult injury
Decrease of Balance is a very big deal!! Ask about it even if they don’t say it.
What are two components that contribute to decreased balance in older adults
- Vestibular Changes
- Vision Changes
What are two things that contribute to decreased vestibular function as we age?
•Vestibular Changes
- •Decreased blood flow
- •Decrease of vestibular nerves at age 55
What are 6 things related to vision changes in older adults?
- •Visual acuity
- •Static decreases at- 60 yrs.
- •Dynamic decreases- approx. 45yrs.
- •Perception of angular movement
- very important for driving
- •Depth of visual field
- •Scotopic vision (use of just rods - night vision)
- •Contrast sensitivity
- •Crowded visual field (something to think about when setting up work environent or choosing task)
When does static visual acuity generally start to decline?
How about dynamic acuity?
•Visual acuity
- •Static decreases at- 60 yrs.
- •Dynamic decreases- approx. 45yrs.
What vision function is very important for driving?
perception of angular movements
What is scotopic vision?
using just rods
“night vision”
How can we apply the knowledge that someone is having trouble with crowded visual fields?
We can try to help them set up their work environment with reduced visual clutter. Or if we are designing a work environment, we can try to minimize visual clutter.
What is important to remember about decreased reaction speed in older adults?
Its negative aspects can be combated with experience and job alterations
Why is decreased flexibility a problem for older adults?
Decreased flexibility may not seem like a big deal, but people with less flexibility often have more body and back pain.
What is a consideration for people with slower mentation?
They will have a decreased ability to multitask
What does WAI stand for
Work Ability Index (WAI)
What is the WAI?
It is a questionnaire that measures the likelihood that people will be able to go back to work and stay at work.
It addresses environmental and personal attributes
WAI:
- Who developed it and when?
- What is the possible score range?
- How many categories are included?
- What kind of predictivity value does it have?
- •Developed at the Finnish Institute of Occupational Health(FIOH) in the 1980’s
- •Questionnaire scored (7-49)
- •7 categories
- •High predictivity value
What is Work Ability Promotion?
Proposes ways to help employee that scored low on the WAI (most focused on what an employer can do)
what are the four different actions that can help Work Ability Promotion?
Which are the two most important?
•Based on 4 different actions
- Adjustments needed in physical work environment
- Adjustments needed in the psychosocial work environment
- Health and lifestyle promotions
- Updating professional skills
first two are arguably the most important
Treating The aging workforce: What are 2 big categories of PT treatment?
Exercise
Education
Treating the aging workforce: What are three parts that should be included in an exercise program?
- Individualized walking program
- Balance training
- Strength training
Treating the aging workforce: What are 3 things you should include as part of your pt education?
- •Self paced work
- Encorage pt’s to work in an environment where they can self pace. Workers who are self paced have lower anxiety, lower depression, and higher job satisfaction. This will also help older adults adopt performance strategies to compensate for aging related problems.
- •Supplemental material on rights as an older worker
- •Ergonomic education
**Also included Other tips and tricks
Fundamental Ergonomic Process: What are the four steps?
- Identify the physical, physiological and psychological demands of the job
- Identify the physical, physiological and psychological capabilities of the worker
- Identify the discrepancy between 1 & 2
- Minimize the mismatches through education and training, and work, tool, equipment and environmental design
As a therapist for any population, you want to consider ergonomics. This process is very simple and can be applied to any population.
why is it important to address ergonomics for workers?
Are companies usually eager to provide ergonomic changes?
People enjoy their work more, they do better, and it benefits the companies. Companies might not want to make the changes, but it really does benefit them in the end.
Case 1:
Pt. Facts: 65 yo male
PMH: Overall good health. Does have wear bifocals, type II diabetes, and HTN (both controlled with medication)
Other relevant history: Continually exercised his whole life, had a recent stress test with no abnormalities, and is excited and motivated to return to work.
Job: Factory worker.
Job Description: Assembly line work repetitively lifting a 5 lb panel and attaching it to a car frame. No restrictions on whether he sits or stands, but he prefers to stand. Assembly requires some reaching overhead. He will work 10 hour shifts 4 days a week from 2 pm - midnight Monday to Thursday. He will be required to install 2 panels every 5 minutes.
Your job: What are some considerations for his job to make sure he is productive and safe? (8)
- Time of Day*
- Height of the assembly line
- Noise in the factory*
- Overhead activity
- Reach zone (how far he has to reach out)
- Temperature of the factory*
- Ensure appropriate work pace
- Proper lighting
*Especially important to older adults
Case 2:
Pt. Facts: 68 yo male
PMH: Previous MI (recovered but limited cardiovascularly), HTN, Type II Diabetes, and wears glasses and hearing aids
Other relevant history: Sedentary most of his life
Job: Fork lift driver at a distributions center
Job Description: Use the forklift to load and unload trucks cargo. Lift up to 50 lbs. Work shift from 6 am - 3 pm.
A little more information: He has driven a forklift before, but it was when he was in his 20’s.
Your job: What are some considerations for this type of job (3), possible modifications to the forklift (3), and environmental considerations (3) to make sure he is productive and safe?
Job considerations:
- Complexity of the task*
- Vision and hearing may affect safety
- Lots of practice and training before*
Modifications to equipment:
- Clearly marked levers and handles
- Simple controls*
- Ensure seat allows proper posture
Environmental:
- Lighting*
- Noise*
- Temperature*
*Especially important to older adults
Case 3:
Pt. Facts: 70 yo female
PMH: HTN, osteoporosis, wears glasses
Other relevant history: She was a lawyer for 30 years and wants to be back around the work.
Job: Secretary for a law firm
Job Description: Basic clerical work, such as: Answering phones, returning emails, filing papers, and scheduling appointments. Work schedule is from 8 am - 5 pm 3 days a week. Some minor lifting of boxes no greater than 20 lbs will be required.
Your job: What are some considerations for this type of job to make sure she is productive and safe? (3 workstation, 2 office, 1 job consideration)
Workstation set up
Chair height
Desk height
Type of phone (hands-free or normal)
Office set up:
Trip hazards (cords, rugs, etc.)
Lighting
Job considerations:
Boredom (she may need something more challenging or mentally stimulating)
What are 3 resources you can access or share with older adult workers?
- •APTA’s Fit After 50 Campaign
- •MoveForwardPT.com
- •AARP’s website
- •http://www.aarp.org/work/working-at-50-plus/
What are 6 main ideas or things you whould have learned from this presentation?
- •Why do you have an aging population
- •How this aging population is affecting the workforce and what type of jobs are they working in
- •Discrimination is a risk factor for our aging and disabled workforce experience
- •Societal and Psychological changes and implications of our growing aging population
- •Understand how to support and treat the older patient in the workforce
- •Ergonomics need to be specific to the job and individual
If an older person with disabilities comes to you and mentions that they want to be able to go back to voulunteering, what might we want to especially keep in mind when treating them?
(corrected)
If we have a person coming to you with disabilities, they might have a goal to just maintain their volunteer job. This might not seem that significant to us, but it could be huge for them.
(corrected: the wrong thing pasted in when I originally made the card - Sara)
