Transcript stress - South West Occupational Health Nurses Group

The Health Issues of an
Ageing Workforce
Dr Shane Tellam
Consultant Occupational Physician
Occupational Health South West
Ltd
Aims
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To understand the demographics
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To consider the health issues of ageing
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To consider the impact on work capability
and the possible need for adjustments
To consider the possible legal aspects
Demographics
Demographics
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The UK population is projected to
continue ageing with the average
(median) age rising from 39.7 years
in 2010 to 39.9 years in 2020 and
42.2 by 2035 (Office for National
Statistics 2011a).
Demographics
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3x number of people aged 90+ by
2035
4x age 95+ by 2035
Age 100+ is projected to rise from
13,000 in 2010 to 110,000 by 2035
(Office for National Statistics 2011a)
Key Facts
 We
are running out of
workers: current employer plans
suggest that we will need to fill 13.5
million job vacancies in the next ten years,
but only 7 million young people will leave
school and college (UKCES 2010/GADa).
Key Facts
 Immigration
will not fill the
gap: current net immigration is around
200,000 people per year (ONS 2011b) and
the Government is committed to reducing
this.
Key Facts
 Older
people are the main
untapped source of labour:
unlike migrants, they already live here,
and their numbers are growing. By 2020,
36% of the working population will be
over 50 (Government Actuary’s
Department).
Key Facts
 People
are living and keeping
fit for longer: most of today’s 65year-olds will live beyond 80, and some
will live beyond 110 (Government
Actuary’s Department).
Key Facts
 The
dependency ratio is
deteriorating: whether retirement is
paid for through occupational or state
pensions, the money to pay for it comes
from the current workforce. In 2008, there
was a ratio of adults under and over
pensionable age of 3.2. By 2033 this will
be 2.8 (ONS 2009).
Key Facts
 More
and more people want
to work longer if the
conditions are right: surveys
regularly show that most older workers
would work longer if they enjoy their work
and could work more flexibly (McNair et al
2004).
Key Facts
 The
proportion of older
workers aged 55 and above
planning to work beyond the
state pension age is 54%,
according to a recent survey (CIPD
2010b).
Common Age Related Health
Problems
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Heart conditions (hypertension, vascular disease, congestive heart
failure, high blood pressure and coronary artery disease)
Dementia, including Alzheimer's disease
Depression
Incontinence (urine and stool)
Arthritis
Osteoporosis
Diabetes
Breathing problems
Frequent falls, which can lead to fractures
Parkinson's disease
Cancer
Eye problems (cataracts, glaucoma, Macular Degeneration)
Cardiovascular
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High blood pressure
High cholesterol
Reduced cardio respiratory fitness
Obesity
Increased risk of ischaemic heart disease
and stroke
Diabetes
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Certain factors can increase the risk of
developing type 2 diabetes (which is most
common in older people).
Over 80 percent of people with type 2
diabetes are overweight. The more
overweight you are, with a body mass
index (BMI) of 25 or more, the greater
your risk of diabetes.
Diabetes
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Physical inactivity has been shown to
contribute to diabetes.
Impaired Glucose Tolerance (IGT)
African Americans, American Indians,
Alaskan Natives, Asian Americans, Pacific
Islanders and Latinos are at higher risk for
developing Type 2 diabetes.
Age - Approximately 18.4% of Americans over
age 65 have type 2 diabetes.
Musculoskeletal
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Arthritic conditions: OA, Rheumatoid, Gout
Lasting joint pain and tenderness
Joint swelling
Joint stiffness
Problems using or moving a joint normally
Reduced functional capability and exertion
tolerance
Cognitive Ability
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Cognitive decline is a deterioration in
cognitive function. There is a normal process
of age related cognitive decline across the
life-span characterised by increasing
difficulties with memory (new learning) speed
of infomation processing, language and other
cognitive functions. This normal process of
age related decline.
Cognitive decline
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mild cognitive impairment increases with
age. The prevalence is 10% in those aged
70-79 years and 25% in those aged 80-89
years.
cerebrovascular disease, Lewy body
dementia, Parkinson's disease, frontotemporal dementias (alcohol
related),Alzheimer's disease, or no specific
underlying pathology (Dementia).
Vision
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There are four major age-related eye
diseases
glaucoma, cataracts, age-related macular
degeneration and diabetic retinopathy
By age 65, 1-in-3 people have some form
of vision-impairing eye disease.
Presbyopia - the lens of the eye loses its
ability to focus
Hearing
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Presbycusis-is the loss of hearing that
gradually occurs in most individuals as they
grow older.
Tinnitus-common in older people.
Sensorineural-damage to the inner ear or the
auditory nerve. This type of hearing loss is
permanent.
Conductive-when sound waves cannot reach
the inner ear e.g. Earwax, fluid, or a punctured
eardrum. Treatable.
Other Ageing Effects
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A slowed reaction time, which is especially
important when judging if a person can drive.
Thinner skin, which can lead to breakdowns
and wounds that don't heal quickly
A weakened immune system
Diminished sense of taste or smell, especially
for smokers, which can lead to diminished
appetite and dehydration
Legal
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Equality Act 2010
Disability discrimination – need to consider
reasonable adjustments
Age discrimination
Forced retirement
Employers
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Flexible working
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Part-time working
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Adjustments
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Redeployment
Why continue
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Studies of older people show clearly that
those who stay in work are healthier and
often happier than those who retire early
(Waddell and Burton 2006, Black 2008).