Section 10: Healthy workplaces

Section 10:
Healthy workplaces

In many parts of the world, the ageing of the workforce has become a growing challenge.

By 2025, there will be a 32 % increase in the number of people aged over 55 years, driving an increasingly aged workforce. (The International Labour Organization)

Designing a healthy workplace for older care workers is particularly difficult since most care workers work as home care workers, travelling between clients’ homes.

Home care workers told us they faced challenges such as:

  • Working in unsafe home environments: Many face uncertainty when enter a client’s home. They can be met by untidy environments, newspapers or even dog mess on the floor. Usually, they have only a small window of time to complete tasks and the risk of falls and injuries rise as they try to finish their work quickly.
“We don’t even have basic devices to transfer residents, such as the wheelchair that can be opened from the side. If we, it makes a lot easier for us to perform the tasks especially to transfer the residents. But for now, everything is manually done without proper devices” (Malaysian Care Worker)
  • Assistive equipment isn’t available or set up to be used: Assistive equipment is essential to protect both the care worker and client from injuries. However, equipment may not always be available or set up, making it difficult to move or adjust clients.
“Sometimes we do have courses on how to correctly lift and manage the elderly, but the devices weren’t available. So, they were not practical, just theory. There are inadequate number of staff and in order to complete the tasks according to allocated time, we ended up doing it alone or with inadequate number of staff that put us at risk of injury.” (Malaysian Care Worker)
  • Constraints on travel time: Travelling between client homes is a challenge for care workers. A slight overrun in spending time with one client could make meeting the next appointment very difficult.
“There is maybe someone doing an 80-hour week, but it’s not 80 hours of work time. They are maybe getting paid for 40 hours but they are out for 80. That was happening on a regular basis.” (Northern Ireland care worker)
  • Abuse: Caring for elderly people can be stressful for both their family members and professionals who care for them. In times of stress and worries, family members can sometimes ‘lash out’ at care workers.
“I actually had a client’s family member become really, really verbally aggressive with me one night. In the end we had to terminate the package because me and a number of staff were threatened over it. He said, “You will not send a male into my mum.”
  • Discrimination: Care workers report discrimination in multiple forms. These impact both their ability to carry out their work and their mental health and well-being. Male care workers report being rejected by families even when they are paired with female colleagues. Black and Ethnic Minorities can face discrimination and ageism can impact both older workers (e.g. family members assuming the older care worker is not ‘up to the job) or younger ones (e.g. being called inexperienced or not up to the job).

Question: Do these issues resonate with you? Have you faced similar challenges? What can be done to address them?

Creating a healthy workplace

A healthy workplace is defined by World Health Organization (WHO) as one in which:

Workers and managers collaborate on a continual improvement process to protect and promote the health, safety and well-being of all workers and the sustainability of the workplace.

This is done by following the WHO Healthy Workplace Model, which takes into account these health and safety concerns in the physical work environment:

  1. Health, safety and well-being concerns in the psychosocial work environment, including organization of work and workplace culture
  2. Personal health resources in the workplace
  3. Ways of participating in the community to improve the health of workers, their families and other members of the community

All care workers – regardless of their age – have the right to work in a healthy and safe workplace. The people using their services are entitled to care and support that is safe and takes their needs, freedom and dignity into account.

Question: Do you agree with this statement? How important are each of these concerns to you? How much of an impact do they have on the health of your workplace?

How to better design work and work organizations to accommodate the older worker

To improve the way that work is designed and organized in order to accommodate the older worker, employers need to address the following questions:

  1. What is known about the performance and health of workers as they age?
  2. Can work for older workers be designed and managed so that it does not challenge their psychological and physical health?
  3. Are those aspects of work that are stressful or satisfying to older workers understood?
  4. Are these different from those experienced by younger workers?
  5. Do managers have an informed understanding of older workers’ needs and abilities?
  6. Are older workers subject to discrimination?
  7. How can work be designed to be more appealing to older workers and persuade them to remain in, or return to, work?
  8. How can advantage be taken of their strengths without disadvantaging them in terms of their weaknesses?

What particular risks to older care workers face?

The health and social care sector is large and diverse workforce. The work exposes them to various work-related risks as they care for a predominantly vulnerable population.

[VIDEO: Interview with Helen Beers (HSE)]

The most common risks they face include:

  • Moving and handling – from moving equipment, laundry, catering, supplies or waste, to helping residents to move. Common risks are back pain and musculoskeletal disorders, which can lead to inability to work. Moving and handling accidents are also an issue, with the risk of injury both to the person being moved and the employee.
  • Slips and trips – Slips, trips and falls are very common among care sector workers – especially those looking after older people – with a serious impact on the lives of employees and those being cared for. The risk of a slip, trip or fall can be higher among older workers but is also preventable.
  • Violence, aggression and challenging behaviours – these incidents are common among workers in the care sector. Work-related violence is defined as ‘any incident in which a person is abused, threatened or assaulted in circumstances relating to their work.’ These might include being bitten by residents with severe dementia, or being verbally abused by a visitor who considers that their relative has not been properly treated.

Risks of violence and aggressive behaviours are higher among employees who are:

  • Working alone
  • Working after normal working hours
  • Working and travelling in the community
  • Handling valuables or medication
  • Providing or withholding a service
  • Exercising authority
  • Working with people who are emotionally or mentally unstable
  • Working with people who are under the influence of drink or drugs
  • Working with people under stress.
Question: Which of these risks have you faced? What can we all do to mitigate them?

What practical changes can we make to manage an ageing workforce?

While some developed countries have made an effort to make changes, there is still a need to transform practices to help to manage an ageing workforce. Progress is still slow. In a 2016 study, Berlin et al. suggested several factors that should allow successful implementation of a change in practice:

  1. Involving employees in the development and implementation of workplace improvements
  2. Management commitment and involvement from the top levels
  3. Including age initiatives in a company-wide programme
  4. Combining the complementary perspectives of safety and health and human resources to develop workplace interventions
  5. Taking a life-course approach that focuses on a healthy workplace throughout working life
  6. Having flexibility based on individual needs at different work stages
  7. Systematically evaluating any implemented measures.
Case study: Malaysia
Speaking with social care workers in Malaysia, we’ve heard how massive improvements are required. They need assistive devices and basic care equipment, improvements around working hours and shifts, an improved proportion or ratio of carers to residents, better communication between managers and workers, incentives and critical allowances (based on the health risks they are exposed to) and skills development through properly conducted training.
“Technically, we are experiencing almost similar health risks like those working in the hospitals… risks for infectious diseases and many more… but we don’t receive any critical allowance like they do”. (Malaysian Care Worker)

malaysia flag

Considering that older workers are even more vulnerable to the social care–related risks we’ve discussed in this section, serious measures, initiatives and strategies should be put in place and implemented accordingly. Management should also be willing to accommodate the needs and issues related to older workers.

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  • Griffiths, A.(2000). Designing and managing healthy work for older workers. Occup. Med. 50 (7): 473-477.
  • World Health Organization (WHO). WHO Healthy Workplace Framework and Model: Background and Supporting Literature and Practice (2010). World Health Organization.
  • Belin, A., Dupont, C., Oules, L. & Kuipers, Y. (2016). Safer and healthier work at any age: Final overall analysis report. Luxembourg: Publications Office of the European Unions.