Section 9: Health and well-being

Section 9:
Health and well-being

Keeping older people at work is becoming increasingly important. But it requires a better understanding on the age-related physical and psychological changes associated with ageing – and its potential impact on the health, safety and health promotion of older workers.

Here’s what a systematic review to understand the ageing process of older workers found:

  • Age-related physical and psychological changes can reduce the workability of older people. But there were large variations between individuals and improvements can be made by physical and mental activity.
  • The reduced speed commonly associated with ageing can be compensated with improved accuracy, better knowledge and experience.
  • Although the risk of chronic illness increases with age, this can be accommodated so that the people affected can still work.
  • It’s important to ensure that job demands do not outstrip ability and any recovery time required – this should be built into job design.

Question: Do you agree with these findings? Does it chime with your own experience? What more can we do to support older workers’ needs?

Organisational support for older workers

An organisation’s health and well-being provision can cater for employees of all ages – especially older workers. These could range from:

  • Basic to full medical cover
  • Work-related stress support such as counselling, and support for returning to work after an illness.
  • Disability benefits to give employees reassurance that they will be looked after should they encounter a disability.

Retaining older talent
Employers are gradually realising it’s in their best interests to cater for the over-65s if they want to retain precious talent for the future. The key is to offer a variety of benefits that fit in with the organisations overall strategy and budget, and to communicate these benefits to workers so they can choose the right ones for them [1].

Managing the risks of social care work

The scope of tasks involved in social care work put carers at various physical and mental health risks. These include:

  • Risks related to communicable disease such as skin diseases (scabies, tuberculosis and HIV)
  • Chronic diseases (particularly back pain from lifting and moving dependent and bed-ridden residents)
  • Mental pressures from the residents themselves and their family members.
Case study: Malaysia
Protecting workers and their families against harmful diseases requires detailed admission screening and acknowledgement of the associated risks to the workers involved. Here are some of the experiences shared by carers (in particular the older ones) during our interviews in Malaysia:

malaysia flag

 “It was once happened here, where we received an HIV patient. But we were never informed about the status of the resident and we were conducting the duty and tasks as usual without precautions. We only found out of he being an HIV patient the day when he died. It was really shocking and frightening thinking about the risks we were exposed to.”

“The most common is back pain, because we have been lifting elderly people manually. If we do it wrongly, we’ll get injured. Sometimes the physiotherapy services which available in some centres are not only for the residents but also being utilised by workers with chronic back pain…The conduction and completion of the care tasks are also become harder and more challenging with increase age due changes associated with ageing process as previously mentioned.”

“It is a fun job to do but very challenging at the same time. At the very beginning, it was really fun. But after a while, when we are getting older, we can’t complete the tasks like we used to. A longer time was needed to complete the tasks, because of less energy and we are getting weaker.”

“When we started this career, we were very healthy, young and full of energy. But when we are getting older, we are expose to many risks, particularly to our health. We have to look after elderly, lifting and bathing them but yet we are also getting old. It is a risk to our health…Verbal abuse and mental torture particularly from demented patients and family members are also common.”

“As carers, we’ve tried our best to perform the tasks given to us, but the family members are always complaining and never satisfied. But at the same time they never willing to look after their old parents or grandparents… it really hurts and we feel unappreciated.” (Malaysian care workers)

Question: How does hearing these stories make you feel? Have you experienced anything similar? What can be done to improve the situation?
Case study: United Kingdom
We also asked UK care workers about managing their own health and well-being at work.

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By far, the biggest challenges they face are managing work pressures and having to complete an increasing amount of tasks within a short space in time.

There is a wealth of evidence that workplace pressure can have an impact on both mental and physical health. It can lead to workers sensing an imbalance between the effort they put into work (e.g. having to complete a task in a short space of time) and the reward that they receive for that hard work (e.g. being paid a living wage or getting satisfaction from work) [12]

If the imbalance is too great and the worker doesn’t feel they have an escape (and for older workers, early retirement is seen as an escape), work starts to erode good health.

Question: Does this reflect your own experience? Do you feel there is a good balance between the pressures and the rewards of the job you do?

The UK workers explained how work pressures are impacting their health in a number of ways:

1. Pressure leads to stress especially when they feel that they have little say over how their work is carried out.

One care worker described her normal work routine:

 “You’ve now got the next six customers ringing the bell. You haven’t got over the fact that you’ve just had two hassles, you’re dealing with the next six ringers, in which time you’ve got somebody on the floor, next to somebody shouting for their tea break.” (UK care worker)

2. Some care workers are sacrificing personal time like forgoing lunch breaks or working unpaid hours.

Many care workers have chosen their careers because they want to help others, so the pressure to get work completed – even if it eats into personal time – can be overwhelming. As one care worker described:

 “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.” (UK care worker)

3. Work pressure might lead to care workers making sacrifices which impact on their own health and welfare.

This can be particularly true of home care workers who must budget into their work routines both time with clients and also travel between visits. Slight delays between meetings can lead to pressures to reach their next clients in short spaces of time:

“Social care workers are working in unhealthy working environments. … We’ve had so many car accidents in the last 30 years, our staff are just pumping, and pumping to get that call time. I think it needs to go to an hourly slot or a two hourly slot even.” (UK care manager)

Older workers employed beyond the normal retirement age indicated several preconditions and motives for staying in the work force.

Health, work characteristics, skills and knowledge, social factors, financial factors and purpose in life are all relevant motives for working beyond retirement age [2].

Good practice for managing older workers’ health and safety in the workplace

With increasing demand across the sector and higher turnover rate among workers, increasing numbers of older people will work as social carers.

Studies show that building resilience and providing social support play an important role in reducing the physical and psychological burden on carers. As well as this, jobs should be designed to suit a range of individuals and not just the strong or fit.

To make sure this happens, run an objective assessment of job requirements to understand the physical job demands. Here are a few things to consider as you take into account age-related changes and their impact on work:

1. Work–rest schedule:

  • Adequate recovery time between tasks

2. Risk assessments and risk reduction measures:

  • Including the musculoskeletal, cardiovascular and respiratory systems, vision and hearing

3. Consideration for shift work:

  • Limiting night work, or stopping it entirely, for workers aged over 45–50
  • Giving older workers priority to transfer to day work
  • Giving older workers their choice of preferred shift where possible
  • Reducing workload
  • Shortening working hours and increasing rest periods
  • Arranging more frequent health checks
  • Giving effective counselling on coping strategies such as sleep, diet, stress management and exercise.

4. Measures to overcome the likelihood of hearing and visual problems:

  • Warning systems, hearing aid provision and more readable materials.

5. Maintaining and updating the workplace skills of all workers is important and helps to stimulate their mental processes.

6. Dealing with stress

  • The demands of social care work may put older people at risk of physical and mental illnesses. The nature of the tasks involved in caring for an older adult can be a form of stress and influence the carers’ daily lives and health.
  • Offer periodic counselling and motivational activities to deal with the stress that older people may feel when they become a carer of another older person – and ensure better mental health among your older social care workers.

7. Reduce the risks of occupational-related injury and time demands

Introduce assistive devices to ease and facilitate physical work such as lifting the bedridden residents

  • Shorter shift hours and increased number of carers to residents’ ratio
  • Revise the scope of jobs – come up with lists or categories of social care tasks that can be done by older people
  • Training to improve skills
  • Provide critical allowance, as occupational related injuries are more likely among older workers
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[1] Haymes, R. (2014). Late retirement means businesses need better benefits for an ageing workforce. The Guardian. Available at

[2] Sewdas, R., de Wind, A., van der Zwaan, L. G., van der Borg, W. E., Steenbeek, R., van der Beek, A. J., & Boot, C. R. (2017). Why older workers work beyond the retirement age: a qualitative study. BMC public health, 17(1), 672.