This document discusses aging workers and how to accommodate them. It notes trends showing that workers are aging and staying in the workforce longer. The effects of aging include declines in musculoskeletal, sensory, cardiovascular and other body systems. Injuries among older workers tend to be more severe and disabling. Wellness programs and ergonomic accommodations can help older workers stay healthy, productive and safe on the job. The document provides examples of specific accommodations employers can implement regarding vision, hearing, balance and more. It emphasizes that wellness programs are important for controlling healthcare costs and maintaining a productive workforce.

1. TAKING CARE OF “US”
Denise Dumont-Bernier, PT, Director

2. Understand the Effects of Aging

3. What do aging workers look like?

4. Objectives today
 Review trends
 Better understand the effects of
aging
 How can you be proactive and
keep yourself healthy and
productive as you age?
 How can you help others?

5. Trends: Aging Workers Are Not Retiring
 Federal legislation rescinding
mandatory retirement (1967);
 Anti-age discrimination laws
 Economic factors
 Need for supplemental insurance
 Need income/poor retirement
planning
 Choose to work: stimulation
 Living longer…decline in mortality
rate… better health

6. Who is the aged worker?
 50 +/- years old
 Between 1990-2005 the number of working
men between 55-64 increased 43%, women
increased by 65%
55 years of age
In 2016, there will be > 40 millionWe are all aging
every day!

9. Generational Differences?
 Entitled
 Lazy
 “Me” attitude
 ?? Priorities
 Always looking to
automate
 “Know it all”
 Hard workers
 Loyal
 Appreciative
 “Family”
 Stubborn
 Prideful
 Resentful to change
18-25 year olds Over 50

10. As we age……(the bad news)
 Musculoskeletal
 Arthritis of joints
 Atrophy of muscle
 Decreased flexibility
 Agility/Balance
 Deconditioning/fatigue
 Decreased reflexes
 Systems
 Hearing
 Visual
 Cardiovascular
 Endocrine (Diabetes)
 Depression
 Immunity
 Other Chronic
Conditions

11. Work related injuries
 HIGH frequency
 Lower severity
 Short duration
 More common to have
“incidents”
 Lower frequency
 HIGHER severity
 Higher % RTW with
restrictions
18-25 year olds Over 50

12. WC Costs
 The 45-55 y.o. claimant’s average claim cost is
52% higher than the 25-35 y.o.
 AGE is the most critical factor in determining length
of disability
 Most common injuries are rotator cuff, knee injuries
and low back
 - Reference source: The Leader Journal, Vl 2, Issue 1, Winter 2015

13. WC Injuries Today
 #1 Sprains/Strains
 Backs
 Shoulders
 #2 Slips, Trips and Falls
 Backs
 Shoulders
 Knees/Ankles

14. Spine: Disc Degeneration

16. Lumbar Facet Joints

17. Motor Control
 10-25% decline in strength by age 65
 POWER muscle groups (quads, deltoids, etc.)
decline the fastestMu
 Losing 25% of flexibility
by age 65
 Balance & Proprioception

18. What is the best predictor of a
shoulder injury?

19. Shoulder Anatomy

20. Shoulder Rotator Cuff

21. Impingement

22. Knees

23. Is It Work Related?
 Degenerative Changes
 Primary reason X-Ray is ordered
may be to help document age-
related DJD, DDD
 Address Causation of Injury?
 Pre-Existing condition?

24.  Those with a chronic disease (HTN, DM)
and/or are obese are:
 2 times more likely to have a WR injury
 5 times more likely to NOT RTW
WC Costs and Chronic Disease

25. Percent of population with chronic
conditions by age group
25%
40%
67%
87%
5%
67%
40%
15%
0%
25%
50%
75%
100%
Age 0-19 Age 20-44 Age 45-64 Age 65+
One or more chronic condition Two or more chronic conditions
Source: Medical Expenditure Panel Survey, 2001, Johns Hopkins University, Partnership for Solutions

26. Lost time & productivity:
by age & # of chronic conditions

27. Contributing Factors
 Age
 Gender
 Genetics
 Medical Conditions
 Diabetes
 Low Thyroid
 Arterial Disease
 Rheumatic Diseases
 Smoking
 Poor Nutrition
 Caffeine
 Hydration
 Rest (Sleep Disorders)
 Stress
 Inactivity
 Physical Condition
 Body Mechanics
 Weight/ BMI
Uncontrollable Controllable
School Wellness Teams
can affect change!

28. Fatigue
 Aerobic capacity at age 65 is about
70% of a 25 year old
 Aerobically demanding work
is more hazardous for older workers
 They have more difficulty regulating body temperature
 more likely to have heat stroke due to slowed response
of sweat glands, and a decrease in overall body fluid

29.  Blood vessels stiffen
 Heart valves stiffen
 Heart cells die
 Muscle thickness of heart
wall decreases
 Cardiac output gradually
decreases
 Functional lung volumes decrease
Age-Related Circulatory and
Respiratory System Changes
Cheitlin MD. Cardiovascular physiology changes with aging. Am J geriatr cardiol 12(1). 2003.
. BMC Medical Imaging 13:1-6. 2013.

30. Vision Changes
Changes accelerate after 40
Atrophy of muscles which control pupil size
Reduced night vision, near vision: Cataracts
Inability to adapt to changing light levelsmit
Processing of visual information greatly reduces –
moving objects are harder to see!
Driving accidents rise significantly over age 70

31. normal vision
floaters cataracts
glaucoma macular degeneration
Age-related vision problems. Mayo Clinic. http://www.mayoclinic.org/healthy-lifestyle/adult-
health/multimedia/vision-problems/sls-20076758?s=7.
Vision Problems

32. Hearing Impairments
 Changes accelerate after 55
 High tones and speech are hard to hear
 Intelligibility declines after 60

33. Hearing Impairments
 A 70 year old person experiences a 10%
intelligibility decline under ideal circumstances
(quiet room, 120 word/minute speech)
 20% decrement with more rapid speech
(300 word/minute)
 30% decrement with added
background noise
 Affects communications
 Embarrassment

34. Nervous System
• (Brain): Changes accelerate after age 60
• Short term memory reduces
• Reflexes – significantly slower with age
• Balance

35. Sleep: Total and Deep sleep

36. Other Changes
 Metabolism reduces = weight gain
 Greater susceptibility to temperature
extremes

37. What Can You Do to Accommodate?
 Ergonomic Improvements
 Fitness For Duty Exams
 Wellness Programs
 Training/ Mentoring Programs

39. Stretch Programs
 Series of stretches
considering age-related
safety
 Incorporate warm-ups
 Flexibility
measurements
 Implementation
process defined

42. Considerations
 Vision: Increase lighting, mandate annual exams
after 40, use larger print, increase contrast
 Hearing: Use flashing lights for warnings in addition
to sounds, communicate key messages away from the
work floor, have workers repeat messages to ensure
they hear everything, reduce unnecessary noise
 Balance: Do balance training, limit stairs/steps,
mandate hand rail use
 Eliminate or limit: Mandatory overtime, Rotating shifts
 Increase job rotation: Do not expect a person
over 50 to be able to maintain vigorous effort at the
level of a 25 years old.

43. Wellness programs
 Because health trends are not sustainable
 Insurance premium increases
 Inactivity/Sedentary lifestyles
 Rising obesity rates
 Poor nutrition
 Rising diabetes rates
 Stress/Poor sleep habits

44. The Full Cost of Employee Poor Health
Personal care costs
Medical Care
Pharmacy
25%
Productivity costs
75%
STD
LTD
Overtime
Turnover
Temporary staffing
Administrative costs
Replacement training
Off-site travel for care
Customer dissatisfaction
Variable quality
Absenteeism
Presenteeism
Sources: Edington DW, Burton WN. Health and Productivity. In McCunney RJ,
Editor. A Practical Approach to Occupational and Environmental Medicine.
3rd edition. Philadelphia, PA. Lippincott, Williams and Wilkens; 2003: 40-152.
Loeppke, et.al., JOEM, 2003; 45:349-359 and Brady, et.al., JOEM, 1997;
39:224-231

45. Key Steps to Successful Wellness
 If you take care of your employees; they’ll take
care of your schools
 Make it part of your “business” strategy
Claims
SpendCulture
Engagement
(Productivity)

46. Wellness Planning
ALIGN
CULTUR
ASSESS &
MEASURE
IMPLEMENT
& ENGAGE
PROMOTE
CULTURE
SUSTAIN &
ENHANCE
EMPLOYEE
WELLBEING
• Align
• Leadership & Vision
• Policies/Health Plan
• Assess & Measure
• data
• Engage (motivate)
• Screens, programs
• Wellness Committee
• Health Coaching
• Incentives
• Culture
• Environment
• Sustain & Enhance
• Community Resources

47. By helping employees to adopt
healthy lifestyles as we age
Worksites Can Make A Difference
The best thing that an old teacher
can teach others is how to be an
old teacher

48. Identify and Use Local Resources

49. Wrinkles should merely indicate
where smiles have been. ~Mark Twain,
Following the Equator
Age does not diminish the extreme
disappointment of having a scoop
of ice cream fall from the cone.
~Jim Fiebig

50. Final Thoughts? & Questions?
Contact:
Workplace Health at MaineGeneral Medical Center
Denise.dumont-bernier@mainegeneral.org
207-242-3924 cell
Office 621-7550