1. The Aging Workforce: Strength is the new Vital Sign Alan K. Novick, MD Rehabilitation Medical Director Memorial Rehabilitation Institute

2. Disclosures I have no financial disclosures

3. Objectives Become familiar with the statistics of the current and expected future workforce Understand the benefits and disadvantages of an older worker Understand the physical/medical changes with advancing age and the implications for injuries and recovery with those changes Develop a knowledge of potential injury and rehabilitation programs specifically for the aging employee

4. Aging Society

5. Age Variations in physical and cognitive capacities within different age groups We all age differently

6. Jack Lalanne Age 95 –Exercises two hours/day –90 min weights –30 min walking or swimming “If man made it, don’t eat it” “If it tastes good, spit it out”

7. Baby Boomers Born mid 1946-mid 1964 Began turning 65 in 2011

8. Aging Population

9. United States Aging Population: >65 years old 43.1 million in 2012 83.7 million in 2050 Estimated 21% total U.S. population in 2030 –1 out of every 5 people Higher in minorities –39.1% in 2050 –20.7% in 2012

10. Aging Population

12. Aging Workforce Workers >55 y.o. –projected to increase by 12 million from 2008- 2018 –Make up 25% of workforce 65 y.o. no longer “normal” retirement age –80% of baby boomers plan to work after retirement age

13. Aging Workforce

14. Age 55-64 –1992- 11.8% –2002: 14.3% –2012: 20.9% –Projected 2022: 25.6%

16. Aging Workforce: Reasons Reduced value of retirement portfolios Improved health Increased Life expectancies Highly engaged in work/ Job satisfaction –Committed to organization

17. Aging Workforce: Reasons From AARP Survey Staying Ahead of the Curve 2005

18. Aging Workforce: Reasons

19. Aging Workforce: Advantages Engaged employees –Use less health care –Take fewer sick days –More productive –Longer tenure –Create stronger customer relationships Fewer accidents –Less risk taking behavior –More supervisory roles –Injuries more severe Avoids “Brain drain”

20. Aging Workforce: Disadvantages Higher compensation/wages Increased cost of healthcare Increased expense of training older workers in new technologies Resistance to change Outdated skills Less mobile –Community roots –Home ownership More disability More sever injuries –Pre-existing conditions

21. Incidence of Disability AgeDisability 18-244.5% 45-5420% >6542%

22. Functional Limitations

24. Aging: Common Effects Vision –Decreased acuity Nearsightedness increases after age 40 Medical ailments increase after age 50 –Macular degeneration –Cataracts –Glaucoma –Eyes lose ability to change shape Unable to focus quickly Impaired night vision Decreased ability to distinguish –Colors –motion perception –Contrast –Dry Eyes

25. Aging: Common Effects Hearing –Decreased –Tinnitus –Loss of high frequencies 30% over 65 y.o. Cognitive Abilities –Mental process slower Decreased response time Fewer mistakes but decisions take longer –Impaired short term memory –Medications may also impact cognition

26. Aging: Common Effects Physical Ability –Decreased joint ROM –Bone mass decreases –Muscles Decrease mass Decrease elasticity/muscles stiffer –Slower response time –Strength decreased –Manual dexterity/fine motor skills decline

27. Aging: Common Effects Slips and falls –Contributing factors Impaired vision Impaired postural stability Decreased muscle elasticity causes shorter stride length Decreased strength –16% of fatalities in age 55-64

28. Aging: Common Effects Medical Conditions –Hypertension –Coronary Artery Disease –Diabetes –Arthritis –Obesity –Osteoporosis –COPD –Depression

29. Hypertension

30. Rate per 100 of Civilian, Noninstitutionalized Population with Diagnosed Diabetes, by Age, United States, 1980–2011

31. Diabetes

32. Coronary Artery Disease

33. Complications of Coronary Artery Disease

34. Memory

35. Depression

36. Lost Work Days

37. Aging Workforce More severe injuries Slower recovery More lost days Apportionment concerns –Impairment from injury or age related disease

38. Injury Prevention: Vision –Modify environment Provide sufficient lighting Use bright or contrasting colors on ramps, stairs and uneven surfaces Use pastel colors in areas requiring high level of concentration –Modify equipment and tasks Use magnifiers to improve seeing small objects Use equipment with audio or tactile cues Limit driving to daylight hours

39. Injury Prevention: Hearing Modify environment –Reduce noise levels Relocate or replace excessively noisy equipment Consider noise levels in room design –Sound absorbing materials Modify/Utilize appropriate equipment –Use visual or tactile feedback for controls that are hard to hear –Ensure alarms are audible/ use light warning systems –Provide communication systems with volume controls –Utilize hearing aides –Utilize protective gear

40. Injury Prevention: Cognition Minimize complexity of tasks Automate processes when possible Lengthen time requirements between steps in tasks Reduce need for multitasking Allow for increase decision-making time Eliminate clutter/distractions Provide training –Use frequent and short hands-on refreshers –Provide opportunities to practice –Limit to no more than 3 critical issues to be learned per session

41. Injury Prevention: Physical Ability Job Modification –Reduce heavy lifts Utilize handling aids (carts, dollies, etc) Multi-person lifts –Ergonomic changes Address Employee issues –Review proper lifting techniques –Strength training, maintain flexibilty and balance exercises

42. Hursh, Lui, and Pransky (2006): prevention strategies to minimize declines in work performance resulting from age-related physical, cognitive, or sensory disabilities: Employer Strategies for Responding to an Aging Workforce Individualized ergonomic design for older workers Job analysis examining specific functions that result in increased injury Assistive technology devices to increase, maintain, or improve the functional capacity of a worker Job accommodations involving changes to the work site or work process

43. Hursh, Lui, and Pransky (2006): Employer Strategies for Responding to an Aging Workforce Training initiatives to upgrade and maintain skills –multiple, shorter training sessions –mixed training formats (i.e., tell-show-do, direct/immediate application of new skills to current job) –small group training formats –extra time and slower pace –distraction-free practice of new skill –link new learning to current work –early error correction, self-paced/directed learning –training environments that minimize noise or provide other accommodations for hearing/vision impaired Wellness and integrated health promotion –smoking cessation –Exercise –weight management

44. Conclusion