Ageing Nation, Ageing Workforce Challenges for Aged Care Provision

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Ageing Nation, Ageing Workforce Challenges for
Aged Care Provision

• Assoc Prof John Spoehr, Executive Director
• Dr Kate Barnett, Deputy Executive Director
• Australian Institute for Social Research
• Paper presented to the ACSA National Conference,
  Aged Care in the Fast Lane, Adelaide, September
  29th 2008

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Overview of Paper

• Workforce development challenges facing aged care
  workforce.
  
• Population ageing increasing demand for aged
  care services
  
• Ageing of the aged care workforce
• Skills shortages
• Workforce development strategies to retain mature
  aged care workforce Age Management

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Challenge 1 Population Workforce Ageing

• Lower fertility rates reducing supply of younger
  workers.
  
• Now 5.25 people each person aged 65
• By 2050, 2.2 each person aged 65
• By 2045, 21 of people will be aged 65
• Impact if Baby Boomers retire at usual age.
• Estimated shortfall of 195,000 workers by 2010
  due to population ageing (DEWR 2005).

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Challenge 2 Skills Shortages

• Knowledge economy shift to high skill
  occupations
  
• In 2000, 50 of jobs required post secondary
  qualification.
  
• In I980, qualification. (Productivity Commission 2002)
  
• Now, estimated 86 of occupations require post
  secondary qualification (Aust Industry Group
  2006)
  
• By 2016, shortfall of 240,000 people with VET
  qualifications.
  
• Especially at Cert III, Diploma, Advanced Diploma
  (Shah Burke 2006).
  

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Challenge 3 Aged Care Workforce

• Range of challenges documented by ACSA (2007) -
  including
  
• Gender and age imbalance in profile
• Shortages in skilled occupations (nursing, allied
  health, personal care workers)
  
• Difficulties in attracting retaining staff eg
  annual turnover of 25 of personal care workers,
  20 of nurses .
  

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Aged care workforce challenges

• There is a need to focus on workforce
  development, not just training. (ACSA 2007)
  

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A growing sector

• Community services and health sector is 3rd
  largest growth sector for labour to 2010.
  
• Expanding at 2-3 annually for last decade.
• Sector employs 10 of all Australians.
• Expected growth to 13.4 by 2011-12.
• Exceeds all industry average (CSH Industry Skills
  Council data)
  

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Challenge 4 Sustaining Community Aged Care

• Community aged care increased 600 in the 8 years
  to 2003/4. (CSH Industry Skills Council)
  
• This increase is more rapid than for residential
  aged care.
  
• 2001-2006, CACPs EACH packages increased by 48
  (AIHW 2007).
  
• Limited by resources and availability of family
  carers.
  

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Sustaining community aged care

• Increased participation of women in paid
  workforce reduces availability of carers to
  assist in delivery of community based care.
  
• Mature age profile of aged care workforce means
  many face work-family conflict in supporting
  older relatives, and sometimes own children.
  
• Very old people have greater quantity of life,
  but not necessarily quality of life.
  

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Challenge 5 Multiple Challenges

• The aged care industry faces a confluence of
  challenges involving -
  
• Increased demand for aged care
• The ageing of its workforce
• Shortages of skills in aged care and across
  industries competition for staff
  
• Broader social and technological change affecting
  how people live and work.
  

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An Aged Care Workforce Race to Retirement?

• Role of government policy
• Affordability of retirement
• Superannuation
• Debt levels

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Affordability Average Superannuation Holdings
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Affordability Average Debt Levels

• Australians aged 45 hold 42 of national debt
• Their share of debt has increased over past
  decade, reflecting their growth in assets.
  
• Share of debt for those aged (Finsia Roy Morgan Research 2008).
  

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Affordability Average Debt Levels

• The debt assets wealth relationship is such
  that retirement before the age of 60 is hindered
  by average debt level, unless assets like housing
  can be turned into .

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Job Replacement Trends

• Another indicator of likely exit from the aged
  care workforce.
  
• Net Job Replacement measure of job openings for
  new entrants due to no of people leaving vs no
  re-entering an occupation.
  
• Estimates prepared for SA health and aged care
  workforce show NPR lower than for total workforce
  (Shah Burke 2006)
  

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Is an ageing workforce a problem?

• Ageing is an individual process, with much
  depending on health fitness, and genetics
  
• Nevertheless, ageist stereotypes work against
  effective employment of older people
  
• AISR (2008) recently reviewed popular myths and
  stereotypes against research evidence as part of
  research for WorkCover SA on workforce ageing.

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Stereotype 1 Older workers have more sickness
based absence

• Age alone is not the key determinant of health.
  Other factors include education, lifestyle,
  fitness, nutrition, socio-economic status, and
  environment.
• These factors are more reliable predictors of
  health in old age than chronological age.
  
• Much depends on the individual.

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Stereotype 1 Older workers have more sickness
based absence

• Rates of chronic diseases and acquired disability
  certainly increase with age. However, these can
  be minimised or prevented at earlier stages of
  life.
• Older workers take less non-certified sickness
  but more certified sickness absence.
  Non-certified absence can be of greater concern
  to employers.

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Stereotype 1 Older workers have more sickness
based absence

• Ergonomic and workplace design addresses the most
  usual cause of absence in older workers
  musculoskeletal issues.
  
• Workplace environment, including degree of
  control/autonomy, plays a key role in worker
  illness and injury, and absence.
  

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Stereotype 2 Older workers have more injuries

• Little conclusive evidence to suggest older
  workers are a greater accident or injury risk in
  the workplace.
  
• Older workers have fewer accidents, but their
  injuries are usually more severe, and
  
• They have a greater risk of fatal injury.

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Stereotype 2 Older workers have more injuries

• Workers aged 55 to 64 have the highest frequency
  and incidence of compensation claims.
  
• Those aged 50 to 54 are most likely to have
  claims involving 10 days or more absence from
  work.
  
• Older workers may take longer to recover from
  their injuries.

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Stereotype 2 Older workers have more injuries

• Workers aged 55 to 64 have the highest incidence
  (no of compensated claims per 1,000 employees) of
  compensation claims.
  
• Workers aged 55 to 64 have the highest frequency
  (no of compensated claims per million hours
  worked, by age group) of compensation claims.
  
• Those aged 50 to 54 are most likely to have
  claims involving 10 days or more absence from
  work. (AISR research for WorkCover SA, 2008).

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Stereotype 2 Older workers have more injuries

• Different types of injury are associated with
  different age groups (eg sprains, falls are more
  likely for older workers).
  
• These can be prevented or minimised through
  training and workplace design.
  

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Stereotype 2 Older workers have more injuries

• It is not necessarily the persons chronological
  age that predisposes them to injury or illness at
  work but their prolonged exposure to health and
  safety risk factors over time.
• Older workers usually are more responsible
  regarding health and safety issues.

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Stereotype 3 Reduced functional capacity means
reduced ability to work

• Cardiovascular and respiratory capacity declines
  with age - exacerbated if people are unfit.
  
• Sensory and sensorimotor ability declines with
  age, but varies with amount of previous exposure
  to certain environmental factors eg loud noise.
  
• However, workplaces can be modified to address
  these issues.

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Stereotype 3 Reduced functional capacity means
reduced ability to work

• Changes in balancing ability increase
  susceptibility to falls, and changes in
  thermoregulatory functions make it more difficult
  to manage extremes of temperature.
• Workplaces can be designed to address these
  issues.
  

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Stereotype 3 Reduced functional capacity means
reduced ability to work

• Ageing brings declines in musculoskeletal
  functioning, increasing the risk of injury and
  reducing physical strength and endurance.
  
• Training and workplace design can reduce risk of
  injury. Individual physical strength and
  endurance can be improved, compensated, and
  overall decline area minimised through prevention
  (eg maintaining fitness).

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Stereotype 3 Reduced functional capacity means
reduced ability to work

• Cognitive functioning shows gradual deterioration
  with age (but with considerable variation from
  one individual to another.
  
• Decline in most abilities does not occur before
  60 years, and is usually evident around 74 years
  of age.
  
• There has been a slowing in the rate of average
  decline over successive generations.

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Stereotype 3 Reduced functional capacity means
reduced ability to work

• Decline is reversible and usually due to lack of
  use of cognitive abilities.
  
• It can also be prevented through active usage and
  practice.

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Stereotype 3 Reduced functional capacity means
reduced ability to work

• Speed of learning declines with age.
• Can be compensated for by strong motivation to
  learn, and actual learning is not dependent on a
  persons age.
  
• Some cognitive functions eg problem solving,
  complex reasoning, use of language, improve with
  age.
  
• Individual health and education critically affect
  age-related functional change.

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Stereotype 4 Older workers are less productive

• Three factors have been found to affect decline
  in ability to work
  
• Excessive physical demand, including repetitive
  movement.
  
• Stressful and dangerous work environments.
• Poorly organised work.
• These are all preventable through workplace
  design.

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Stereotype 4 Older workers are less productive

• Older workers more likely to have slower speed of
  working - offset by a higher quality of output.
  
• Reducing time pressures and giving preference to
  quality rather than quantity of output enhances
  the productivity of older workers.
  
• Productivity does not simply decline with age.
  Much depends on individual health, cognitive
  functioning, ability to adapt to change and learn
  new information.

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Stereotype 5 Older workers are less able to
adapt to change

• Older workers can adapt to change, including in
  the workplace.
  
• Adaptation is influenced by a range of factors,
  rather than by age.
  
• Resistance to change can be reduced through
  appropriate consultation, training, support and
  flexible adjustment to individual need.
  

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Stereotype 6 Older workers lack capacity for
training re-training

• Mature workers require confidence to benefit from
  training - especially if they have low levels of
  literacy and numeracy.
  
• Usually need training to be applied to their
  workplace.
  
• Respond well to self-paced learning and
  collaborative (eg with peers) learning.
  
• Usually require more time to learn and to
  practise new learning.
  

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Stereotype 6 Older workers lack capacity for
training re-training

• Learning is not dependent on age, but people
  learn in different ways at different ages, and
  learning is facilitated by educational level.
  
• Cognitive changes do not mean that older workers
  are unable to learn new information but the way
  in which they learn is likely to be different.
  
• Therefore, the way in which training is delivered
  is critical.

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Stereotype 7 Older workers represent lower
return on the training investment

• Although they may have less time until
  retirement, older workers usually have lower
  turnover rates, which increases their potential
  return on a training investment.
• Due to increased longevity, those currently in
  the pre-retirement age group are likely to work
  for longer than previous generations, provided
  they are given flexible working conditions and
  the training needed for their work.

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Summarising Benefits of Mature Age Workers

• Broader experience from having worked in a
  variety of jobs, industries and organisations.
  
• Higher rates of retention.
• Greater reliability.
• Reduced unsubstantiated absenteeism.
• Lower rates of absenteeism.
• More responsible attitude to workplace safety
  (Benjamin Wilson 2005 Berger 2005 Brooke
  2003 Critchley 2006 Ilmarinen 2001 Selby
  Smith et al 2007).

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Age Management

• establishing employment conditions for older
  workers that provide an environment in which each
  individual can achieve their full potential
  without being disadvantaged by their age.
• (European Foundation for the Improvement of
  Living and Working Conditions)

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Age Management Goals

• Assist organisations to adjust to the ageing of
  their workforces.
  
• Enhance the competitiveness and productivity of
  ageing workforces.
  
• Improve the employability of ageing workers.
• Assist in prolonging working life.
• Ensure more equal opportunities between workers
  of different ages.

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Age Management Business Case

• Strong business case to adopt age management as
  part of core workforce planning and development.
  
• Enabling older workers to perform to maximum
  ability has growing support among employers.
  
• Research has begun to quantify the benefits.

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Costs Benefits of Mature Age Workers Quantified

• Australian Employers Convention (2001) research
  findings about workers aged 45
  
• A TURNOVER AND RETENTION
• 2.6 times less likely (than those left their jobs in preceding 12 months.
  
• Average time with 1 employer 11.4 years
  (compared with 4.8 years for those 45 years).
  
• Duration of employment 2.4 times greater.

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Costs Benefits of Mature Age Workers Quantified

• A TURNOVER AND RETENTION
• Net recruitment Benefit for workers 45 estimated
  at 1,424 per year, per worker
  

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Costs Benefits of Mature Age Workers Quantified

• Australian Employers Convention (2001) research
• B TRAINING INVESTMENT
• Due to reduced turnover and increased retention,
  those 45 represent potential 20 year
  investment.
  
• Nett training benefit estimated at 987 per year
  per worker aged 45.
  

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Costs Benefits of Mature Age Workers Quantified

• Australian Employers Convention (2001) research
• C UNSCHEDULED LEAVE OF ABSENCE
• Workers aged 45 take slightly more unscheduled
  absence leave than those
• Nett Unscheduled Leave Cost estimated at 116 per
  year per worker aged 45.
  

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Costs Benefits of Mature Age Workers Quantified

• Australian Employers Convention (2001) research
• D INJURY AT WORK COSTS
• Workers aged 45 have higher work injury costs
  than those
• Nett Work Injury Cost estimated at 330 per year
  per worker aged 45.
  

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Costs Benefits of Mature Age Workers Quantified

• Australian Employers Convention (2001) research
• E TOTAL NETT COST BENEFIT
• Workers aged 45, represented a Nett Benefit
  estimated at 1,956 per year per older worker.
  
• www.businessworkageing.org/downloads/HUMAN_part1.p
  df
  

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Benefits of Age Management (Taylor 2006)
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Summarising research findings

• Older workers are diverse ageing process varies
  with individual.
  
• Chronological age mediated by other variables esp
  health education.
  
• Many functional changes can be delayed or
  reversed.
  
• Workplace critical role in prevention early
  intervention across life cycle, promoting health
  fitness etc.
  

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Summarising research findings

• A general conclusion of the studies that have
  been carried out is that
  
• Differences in individual performance on work
  tasks are greater than
  
• Differences between age groups, reflecting
  different work experiences, educational level and
  profession.
  
• (Ilmarinen 2005).

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Planning for the Aged Care Workforce

• Major challenge in lack of an accurate,
  comprehensive workforce data base.
  
• ABS data identifies Residential care workforce
  only.
  
• Community care workforce found within Health
  Community Services industry data.
  

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Informed Workforce Planning

• Current workforce data collection is
  Program-centred not workforce-centred.
  
• Current national census of community care
  workforce reflects CW funded only (CACPs etc) but
  not HACC funded.
  
• Need either discrete ABS Aged Care Workforce
  (Resi Comm) category or regular Census to
  capture total workforce.
  

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Intergenerational Workforce Development

• Flexibility and Degrees of Autonomy Relationship
  to preventing and managing work-related illness
  or injury and achieving timely return to work.
  
• Capacity to adapt working hours, control breaks
  and ordering of tasks (AISR 2007 and
  international research findings).
  
• Critical to retention of young and mature age
  workers.
  

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Intergenerational Workforce Development

• AISR (2007) aged care workplace culture factors
  likelihood of workers compensation claim -
  
• Effective manager-staff communication p
• Effective within team communication p
• Good level of trust within teams p
• Absence/low levels of workplace bullying
  p
• Work teams supportive to injured/ill employees -
  p
• Management supportive to injured/ill employees -
  p

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Age Management Intergenerational Benefit

• Good Practice in Age Management (European
  Foundation research)
  
• Emphasis on Prevention address risk factors in
  early stage of working life.
  
• Whole Life Course focus not just older age
• Holistic focus addresses range of issues
  including health, education, training
  
• Compensatory provision for older workers eg
  missed opportunities for training in earlier work
  life, eg those whose health has suffered due to
  work.

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In Conclusion

• The aged care industry has no precedent to follow
  in its age management practices. It is creating
  its own pathway and identifying the lessons along
  the way.
• Rather than submitting to a potential double
  jeopardy situation, the aged care industry is
  well placed to be a leader in effective workforce
  age management.

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Further information

• Full paper www.aisr.adelaide.edu.au
• Contact
• John.spoehr_at_adelaide.edu.au
• Kate.barnett_at_adelaide.edu.au