Table 1 Tasks and challenges in hospital ward settings that have become more difficult with age
Tasks impacted by age-related factors | Reported reasons why each is more difficult |
|---|---|
1. Reading drug labels and information sheets | Age related factors: |
2. Reading other print communications | â–ª Deteriorating vision |
| Â | Exacerbated by: |
| Â | â–ª Poor light at night, environmentally friendly light bulbs |
| Â | â–ª Small print (eg. drug labels, information sheets, ampoules, imprints on foil packs) |
| Â | â–ª Colour of print (eg. orange or red writing on ampoules) |
| Â | â–ª Reading through plastic sleeves |
| Â | â–ª Losing glasses - continually taking them on and off |
| Â | â–ª Increased computer work - associated eye strain |
| Â | â–ª Size of phones, keypads, text messages |
3. Administering medications | Age-related factors specific to these tasks - |
Including: | â–ª Reduced strength in hands and wrists |
â–ª Cracking ampoules | â–ª Pain in hands and wrists |
â–ª Administering IV medications and removing IV lines | â–ª Fine motor co-ordination reduced |
â–ª Openning packages - lids, jars, plastic overwrap, boxes with tape, dressing packs, seals, child proof packages, IV fluid bags | â–ª Reduced dexterity |
| Â | â–ª Increased cramping of fingers |
| Â | Exacerbated by: |
| Â | â–ª Smaller, more secure packaging |
| Â | â–ª Environmentally friendly gloves |
4. Hearing in the hospital ward or unit | Age related factors: |
In particular: | â–ª Deteriorating hearing |
â–ª Hearing patients | â–ª For some, noise induced hearing loss |
â–ª Hearing at the work- station | Â |
   - Drug orders, other instructions and conversation over the phone | Exacerbated by: |
   - Other staff | ▪ Accents of some non-English-speaking staff |
   - Alarms and distinguishing between them | ▪ High background noise level of wards with open office |
| Â | â–ª Distractions - constancy of phones ringing, others talking |
| Â | â–ª Anywhere where there's a crowd |
| Â | â–ª Speech of younger staff |
5. Manual handling - lifting and/or moving patients and equipment | Age-related factors: |
In particular: | â–ª Musculo-skeletal changes affecting strength, muscle tone, flexibility |
â–ª Examining patients | â–ª Stability and balance |
â–ª Dressing patients - shoes & socks, adjusting clothes/attire | â–ª Increased pain, stiffness (+/- osteoarthritis) in: |
▪ Holding limbs and draping surgical patients |    - Joints - hips, knees, hands, feet |
▪ Pushing/pulling equipment - eg. beds, chairs |    - Neck and shoulders |
▪ Showering patients |    - Back |
â–ª Toileting patients in difficult areas | â–ª Manoeuvring more difficult when older; fuller figures of both patients and staff |
â–ª Squatting or kneeling - for procedures, picking things up off floor | Exacerbated by: |
â–ª Doing dressings | â–ª Manoeuvrability and maintenance of equipment |
â–ª Making beds, adjusting bed heights | â–ª Workplace ergonomics and design of facilities (old) |
â–ª Walking up and down steps | â–ª Narrow bathrooms and doors don't allow room for lifting aids |
â–ª Transporting objects, records | â–ª No shelves or poor position of shelves |
| Â | â–ª Unco-operative patients |
| Â | â–ª All-in-one gowns - difficult for examining patients |
6. Shift work | Age-related factors: |
In particular: | â–ª Tiredness, especially after lunch |
â–ª 10 hr shifts, longer shifts, more shifts, double shifts, early shifts, split shift | â–ª Reduced stamina from physical demands on body |
â–ª Rigid roster | â–ª Longer recovery periods - "takes 2 days to get over a double shift" |
â–ª On call | â–ª Lack of sleep, disturbed sleep patterns, "waking at 3 am" |
â–ª Long working days | â–ª More anxious, not dealing with lack of sleep as well as before |
| Â | â–ª Strong work ethic of older workers - "if you were younger, you would just go off" |
| Â | Exacerbated by: |
| Â | â–ª Inflexible work hours |
| Â | â–ª Lack of staff - "can't go off sick, no one to replace you" |
| Â | â–ª Unable to take time out to recover |
| Â | â–ª Poor recovery after inconsistent shifts; insufficient rest times between rotations and being on call |
| Â | â–ª Some older workers more resistant to shift changes |
7. Long periods of standing, walking or sitting | Age-related factors: |
In particular: | â–ª Manoeuvring more difficult when older, fuller figures of both patients and staff |
â–ª Sitting down for long periods eg. data entry | â–ª More difficult to get mobile quickly after sitting, due to stiffness and back problems |
â–ª Standing/walking, being on your feet for long periods or all day. eg. in operating theatre | Â |
â–ª Unnecessary walking | Exacerbated by: |
| Â | â–ª Past surgical procedures |
| Â | â–ª Design of facilities - long distances to medication rooms, utility rooms |
| Â | â–ª Running phones up and down to patients, "have to leave what you are doing" |
8. Midwifery | Age-related factors: |
In particular: | â–ª More difficult to lean, bend, stand for long periods now older |
â–ª Delivery of babies - long periods of: | â–ª Back pain and stiffness |
   - Leaning over beds | ▪ (As above for manual handling) |
   - Bending |  |
   - Being on your feet | Exacerbated by: |
   - On floor with mother | ▪ New options/positions for birthing & birthing chairs |
| Â | â–ª Presentations now more complex, with more requirements |
9. Physiotherapy | Age-related factors: |
In particular: | â–ª Back pain and stiffness |
â–ª Patient exercises - bending/reaching over beds leading to back-strain | â–ª (As above for manual handling) |
| Â | Exacerbated by: |
| Â | â–ª Allied health workers in rural areas are often sole practitioners with no help |