Table 5 Challenges reported that span work settings and particular tasks
Challenges impacted by age-related factors | Reported reasons why each is more difficult |
|---|---|
1. Dealing with mental demands of work | Age-related factors: |
In particular: | â–ª Memory and recall not as good as when younger |
â–ª Dealing with the paperwork | â–ª Added stresses affect cognitive function |
â–ª Remembering things | â–ª More difficult to concentrate for long periods and with distractions |
- Passwords | â–ª Mental fatigue leads to tiredness |
   - Clients names | Exacerbated by: |
   - Where "lists are" | ▪ Constant changes in work systems |
â–ª Emails and other required reading | â–ª More hats to wear - roles, variety of tasks and multi-tasking |
â–ª Keeping mind on task | â–ª Information overload |
▪ Managing stress and burn-out |    - Increased emails, required reading, amount of reading within tasks |
|  |    - "Too many meetings" |
| Â | â–ª Stress and expectation to have "stuff in your head" |
|  |    - New information and passwords (see computers) |
|  |    - Client expectations to remember their names |
| Â | â–ª Pressure of meeting several demands at once |
| Â | â–ª Longer term impacts - always stretched, physical and emotional stress, less happy, less tolerant etc. |
2. Meeting the physical demands of workload as an older health worker | Age-related factors: |
| Â | â–ª Musculo-skeletal changes - increased pain, stiffness |
| Â | â–ª General tiredness and fatigue - especially after lunch, end of day, focusing for long periods |
| Â | â–ª Reduced fitness and endurance - reduced energy levels and loss of weight (or gain) |
| Â | â–ª Slower physically - takes longer to do things, including routine tasks, can't walk as quickly |
| Â | Exacerbated by: |
| Â | â–ª A sense there is more to do, but not enough time to do everything, or do it well |
| Â | â–ª "Patients (and populous) are older, heavier- and so are we" |
| Â | â–ª Sicker, more dependent and debilitated patients |
3. Coping with change | Age related factors: |
These may be: | â–ª Subdued mental reflexes/agility |
â–ª Procedural | â–ª Need more time to assimilate knowledge/change |
â–ª Organisational | â–ª Less/lack of adaptability |
In particular: | Â |
â–ª Role changes | Exacerbated by/resistance to change due to: |
â–ª Coping with change both cognitively and emotionally | â–ª "Constant change" referring to the many changes in the health service over the past 15 years eg. in systems, procedures, roles |
Coping with sudden change | â–ª Change often associated with increased paperwork requirements, new computer programmes |
| Â | â–ª Less tolerance for supposedly 'new things' and "reinventing wheels" |
| Â | â–ª Experience of older workers not valued, "people don't ask us (about the change), the opportunity is not provided" |
| Â | â–ª Casual workers - don't always know about changes |
| Â | â–ª In contrast, participants also noted that some workers refuse to change or learn - "doggedness") |
4. Dealing with emotional impacts of attachment, loss and awareness of own ageing and mortality | Age related factors: |
In particular: | â–ª Confronted by ageing process in clients, colleagues |
â–ª Emotional stress after episodes in acute care | â–ª Death of older people affects us more as we age - closer to own age" |
â–ª Death of older people, who are often well-known to workers | â–ª Dealing with ageing in clients and own ageing/mortality |
â–ª Loss, grief associated with colleagues leaving | â–ª Slower recovery from physical and emotional stress |
Coming to work with younger colleagues | â–ª Difficulty sleeping |
| Â | Exacerbated by: |
| Â | â–ª Patients are becoming peers, bonds formed over any years - "Now you know them, they're not just a patient" |
| Â | â–ª No debriefing available |
5. Dealing with emotional impacts of not achieving personal standards and goals | Age related factors: |
Including: | â–ª Self-awareness that things take longer/workload |
â–ª A sense of change from total patient care to something less, with lower standards | Exacerbated by: |
â–ª Lack of time to achieve higher standards of care | â–ª Difficulty saying no to physical work required (ethic) |
â–ª Less job satisfaction: | â–ª Lack of time to achieve high standards leading to feelings of 'guilt, frustration, lack of pride, poor job satisfaction' |
| Â | â–ª Seeming lack of understanding by higher executives of encroachment of administrative work on clinical time |
| Â | â–ª Declining work conditions over the years - shared offices, technology, work cultural changes, more stimulation |
6. Emotional impacts of not meeting/fulfilling expectations of others | Age related factors: |
Including : | â–ª Less able to cope with stress and changing roles (see above) |
â–ª Patients expectations | Exacerbated by: |
â–ª Organisational expectations relating to workload and workforce: | â–ª Nature of job - increasingly stressful and changing roles at a time of life when less able to cope |
â–ª Peer expectations - supporting other staff and being the "stable" staff member | â–ª High expectations of clients for complete recovery and short recovery times mismatched with staff perspective - leading to tension/stress |
| Â | â–ª High organisational expectations relating to workload |
|  |    - Sense that required documentation is largely driven by fear/risk of litigation |
|  |    - Workforce issues - recruitment in rural areas, getting harder |
| Â | â–ª Supporting other staff - exhausting |
|  |    - "Others revolve, rotate around you and you have to take on more of the support/responsibility role" |
7. Balancing work/family life commitments | Age -related factors: |
Including: | â–ª Own health issues - need for health appointments, specialists |
â–ª Juggling work, family and sharing time with all family members | â–ª Coping with the many facets of life and still keeping your mind on the job |
â–ª Time to fulfil all commitments | â–ª Less energy, slower, more weary, yet seemingly more tasks to do |
â–ª No time for self - to look after yourself | â–ª Wisdom - desire for balance of work and family life |
| Â | Generational factors: |
| Â | â–ª Main carer role in family - |
|  |    - Ageing parents |
|  |    - Looking after husband, older parents, growing children, adult children needing help eg. minding grandchildren |
|  |    - Going home to do more physical work |
| Â | Exacerbated by: |
| Â | â–ª Other shift workers in family |
| Â | â–ª Split days off |
| Â | â–ª Distances to travel to see family |
| Â | â–ª "More to do (family), less time to do it", |
| Â | â–ª Assumptions by organisation and younger colleagues that older workers don't have family commitments |
8. Staying engaged and positive in spite of difficulties | Age related factors: |
Including: | â–ª Less capable of dealing with the increased physical/emotional workload posed by demanding patients (see above) |
▪ Maintaining tolerance for attitudes and behaviours of patients, organisation and younger workers |    - On the one hand, tolerance often lower for rudeness of people - "get to an age where you say - hang on, you can't speak to me like that" |
â–ª Maintaining tolerance for attitudes and behaviours of patients, organisation and younger workers | â–ª In contrast: wisdom and tolerance gained through experience |
|  |    - "As you get older, you realise you can't fix things... you can only do so much" |
| Â | â–ª Sensitivities and the "psychology of ageism" |
|  |    - More sensitive to criticism when older |
|  |    - Negative thinking/spin from others and from self eg. "I'm too old" |
| Â | â–ª Tiredness dealing with difficult situations eg. confrontation associated with "dealing with destructive and undermining behaviours - would rather avoid it" |
| Â | Exacerbated by:- |
| Â | â–ª Attitudes and behaviours of patients, organisation, younger workers |
| Â | â–ª Interpersonal communication |
|  |    - Communication with younger workers difficult - language used, seem "less compassionate", seem to "only half listen" |
|  |    - In contrast: "Not in our team, we work well and communicate well," (need to) "beware of generalising" |