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Editorial: Putting Aging into Perspective for Our Profession
The nursing workforce is aging, with the mean age of U.S. nurses now at 46.8 years (U.S. Department of Health and Human Services [HRSA] 2004). As a professional group, how do nurses proactively address the many issues associated with aging? How will the nursing profession maximize the expertise, nursing skills, experience, and manpower of its older nurses?
Aging is a normal component of our developmental life cycle. Granted, the years pass, our hair grays and our physical, cognitive, sensory, and other capacities decline. Yet, we are in an era with an increasing number of vibrant centurions and productive older adults. Moreover, healthcare advances in prevention, diagnosis, treatment, and long-term management have created positive outcomes in many conditions, such as heart disease, cancer, and stroke with the trend expected to continue. Healthy People 2010 serves as a valuable roadmap grounded in science that provides measurable outcomes to promote health and to prevent illness, disability, and premature death for all age groups (HRSA, 2000).
For this discussion, older adult is defined as age 55 or older, but not all literature is in agreement with this definition (Canadian Centre for Occupational Health and Safety [CCOHS, 2006]). For instance, a review of the occupational health and related literature indicates that workers can be labeled as an older adult as young as age 45 (National Academy of Sciences [NAS], 2004).
In the United States, there are currently 93 million people aged 45 and older, representing 44% of our noninstitutionalized population. By the year 2050, it is projected there will be 170 million people 45 and older, representing 53% (NAS, 2004).
How should nurses take these changing demographics and apply them to nursing? The following are important points to consider:
We must also dispell several of the common aging myths.
Myth 1: Benefit and accident cost rates are higher for older workers.
Because older adults have fewer acute illnesses and sporadic sick days, they take fewer total sick days than other age groups (Coombs, 2006). In addition, older workers take fewer risks than younger workers and statistically have lower accident rates than other age groups (CCOHS, 2006).
Myth 2: Older adults cannot learn new activities.
Research indicates that older adults under the age of 70 have neglible losses of cognitive function (American Business and Older Employees [OBOE], 2000). Although they may take longer to absorb completely new information, as a group older adults tend to have positive attitudes and experience, which lowers training costs. Olson (2001) also found that older workers sometimes fall behind in acquiring new skills because they are not given the same training opportunities as younger workers. Unfortunately, employers tend to give the most training to employees age 40 and younger and the least to those over 55 (Letvak, 2002).
Myth 3: Older workers are not as creative or innovative.
General intelligence levels are the same for younger and older workers. Eighty percent of the most worthwhile and workable new productive ideas have been produced by employees over age 40 (OBOE, 2000).
Myth 4: Older workers are not as productive as younger workers.
Productivity does not appear to decline as a function of age. Productivity in older workers may actually rise due to greater accuracy, dependability, and their capacity to make better spontaneous judgments (OBOE, 2000).
Body functions change with increasing age. For most people, physical maturity occurs around age 25 noticeable signs of aging beginning between 40 and 50 (CCOHS, 2006). Examples of physical changes that can affect work are loss of muscular strength and joint mobility, changes in posture and balance, lessening ability to adapt to environmental temperature change, and decline in hearing and vision. However, a well-designed work place benefits everyone in any work setting. More importantly, different working conditions may be needed for many employees and not just those who are older (CCOHS, 2006; NAS, 2004).
To take advantage of this information, we must become more informed with regard to the normal changes associated with aging and building this foundation of knowledge on scientific evidence rather than myths or inaccurate data. We should also examine strategies to successfully maximize our work situation for nurses of all ages. Within rehabilitation, as other healthcare situations, older nurses have much to offer. In a study involving hospital-based RNs age 50 and older, Armstrong-Stassen (2005) discovered that older nurses want to be respected and recognized for their knowledge, skill, and expertise. Letvak (2003) identified that despite the stress created by intergenerational conflicts with younger nurses, perceptions of being less respected by patients and families, and inequity in pay, older nurses continue to practice because of their strong caring attitude, confidence in their professional abilities, and desire to make a difference. Unfortunately, Letvak (2002) further found that despite older nurses’ strong commitment to their profession, most administrators and other healthcare leaders had no policies or plans to address the needs of these older workers.
It is critically important that administrators and healthcare leaders consider new ways to take advantage of the expertise, experience, and talents of older nurses, for example, contemplating more flexible and creative staffing patterns, rewarding experience with autonomy, considering job redesign, more flexible assignments that permit telecommuting, seasonal work schedules, or special assignments (Goldberg, 2000; McIntosh, Palumbo, & Rambar, 2005). With the increasing nursing shortage, it is imperative that new approaches be used to retain nurses of all ages, but especially older nurses.
American Business and Older Employees. (2000). Myths about Older Workers. American Association of Retired Persons. Washington, DC: Bureau of Labor Statistics.
Armstrong-Stassen, M. (2005). Human resource management strategies and retention of older RNs. Canadian Journal of Nursing Leadership, 18(1), 50–64.
Canadian Centre for Occupational Health and Safety. (2006). Aging workers. Canada’s National Health and Safety Resource. Retrieved March 11, 2006, www.ccohs.ca/ oshanswers/psychosocial/aging_workers.html.
Coombs, A. (2006). Report challenges myth of the costly older worker. Prudential Financial. Retrieved March 11, 2006, www.prudential.com/newArticle/0,2586,intPageID%253D15%2526bln.
Goldberg, B. (2000). Age Works. New York: The Free Press.
Letvak, S. (2003). The experience of being an older staff nurse. Western Journal of Nursing Research, 25(1) 45–56.
McIntosh, B., Palumbo, M. V., & Rambur, B. (2003). The older nurse: Remedies and Reminders. Burlington, VT: University of Vermont.
Olson, C. A. (2001). Who receives formal firm sponsored training in the U.S.? National Center for the Workplace Working Paper Series. Berkeley: University of California. Available at http://ost-socrates.berkeley.edu/iir/ncw/wpapers.
Ramsey, S. D., Berry, K., Moinpour, C., Giedzinska, A., & Andersen, M. R. (2002). Quality of life in long-term survivors of colorectal cancer. American Journal of Gastroenterology, 97(5), 1228-1234.
U.S. Department of Health and Human Services. November 2000. Healthy People 2010: Understanding and Improving Health (2nd ed.). Washington, DC: U.S. Government Printing Office.
U.S. Department of Health and Human Services. (2004). Preliminary Findings: 2004 National Sample Survey of Registered Nurses. Retrieved March 13, 2006, http://bhpr.hrsa.gov/healthworkforce/reports/rnpopulation/preliminary findings.htm.