WORK ABILITY, AGE AND INTENTION TO LEAVE AGED CARE WORK

1. WORK ABILITY, AGE AND INTENTION TO LEAVE AGED CARE WORK AAG Workshop on Older Women in Aged Care, February 11 2014

2. This paper… • explores the relationship between age, work ability and intention to leave (ITL) amongst mature age women working in the Australian aged care sector . • Is co-authored with Therese Jefferson, Rhonda Sharp, Rachel Ong, Gill Lewin and Valerie Adams

3. Work Ability: Concept & Measurement • subjective estimation of present work ability compared with lifetime best performance (0–10 points); • subjective work ability in relation to both the physical and mental demand of the work (2–10 points); • number of diagnosed diseases (1–7 points); • subjective estimation of working impairment due to ill health (1–6 points); • sickness absence during the past year (1–5 points); • own prognosis of work ability after 2 years (1, 4 or 7 points); • psychological resources (enjoying daily tasks, activity and life spirit, optimistic about the future) (1–4 points). Work Ability: Workers’ ability at present and in the near future to meet the demands of their jobs The Work Ability Index (WAI): Derived from 7 survey questions on workers’ health and their resources in relation to work demands.

4. Work Ability: Previous Studies Camerino et al. (2006). Data on Registered Nurses in 10 European countries Findings: work ability is lower among older nurses; work ability is significantly associated with intention to leave nursing. • The Work Ability Index (WAI) has been used for more than 25 years to study: • Workers’ functional capacity and how this might change with age; • Workers’ risk of future disability and receipt of a work disability pension; • The effectiveness of programs aimed at improving occupational health and employee retention; • The determinants of ITL Illmarinen et al. (1997) Data on mature age Finnish workers between 1981 and 1992. Findings: work ability declines with age; work ability is lower among workers in physically- versus mentally demanding jobs

5. Work Ability: This Study Measures: • Examines: • The work ability of mature age women working in different occupational roles in Australia’s aged care sector; • The relationship between age and work ability for women in these roles; • The relationship between workability and ITL for women in these roles; • The similarities and differences in the measured work ability (and its links to ageing and ITL) of Australian mature age workers and their European counterparts. • Work Ability: the WAI • Intention to Leave (ITL) • Data from responses to 2 related survey questions • Q) “In the past year have you ever thought about leaving the aged care sector?” • Q) “How often have you had this thought?” • “At least once a year”; • “At least once a month”; • “At least once a week”; • “Every day”. • Data: • MAWAC data on 2721 aged care workers (RNs, ENs, PCAs and CCWs)

6. Results: Work Ability Across Occupational Groups (Australian female aged care workers aged 45+, 2012)

7. Our data indicates that…. • Compared to mature age ENs, PCAs and CCWs in the Australian aged care sector, RNs achieve relatively poor levels of work ability. • However, at age 45-49, Australian RNs in aged care achieve a level of work ability that compares favorably with that of European RNs. • In the over-55 age group, only RNs in Finland, the Netherlands and Italy achieve higher average work ability scores than their Australian counterparts.

8. Our data indicates that…. • CCWs and PCAs achieve relatively high levels of work ability. • This contrasts the findings of other country studies, which show that women in ‘physically demanding’ roles, such as ‘home care’ and ‘auxiliary’ roles have lower levels of work ability than women in ‘mentally demanding’ roles, such as nursing and teaching. • Thus, our finding challenges the notion that physically demanding work, per se, is a source of low work ability.

9. Results:Age & Work Ability Across Occupational Groups(Australian female aged care workers aged 45+, 2012) Average Work Ability Index scores

10. Our data indicates that….. • Amongst ENs, PCAs and CCWs, work ability is not significantly associated with age. • The work ability of RNs declines strongly between age 45-49 and 50-55 but stabilises after this age. • This contrasts the findings of some other studies and common stereotypes. • The combined evidence recommends that managers and others exercise caution before assuming that older workers have low work ability.

11. Results: Work Ability & ITL Across Occupational Groups (Australian female aged care workers aged 45+, 2012)

12. Results:Association between WAI score and ITL by occupation (Australian female aged care workers aged 45+, 2012)

13. Our data indicates that….. • Enrolled Nurses, PCAs and CCWs with low work ability typically have a high intention to leave the aged care sector; and high work ability appears to be important to their retention in the sector • Thus, strategies aimed at retaining ENs, PCAs and CCWs will need to focus on work ability.

14. Our data indicates that….. • Work ability is not strongly related to ITL for RNs • This suggests that factors other than work ability, such as pay, are more important in the determination of their ITL. • It could also indicate that RNs with low work ability perceive that moving to a nursing role other than aged care would be difficult or undesirable.

15. Summary • The WAI measures workers’ ability at present and in the near future to meet the demands of their jobs • This study suggests that Australian female aged care workers have relatively high levels of work ability • Furthermore, their work ability remains high in their 50s and 60s, in contrast to some prevailing stereotypes. • Work ability is a key determinant of ITL for ENs, PCAs and CCWs, suggesting that retention strategies incorporate programs for occupational health and mental and physical wellbeing.