The workforce is definitely aging, and that can be great for employers. These workers typically are extremely loyal, dedicated to quality, and can serve as mentors to younger workers with less expertise and experience. To get the most benefit from older workers, companies need to make sure they stay safe and healthy. Understanding some of the unique factors involved in the aging process can help protect these workers, and make sure they get the most appropriate treatment when they are injured.
Currently, 20 percent of the workforce — 9 million workers, are over 65. That number is expected to increase to 98 million by 2060, according to experts. Older employees have the fewest number of work-related injuries but treating their injuries is more costly than it is for their younger colleagues. That is partly due to the higher wages typically paid to older workers. But it also has to do with longer recovery periods and comorbid conditions.
Increasingly, we are seeing more injured workers in their 60s, 70s or even older. The types of injuries they have differ. Where younger workers typically have more acute injuries, aging workers often have injuries that affect, or are affected by other conditions associated with aging. The way we, as physical therapists treat older injured workers is often different from how we treat younger workers.
Underlying preexisting issues tend to make recovery slower and we have to treat the injuries in a way that doesn’t exacerbate them. In treating a sprained knee, for example, we might find out there are underlying arthritic changes and we have to be less aggressive with therapy so we don’t aggravate it.
Unfortunately, treating physicians often fail to mention comorbid conditions. That means it is often up to us as physical therapists to identify conditions that might cause complications. It’s really important we talk with an older injured worker before diving in with traditional treatment. The last thing we want to do is cause unintended consequences for the worker while trying to help him heal. At the same time, it’s important for employers and payers to understand the potential effects of comorbid conditions on elderly workers to avoid paying for treatments that are ineffective and have nothing to do with the workplace injury.
Knee replacements are probably the most prevalent, wasteful expense for work-related injuries we see. That surgery becomes necessary because of arthritic changes in the joints, something that takes years to develop. It’s extremely rare that an acute injury would cause a knee fracture so severe that it crosses into the joint. Yet, I see many older injured workers getting knee replacements paid for through the workers’ compensation system for problems that, quite frankly, have to do with degenerative changes and nothing to do with a workplace injury.
If you have an older worker who’s been told to get a knee replacement, I would strongly advise getting a second opinion to find out if the problem is in any way due to a worksite injury.
Another example is herniated discs. If you were to do MRI screenings on people with absolutely no symptoms, I can just about guarantee 50 percent of them will show there’s a herniated disc in the lower back. That means a worker who strains his back lifting something at work and then goes for an MRI may very well find he has a herniated disc, and he believes that is the source of his pain. What’s really causing the pain is the strain from lifting. In most cases, conservative care will help relieve it.
Employers and insurers spend money trying to help the worker alleviate the pain, but to no avail. They and the worker think the herniated disc came about because of the lifting incident and that must be causing the pain, and that surgery to repair the disc will be the answer. They don’t realize the herniated disc was likely present for years and has nothing to do with the pain caused at work.
Protecting Older Workers
While spending money on unnecessary, ineffective surgeries won’t help prevent or heal work-related injuries, there are steps employers can take. Older workers are the population that greatly benefits from injury prevention programs, like stretching and body mechanics training. Including these in wellness programs can be very effective in helping to reduce injuries among older workers.
Older workers often have developed movement patterns that can cause injuries. Physical therapists can teach them the correct movements to prevent injuries, especially when we are right there at the person’s job site to see exactly what they do. We can show them exactly why certain ways of moving are causing them pain and demonstrate better ways to do their jobs.
Working with a physical therapist is a great way for companies to protect the health and safety of one of their most valuable assets; the older worker.
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