A systematic review of literature on occupational health and safety interventions for older workers.

As the global population ages there is an imperative to enhance labour participation of older workers in ways that support good physical and psychological health. However, there is limited guidance for organisations on how to do this effectively. This systematic review examined literature identified through four databases and a targeted web-search, yielding 39 PRISMA records (32 scholarly, seven grey literature) reporting workplace interventions aimed at improving the injury outcomes of older workers. The review revealed that organisational and composite interventions may be most effective, although an absence of robust research in this area and a scarcity of empirical evidence-based interventions known to improve injury outcomes for older workers was noted. Responding to these shortcomings, this article presents 'A future research agenda for older worker health, safety and well-being interventions.' This systems-based approach has a dual focus on organisational and composite interventions combined with robust research design.Practitioner summary: We conducted a systematic literature review of studies focussed on workplace interventions to improve the physical and psychological safety of older workers. Within the existing literature, evidence for effective interventions and guidance for organisations is weak. We present a future research agenda with a systems approach to address these gaps.

What is the impact of dementia on occupational competence, occupational participation and occupational identity for people who experience onset of symptoms while in paid employment? A scoping review.

BACKGROUND/AIM: Engagement in meaningful occupation, including paid work is considered an important determinant of health, impacted by injury or illness. Dementia is one neurodegenerative syndrome with potential to compromise capacity for remaining engaged in paid employment. In response to 'ageing' populations globally, policy shifts within developed economies are increasing workforce participation for those over 45 years and eligibility ages for retirement pensions. Dementia onset is not limited to 'older age', consequently an increased impact of dementia is likely for both older workers and those experiencing younger onset dementia. Therefore, identifying and addressing workforce participation issues confronting people with dementia is becoming increasingly important for occupational therapy practice. METHOD: This scoping review draws on peer reviewed literature to explore the impact of dementia on workers across the three domains of occupational engagement: occupational competence; occupational participation; and occupational identity using the Model of Human Occupation (MOHO). International studies published in English including full-text translations between 2000 and 2017 were identified from an incremental search of electronic databases (Web of Science; Scopus; Proquest; MEDLINE; CINAHL; and Health Business Elite) and hand searched reference lists. RESULTS: Six relevant papers were identified and retained for analysis, all reporting qualitative studies. Data were collated under the three domains of occupational engagement and further organised into emergent subcategories. While evidence was limited, person-centred approaches addressing dementia-related changes in occupational competence; workforce participation choices; and redefinition of occupational identity may mitigate negative experiences associated with transitioning from paid worker roles. CONCLUSION: There is a significant need for further research exploring the impact of dementia on engagement in paid work. Occupational therapists have an important part to play in enabling access to person-centred interventions that promote continued engagement in meaningful occupational roles, including opportunities to extend workforce participation and engage in supported transitions to retirement.

An integrative review: understanding driving retirement decisions for individuals living with a dementia.

AIM: To synthesise primary research exploring decision making practices used to determine the time to retire from driving for individuals living with a dementia. BACKGROUND: Driving requires complex cognitive and physical skills potentially compromised due to the progressive nature of dementia. Whilst on-road assessments are considered reliable indicators of driving capacity by clinicians, drivers with dementia disagree. DESIGN: Integrative literature review informed by Whittemore & Knafl (2005). DATA SOURCES: Electronic database search of Medline, CINAHL, Web of Science, Google Scholar 1997-2012; and incremental hand search. REVIEW METHODS: Primary studies published in peer reviewed journals were appraised against quality assessment criteria using CASP methodological assessment tools. RESULTS: A total of 43 studies were retained for synthesis. Key findings were abstracted and a themes matrix was generated to identify patterns of meaning. Six themes emerged: (i) dementia may compromise the complex task of driving; (ii) defining onset and severity of dementia is problematic; (iii) symptom progression impacts on driving skills; (iv) assessment of fitness to drive remains subjective; (v) some drivers are reluctant to accept negative assessment outcomes; and (vi) the search for effective strategies to enhance acceptance of driver retirement continues. CONCLUSION: This integrative literature review identified a large body of knowledge exploring the issues of driving cessation for drivers with dementia. However a challenge remains for practitioners, drivers and their family carers regarding how best to address this highly emotive issue. Findings could inform a structured approach to address this sensitive topic in a timely manner.

"The Challenge is Not to Make Her Feel Old and Bad": Exploring Australian Family Member Experiences of Conversations About Driving With Older Adults Using an Online Survey.

This study explored the experiences of Australian family members having conversations about driving with older adults. An exploratory cross-sectional design using an online survey was carried out with Australian family members of current or retired (former) older drivers. One hundred and fifty-six intergenerational family members across Australia completed the survey. Qualitative content analysis of free-text responses identified that the outcomes of conversations were impacted by a range of environmental and individual factors. The essence of conversations centered around two opposing (positive and negative) discourses. The findings highlighted that an individualized approach to the content of conversations is required due to; driver attributes and actions, variations in the level of support experienced by family members, differences in physical and cognitive declines with age, negative perceptions on the impact of driving retirement, and absence of acceptable alternatives to driving. We recommend using positive discourse and reappraisal techniques when initiating driving conversations with older adults.

Older Worker-Orientated Human Resource Practices, Wellbeing and Leave Intentions: A Conservation of Resources Approach for Ageing Workforces.

At a time where there are ageing populations, global shortages of skilled labour, and migration pathways impacted by the COVID-19 pandemic, retaining older workers presents as a vital strategic initiative for organizations globally. This study examines the role of Human Resource Practices (HRPs), which are oriented towards accommodating the needs of an ageing workforce in mitigating psychological distress and turnover intentions. The study collected self-reported survey data from 300 Australian employees over the age of 45, over two time points. Using structural equation modelling, the study analyzed the extent to which Older Worker-oriented Human Resources Practices (OW-HRPs) translate into employee psychological health and retention within organizations, through the mediation of ageism and work-life conflict. The results support our hypothesis that OW-HRPs are associated with lower ageism, better work-life balance; and in combination these reduce psychological distress and help retain older workers in the workforce. We conclude that OW-HRPs can foster work environments conducive to older worker wellbeing, supporting the retention of talent and maintaining effectiveness, in the face of substantial labour supply challenges brought on by the COVID-19 pandemic and an ageing population.

Defining currency of practice for nurse educators.

Recent Nursing Council of New Zealand (NCNZ) guidelines for competence-based practising certificates (NCNZ, 2001) and the fact that all nurse educators must have a current practising certificate prompted the Nursing Schools within the Tertiary Accord of New Zealand (TANZ) to explore issues surrounding current competency in practice and how this can be maintained by nurse educators. This is a topical debate as discussions related to competence-based practising certificates generally refer to competence only in terms of direct patient care. This article sets out to clarify the issue with specific reference to nurse educators who, by the nature of their scope of practice, often do not carry a patient caseload. The literature relating to currency of practice is explored to provide background to current definitions and existing strategies for maintaining competence. This article draws on the findings of a survey by the TANZ Nursing Schools and provides a position on how currency of practice applies to nurses working in educational settings. In addition, strategies to maintain clinical, teaching and scholarly currency are presented along with suggestions for providing evidence that currency of practice is maintained.