Assisted living workers provide necessary services, yet their daily tasks may provide risks to their own physical well-being. The continual duties of moving some residents into and out of beds or wheelchairs, helping them stand or walk and assisting with a host of other repetitive daily tasks can lead to painful musculoskeletal disorders.

At Ohio University’s Russ College of Engineering and Technology, I research and study workplace ergonomics and continue to find that the implementation of an ergonomics program can improve productivity, safety and performance. Each profession is unique, however, and must be approached accordingly. Because workers in assisted living communities face high injury risks, often at low-salary jobs with high turnover rates, it is up to community owners and managers to demonstrate that they are willing to instill a culture of safety through respect, honesty and trust.

Promoting a culture of safety

The federal Occupational Safety and Health Administration provides guidelines for introducing ergonomics in assisted living communities with the goal of reducing the number and severity of work-related musculoskeletal disorders. These guidelines, although essential to building a culture of safety, are voluntary. It is up to company leaders to instill safety practices that can be adopted by all employees. As I tell my graduate students who one day will be workers and future leaders, implementing a culture of safety does not happen overnight but must be taught and encouraged from the top down.

Companies are responsible for creating clear mission statements to enable the workers to provide high-quality care and services in a safe manner. Management must show a strong commitment by defining objectives for the ergonomic process, discussing these goals with workers, assigning responsibilities to designated employees and leading by example.

Addressing risks with ergonomic techniques

For ergonomics to be effective, a participatory approach is required. Workers can provide valuable insight by identifying hazards in the workplace. They can collect data on past injuries, thereby understanding potential risks and educating themselves on the importance of safety.

The greatest risk that workers encounter are musculoskeletal disorders as a result of assisting residents with the activities of daily living of transferring, bathing and dressing. Resident lifts can cause workers to overexert themselves and, if the resident is connected to a catheter, I.V. or other medical equipment, to use awkward postures during transfers. In these situations, I would recommend that a task analysis be completed and would investigate which types of ergonomic assistive devices (for instance, slide boards, gait belts or mechanical slings) would help to reduce the risk of injury to the employee and to the resident.

Ergonomic training should focus on reducing the primary risk factors of force, repetition and posture in relation to resident transfers, bending to make a bed or feed a resident, pushing heavy carts and other everyday tasks. Workers also must understand the proper use of equipment and assistance machines, safety procedures and indicators of potential risks for causing musculoskeletal disorders.

Further reading

Governmental agencies such as the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health and the Department of Labor’s Occupational Safety and Health Administration and Bureau of Labor Statistics provide additional information about musculoskeletal disorders and workers. Although some these materials were not produced specifically for assisted living workers, the information in them is applicable.

“Caring for Yourself While Caring for Others”

“How to Prevent Musculoskeletal Disorders”

“Occupational Hazards in Home Healthcare”

“Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders”

“Prevention of Musculoskeletal Disorders in the Workplace”

“Occupational Outlook Handbook: Nursing Assistants”

“OSHA Requirements for Assisted Living Facilities”

As I already have mentioned, although the principles of ergonomics remain constant, the solution to problems differs based on the needs of specific professions and available resources. The same holds true for different assisted living communities. For example, to reduce the risk of injury, some communities may be able to install risk-reducing technologies, whereas others may implement new policies (for instance, two-person lifts). In either case, employees should be trained on evaluating risk and should have input on improving tasks.

Continued evaluation, continued improvement

For the system to work effectively, employers actively must evaluate the procedures in place and make it easy to implant new techniques. Workers need to know the procedure for reporting work-related injuries, reporting forms need to be readily available and the benefits of reporting symptoms of musculoskeletal disorders early need to be discussed.

In addition to reducing risk through ergonomic awareness, assisted living communities also can save money. The costs of hiring and training new employees will decrease when current employees feel healthy and respected within a culture of safety. Fewer injuries also mean reduced workers’ compensation expenses.

As the current population continues to age and more people need assistance in their later years, workers who can provide needed care and services will continue to be a great asset. Their health and contributions are vital to ensure high-quality care and respect for the elderly. The importance of ergonomics in keeping workers healthy cannot be overstated. Many solutions consist of simple modifications to procedures that do not require a lot of time or resources but will lead to long-term benefits for everyone.

Diana Schwerha, Ph.D., is an associate professor of industrial and systems engineering in the Russ College of Engineering and Technology at Ohio University in Athens, OH. She advises graduate students pursuing research in aging and ergonomics, the usability of technology and factors related to technology adoption among older users. She is the director of a training project grant in occupational safety for the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health. She has published numerous journal articles and conference papers and has given presentations in the United States and Europe.

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