Why Senior Facility Employees Need Opportunities to Keep Themselves Healthy

Posted on January 25, 2024 by LeadingAge

This article was contributed by Heidi Orstad, DNP, RN, PHN, CCM. Dr. Orstad is a clinical nurse consultant with Marsh McLennan Agency, a preferred vendor of LeadingAge Minnesota Solutions.

It’s no secret that senior living facilities have difficulty attracting and retaining good employees. For some workers, the wages are low, defined by the Bureau of Labor Statistics as $9.25 an hour or less.

An outsized portion of that take-home pay has to cover out-of-pocket health care costs. In fact, the Bureau of Statistics reports that one dollar out of every three pre-tax dollars of low-income workers goes to pay for health care.

A recent study by KFF, an independent non-profit providing health policy research, finds that lower-income adults are more than twice as likely (31%) to have trouble paying medical bills as higher-income adults (13%), which can negatively affect health outcomes. 

High healthcare costs as well as the fear of losing income from being absent from work can deter employees from seeking medical care. The KFF study shows employees not being able to afford healthcare can result in being forced to make incredibly hard choices—pay rent, buy groceries, see the doctor, or fill a prescription. They can even be pushed into medical bankruptcy by the cost of healthcare and health insurance.

Senior living employees may be susceptible to a wide range of chronic illnesses.

Working conditions have always been challenging for healthcare workers, even before the pandemic. Work in healthcare often involves:

Intensely stressful and emotional situations. According to the CDC, work stress can lead to poor mental and physical health.  Many senior care workers place the well-being of others before self, which can ultimately be harmful if it delays or prevents workers from getting the help that they need for their own health and well-being.

Burnout from a variety of exposures. More than 45% of healthcare workers reported feeling burnout in 2022, up from 32% in 2018. Reports of poor mental health symptoms also increased more for health workers than for other worker groups as a result of:

• Continuing exposure to human suffering and death
• Pressures from patients, family members, and employers
• Risk for hazardous exposures such as COVID-19, other contagious infectious diseases, and hazardous medications
• Demanding physical work and risk of injuries
• Long and often unpredictable work hours, including night shifts
• Compassion fatigue that can lead to substance abuse as a way to cope

Research indicates that employees who do shift work and/or who earn a low income are more likely to suffer from cardiometabolic diseases such as pre-diabetes, diabetes, hypertension, and heart disease.

Senior facility employees who work with residents also endure a higher-than-expected incidence of musculoskeletal injuries as a result of their work.​​​​​​​ The Bureau of Labor Statistics reported that senior living employees are more than seven times more likely to suffer a musculoskeletal injury on the job compared to the average of all industries in 2023.

Addressing the social determinants of health is fundamental for improving health

According to one Senior Living Marsh McLennan Agency client in the Upper Midwest, “We cannot address health benefits until we address the fact that we have employees living in their cars.”

A large percentage of senior living employees earn low wages, according to the Brookings Institute. This often leads to lack of access to transportation, housing, childcare, education, food and more. These inequities affect the employee and their family, as 43% of low-wage earners are raising children.

According to the World Health Organization, 30-55% of a person's health is determined by socioeconomic factors, health-related behaviors, and environmental conditions.

The Centers for Disease Control (CDC) identifies social determinants of health as:

• Access to quality health care
• Education access and quality
• Social and community context
• Economic stability
• Neighborhood and built environment

How can leaders at senior facilities promote opportunities to improve employee health?

There are strategies senior living leaders can use to help employees become healthier, mitigate stress, and more.

1. Prioritize safety at work. The CDC’s Safety Culture in Healthcare Settings is one helpful resource.
2. Provide affordable, accessible benefits that serve the diverse needs of your employees and their families. According to the KFF study, a majority of employers are attempting to help lower-income employees with benefits ideas such as:
   • Salary-based premium programs that lower monthly premium costs but may not provide costs for other out-of-pocket expenses like deductibles
   • Co-pay plans that offer flat fees for routine doctor visits and typically have low deductibles
   • High deductible health plans (HDHPs) with low premium costs
3. Survey your employees to understand what it is they are needing from their employer and health benefits. Some pulse surveys are publicly available.
4. Offer access to care in ways that eliminate or reduce the cost to employees while reducing employer risk. Examples include using vendors that provide telemedicine, mental health care, and virtual physical therapy.
5. Promote awareness of community resources and tools like findhelp.org to provide improved healthcare access.

For information about how to partner with a team of Marsh McLennan Agency Clinical Consultants who can support your journey towards improved employee health and wellbeing, contact us.

About Marsh McClennan Agency

Marsh McLennan Agency offers a team of clinical professionals, data analysts, and health management consultants who can interpret data against the known challenges in the industry and a facility’s location. They can help develop a wellness strategy most relevant to employees, including creating the best health solutions designed to mitigate health risks in your facility. To learn more, contact a Marsh McLennan Agency representative.