Early retirement (before age 65) is the norm among publicly employed Canadian RNs and AHPs. We were able to test a pared-down version of a literature-derived conceptual model of early retirement: overall our tested model explained between 19 and 25% of variance in RN and AHP early retirement. As a country with existing shortages in health professionals (e.g., audiology and speech language pathology [33], pharmacy [34], occupational therapy and physiotherapy [33]) and an aging population, it is in Canada’s best interest to try and extend the work lives of RNs and AHPs.
It is unsurprising that much of the variation in early retirement remains unexplained by our model; we were unable to test associations of many meso-level variables (i.e., those identified in the categories of work-related, organizational factors and workplace characteristics in the complete conceptual model [9]) as these factors were not measured in the CLSA. The Life Course Perspective, used to guide our conceptualization of retirement, emphasizes the importance of micro-, meso-, and macro-level factors as influences of life course decisions.
Unfortunately, nearly all factors significantly associated with early retirement in our analyses are not easily mitigated or altered by health administrators or policy-makers. Although only 12% of RNs and 9% of AHPs reported that organizational restructuring contributed to their retirement decision, it was a significant predictor of early retirement among both RNs and AHPs. Previous research has demonstrated that the older workforce is at disproportionate risk throughout the process of organizational restructuring. There is a tendency to introduce and/or expand early retirement programs during restructuring in order to reduce the size of the workforce as the optics are better than those associated with sizeable layoffs [35]. Additionally, as restructuring is frequently triggered by financial constraints, reducing the number of older, more “expensive” [36] workers is seen as a way of reducing organizational expenses. In a unionized system, such that exists across Canada, administrators may seek to vacate positions by offering older workers incentivized early retirement packages.
Across Canada and the world, organizational restructuring is a common response to resource scarcity (actual or expected); as health care costs make up a significant part of many government’s budgets, the need for cost-cutting in health systems is unlikely to diminish. For nurses in particular, organizational restructuring commonly results in an increase in workload [37]. Early retirements triggered by organizational restructuring may exacerbate resource scarcity. Burke, Ng, and Wolpin [38] suggest that collaboration during implementation of change between hospital management and unions (such as nursing unions) may mitigate negative impacts on the employees in the organization.
Desire to stop working or being “tired of work,” which in this analysis was associated with significantly lower odds of early retirement among RNs, is a “catch-all” response worthy of further study. Respondents were specifically asked if wanting to stop working contributed to their decision to retire. They were given an opportunity to offer “other” reasons contributing to retirement but only two respondents in our analytic sample elected to do so. Without a better understanding of what it is specifically that made them want to stop working, it is difficult to develop strategies to alter this desire. It is possible that many of the meso-level factors not measured in the CLSA (but included in our conceptual model) such as frequent/pervasive change in the workplace and opportunities for flexible hours of work (or lack of) may have contributed to respondents’ desire to stop working.
In our analysis, caregiving responsibilities were associated with significantly higher odds of early retirement among RNs. The health professions are female-dominated, and according to US data, 60% of unpaid care providers are female [39]. In addition, female care providers are more likely than male care providers to provide caregiving as a reason for retirement [1]. Glenn [40] argues that for many women—whose roles often include mother, wife, and daughter—the duty to care is a role obligation.
Humble, Keefe, and Auton [41] noted that caregivers reported a willingness to remain in the paid workforce should circumstances be altered to facilitate their doing so. Strategies to subsidize caregiving support, expand leave policies to accommodate employees’ needs to provide care [42], and/or facilitate work flexibility [40] may be effective deterrents to early retirement. Glenn [40] also argues that, due to existing inequalities in the labor market that perpetuate gendered caring, affirmative-action policies and application of anti-discrimination laws could serve to equalize the cost of engagement in caring work for women.
It is clear, both from the number of literature-derived variables appearing in our model that were not measured in the CLSA and from the fact that our tested model left the majority of variance in the outcome of early retirement unexplained, that our understanding of retirement decision-making among publicly employed RNs and AHPs is far from complete. Future studies with a focus on measurement of workplace characteristics, attitudes, and beliefs and work-related factors would facilitate testing the influence of the remaining factors in our conceptual model on early retirement.
The diversity of AHPs in our sample likely contributed to the limited number of statistically significant relationships identified in the AHP model of early retirement. Although adequately powered to detect predictors of early retirement among AHPs in general, there were insufficient numbers of individual groups of professionals to test for differences across allied health professions. It is possible that a factor that contributed to higher odds of early retirement in one sub-group (e.g., pharmacists) contributed to lower odds of early retirement in another (e.g., social work) and thus sub-group analyses should be undertaken with a sufficient sample.