To work after retirement: a qualitative study among mental health nursing assistants

Abstract

Significant shortages of nursing staff threaten the provision of sustainable and high-quality patient care, which may be partially addressed by encouraging experienced staff to postpone their complete exit from the workforce and extend their careers. This qualitative study explored the transition to retirement, the motivation to engage in post-retirement work, and experiences of working after retirement among retired nursing assistants (aged 67–75 years) working in inpatient psychiatric care in Sweden. Interpretative Phenomenological Analysis (IPA) was used and allowed for a detailed, in-depth systematic analysis of data from seven individual interviews. Four superordinate themes were identified: (1) Adjustment difficulties to life as fully retired; (2) Good health as a precondition to work and a consequence of working; (3) The intrinsic joy of working and the importance of feeling competent; and (4) Work and organization-related factors contributed to well-being at work and facilitated an extended working life. Post-retirement work was found to facilitate the transition to retirement and contribute to well-being. Furthermore, good health was considered a prerequisite for, and a consequence of, continued working. Intrinsic motivation to work, being competent in performing the job, along with different work and organizational factors were considered important to continuing working after retirement. The findings contribute to informing the design of work environments and tailored HR strategies that facilitate aging-in-workplace and encourage extended working lives.

Keywords:

• Post-retirement work
• bridge employment
• healthcare
• older workers
• qualitative
• interpretative phenomenological analysis

Introduction

Extended careers and postponed retirement seem increasingly important in view of demographic ageing having changed the age structures in the general population and the workforce in a large number of countries (OECD, 2019). Specifically, the increasing number of older people, accompanied by historically low birth rates, reduce the workforce, and bring about serious labour shortages in key sectors, such as healthcare (OECD, 2019, 2021a). With respect to mental healthcare, particularly following the COVID-19 pandemic, there is an increasing global awareness of the importance of providing good access to mental healthcare services (OECD, 2021a). However, the worldwide shortage of mental health nursing staff, which also holds for Sweden (Holmberg et al., 2018; Hurley et al., 2022; Stewart et al., 2022), threatens the provision of sustainable and high-quality mental healthcare (OECD, 2021b).

Nursing assistants make up 40% of the Swedish healthcare workforce and have a central role in patient care (Swedish National Board of Health and Welfare, 2021), including psychiatric care (Gabrielsson et al., 2014). Older nursing assistants, with their accumulated experience and expertise, may be a valuable resource to fulfil staffing demands and maintain the competence within the healthcare organizations (Swedish Association of Local Authorities and Regions [SALAR], 2017). However, on average, there is a preference among nursing assistants to retire earlier than what is still considered the normative retirement age of 65 years (Stattin & Bengs, 2022). Among those nursing assistants employed by municipalities and regions in Sweden aged 60 years and older, the average exit age was 63.4 years in 2022 (Swedish Association of Local Authorities and Regions [SALAR], 2023). In view of this, it is important to understand how individuals belonging to this important occupational group can be encouraged to delay their timing of completely exiting the workforce and to prolong their working lives.

Background

To address the challenges of an aged population, governments worldwide have implemented several reforms aiming at increasing the participation of older workers in the workforce (OECD, 2019). Retirement has then been at the centre of the political agenda in many countries and is an increasingly prominent research topic (Henkens et al., 2018). The flexibilization of pension systems, as an attempt to respond to the challenges of an ageing population, along with longer and healthier lives, and less physically demanding jobs, have changed the patterns of work and retirement in older ages and facilitated the extension of working lives (Mazumdar et al., 2024; Scherger et al., 2012; Zhan & Wang, 2015). Retirement decisions have become more individualized and diverse in terms of the timing of complete workforce withdrawal and exit patterns (Boveda & Metz, 2016; Furunes et al., 2015, Halleröd et al., 2013). Instead of a sharp and permanent exiting from the labor force, an increasing number of individuals continue, to some extent, their gainful employment after having started to take up their retirement pensions, before permanent retirement (European Union, 2020; Hess et al., 2021). The form of paid work that takes place after a person formally retires and before the complete withdrawal from the labour market is commonly referred to in the literature as bridge employment (e.g. Kim & Feldman, 2000; Wang et al., 2008). However, the adequacy of this term has been questioned (Brown et al., 2014; Scherger et al., 2012), as it suggests a unidirectional transition between employment and retirement, usually with a reduction of working hours, and ignores the possibility of several transitions in and out of employment. Instead, Scherger et al. (2012) suggests a more neutral term, i.e. “post-retirement work”, which is used in this study. The participation in post-retirement paid work has been conceptualized as a distinctive new stage occurring in the late career years, instead of being viewed as a mere transitional state between employment and full retirement (Brown et al., 2014; Platts et al., 2021; Wang & Shi, 2014).

Besides potential individual benefits, including personal fulfilment, enhanced health and well-being, and financial security in old age (Cahill et al., 2012; Galkutė & Herrera, 2020; Zhan et al., 2009), post-retirement work may be an effective way for organizations to retain older workers and make use of their competence and expertise to facilitate the intergenerational transfer of knowledge and skills (Alcover et al., 2014; Fasbender et al., 2022; Shultz & Wang, 2011).

There is a growing number of studies of factors relating to the decision to retire (for meta-analyses and literature reviews, see Fisher et al., 2016; Scharn et al., 2018; Topa et al., 2009; Topa et al., 2017; Wang & Shi, 2014). However, considerably less attention has been given to the meaning of retirement for retirees involved in post-retirement work and the underlying mechanisms influencing extended careers after retirement (de Wind et al., 2016; Mazumdar et al., 2024), with employees older than 65 being under-studied (Hovbrandt et al., 2019a; Platts et al., 2021). Considering the complexity of individual experiences and thoughts about work and retirement transitions, in-depth qualitative studies may add to a more comprehensive understanding of the dynamics involved (Amabile, 2019; Mazumdar et al., 2024; Stattin & Bengs, 2022; Shultz & Henkens, 2010; Taneva et al., 2016). However, and as noted in a recent systematic review (Galkutė & Herrera, 2020), few studies have used a qualitative approach to investigate the factors that drive and contribute to individual’s extending their careers and engaging in post-retirement work, and experiences of working beyond the pensionable age (for exceptions see, for example, Hovbrandt et al., 2019a; Platts et al., 2021; Sewdas et al., 2017).

Quantitative studies show that working after retirement is more frequent among men, younger ages, healthier people, higher educational levels and white-collar occupations (e.g. Dingemans et al., 2016; Scharn et al., 2017; Wang et al., 2008). The role of financial factors is not straightforward (Beehr & Bennett, 2015). While some studies show that higher salaries and pension incomes were negatively associated with the likelihood of engaging in post-retirement work (Dingemans et al., 2016), other studies have found that wealth did not predict the decision to continue working after retirement (Wang et al., 2008). As for work-related and organizational factors, the engagement in post-retirement work versus full retirement has been associated with better working conditions (Topa et al., 2009), work engagement (de Wind et al., 2016), job involvement and schedule flexibility (Pengcharoen & Shultz, 2010), lower work stress and higher job satisfaction (Berglund et al., 2017; Wang et al., 2008), and organizational commitment (Zhan et al., 2013).

Research has shown that the work environment in inpatient psychiatric wards is characterized by high levels of psychological job demands, as well as low levels of control and social support (Leka et al., 2012; Molin et al., 2016). A systematic review (Adams et al., 2021) of the research regarding factors contributing to job retention within the mental health nurses found younger, less experienced, male and single mental health nurses to report a higher intention to leave their current positions. Perceptions of the job as both rewarding and important to others were important reasons for staying in mental healthcare, while experiences of patient-initiated violence or concerns regarding risks, as well as moral distress, emotional exhaustion, and burnout were reasons for considering leaving the profession. Opportunities for training and development were found relevant to improve retention. The same held for supportive working relationships with colleagues and supervisors, satisfaction with the salary and the work schedule, and having enough resources at work (e.g. sufficient staffing).

With most studies of career-related issues within the healthcare sector having focused on medical doctors and nurses, perspectives of other occupational groups, such as nursing assistants, have been given less attention (Bengs & Stattin, 2018; Holmberg et al., 2018). Moreover, given that the characteristics of paid work in the retirement years is distinct from work before the pensionable age (Platts et al., 2021), other factors may be involved when engaging in post-retirement work. Importantly, such factors may not surface in studies of younger working populations. Still, no studies were found to have investigated experiences of working through the retirement years of psychiatric mental health nursing staff.

The present study

Considering the above, the present study explored, in-depth, the transition to retirement, the factors shaping the decision around engaging in post-retirement work, and the experiences of working after retirement among a group of retired nursing assistants working in inpatient psychiatric care in Sweden, using a qualitative phenomenological approach. The study findings may inform the design of work environments and HR strategies that encourage extended careers.

The Swedish context

Given the relative flexibility in the pension system and the high employment rate among older workers (OECD, 2019), Sweden is a particularly interesting context for the study of retirement decisions and experiences of continued work after retirement. In Sweden, there is no statutory retirement age, and employees have the possibility to retire between ages 62 and 68, with financial benefits for later retirement (Swedish Pensions Agency, 2020). The pension can be drawn as 25–100% of the whole, and there is a possibility to suspend and subsequently restart the payment of the pension at any time. Also, retirees may continue to work and earn new pension entitlements after having started to draw their pensions (Government Offices of Sweden, 2016). Of the OECD countries, Sweden has one of the highest levels of labor market participation of retirees in paid employment (OECD, 2019), and the percentage of the population aged 65–74 years who are working has increased from 6% for women and 14% for men in 2005, to 13% for women and 21% for men in 2018 (Fransson & Söderberg, 2019). Of those who continue working, individuals with post-secondary education are overrepresented (Hansson, 2020). In 2022, 3.9% of the nursing assistants were aged 65 and older. This figure includes those who postponed their retirement and those who worked on an hourly basis after having started to take up their pension benefits (Swedish Association of Local Authorities and Regions [SALAR], 2023).

Materials and methods

Participants and procedure

Purposive sampling was used to recruit participants from a psychiatric department located at a large Swedish general hospital, following three criteria: 1) age 55 years or older; 2) having started to receive pension benefits; 3) working as a nursing assistant. The second author contacted the operational managers of two inpatient units and the head of the department, and presented the study aim and sampling criteria. The managers approved the study and distributed a leaflet including a description of the research project and contact details to the research team to nursing assistants meeting the sampling criteria.

The study participants are seven retired nursing assistants (including four men and three women), aged 67–75 years who were employed on an hourly basis. At the time of the interview, all had worked more than one year after their retirement with their average working time being 50–100+ % of a full-time schedule of 40 h per week, with the exception of one who was working less than one day a week (less than 20% of full-time). All had worked full-time as psychiatric nursing assistants before retirement with their retirement ages ranging from 62 to 67 years. Moreover, all interviewees had worked at the hospital before retirement and were familiar with the organization. As for their personal life situations, five interviewees lived alone.

The small and homogeneous sample of seven retired nursing assistants aligns with the idiographic focus that characterizes the methodological approach adopted in this study (Interpretative Phenomenological Analysis [IPA]; Smith, 2004; Smith & Osborn, 2003; Smith et al., 2022). IPA studies typically include small samples ranging from 5 to 10 participants (Smith, 2004). By “sacrificing breadth for depth” (Smith & Osborn, 2003, p. 56), the use of the IPA approach allows for a detailed and nuanced interpretative analysis of the nursing assistants’ lived experiences of retiring and engaging in post-retirement work in inpatient psychiatric care.

Interviews

The interviews were conducted in Swedish by the second author in 2017 and took place in a meeting room at the hospital or at a quiet café, following the interviewee’s preference. The interviews lasted 50–75 min and were recorded and were transcribed verbatim by the second author. The interviews followed a flexible semi-structured interview guide, which covered four areas: 1) The retirement process; 2) The meaning of work; 3) The decision to continue working, and; 4) Aging in the workplace. The questions were open-ended and broad, and prompts were used when needed, to facilitate the flow of the interview and to encourage the interviewees to expand on the topic. Examples of questions were: “What did you think and feel about retirement when you retired?”, “Can you describe your decision to continue working after retirement?”, “How do you experience your work as a nursing assistant in this psychiatric unit?” and “What is aging like for you?”. The characteristics of the questions (and follow-up questions) encouraged interviewees to reflect in detail around their individual experiences, thus providing rich and thorough accounts, allowing for a fine-grained analysis of their sense-making.

To ensure the validity of the interview guide, the guide was first pilot tested with two retired nursing assistants, and minor adjustments were made to improve the clarity of the questions. These interviews were not included in the analyses.

Ethics

The study was approved by the Regional Research Ethics Board in Stockholm (ref no. 2017/1720-31/5) and is part of a larger research project focusing on older workers’ retirement decision-making. Interviewees were reminded at the beginning of the interview that their participation in the study was voluntary, that they had the possibility to withdraw and discontinue participation at any time without explaining why, and that the study was totally independent from the hospital. The interviewer then repeated the study aims and interview content. Next, the informed consent was read together and this was then signed. The document informed about the conditions relating to the study participation and ensured confidentiality and respect of interviewees’ integrity. All interviewees are referred to by pseudonyms to mask their identities.

Analytical approach

This study used IPA, a qualitative research approach where the individual’s lived experience and the interpretation of such an experience is at focus (Smith et al., 2022). Involving a detailed inductive, bottom-up analysis of transcripts and the identification of patterns (“themes”), IPA can be considered a specific form of thematic analysis (Smith et al., 2022). Smith et al. (2022, pp. 60–64) provide a detailed comparison of IPA and several other qualitative frameworks. Considering the current study focus, we restrict the comparison to the distinctive features of IPA as compared to Thematic Analysis (TA). The theoretical orientation of IPA distinguishes it from other qualitative (thematic) approaches. TA is a flexible and versatile approach that allows for a wide range of analytic alternatives. As such TA can be applied across various epistemologies (Braun & Clarke, 2006). While the following aspects are inherent to and mandatory parts of IPA, other types of TA may or may not include such aspects.

IPA draws on phenomenology (i.e. focuses on how individuals perceive an experience or event), hermeneutics (in that the researcher explores, describes, and interprets how individuals make sense of their experiences) and idiography (as the researcher focuses on the in-depth analysis and understanding of the individual’s subjective experience and perspective in their unique context, before turning to the analysis of the whole data set) (Smith et al., 2022).

IPA strongly emphasizes an inductive or “bottom-up” analytic process. Other types of TA also allow a theoretical or deductive or “top-down” approach to the analysis and thus involve coding data into pre-determined themes (Braun & Clarke, 2006). Moreover, within IPA, themes are always experiential, whereas other types of TA may have a focus going beyond personal experiences and include the identification of other characterizations of themes.

Another characteristic of IPA, that derives from its idiographic focus, includes specific recommendations on sampling and sample size. Specifically, this includes collecting rich, detailed, and first-person accounts of experiences at focus. Considering the theoretical underpinnings of IPA, samples are selected purposively and are typically small and fairly homogeneous, and thus include individuals sharing key characteristics at focus in a study (Smith et al., 2022). In this study, interviewees shared their employment status (having started to receive pension benefits and working on an hourly basis) and the characteristics of their work (nursing assistants in psychiatric care). Moreover, all worked at the same department. In contrast to IPA, TA allows for larger and heterogeneous samples.

The choice to use the IPA approach instead of other types of TA followed from the study aim, which was to explore, through a fine-grained analysis, how retired nursing assistants working in psychiatric care experienced and made sense of their transition to retirement, as well as their involvement in post-retirement work. A phenomenological, hermeneutic, and idiographic approach, such as IPA, suited this purpose.

This study involved an inductive or “bottom-up” analysis of transcripts and a data-driven identification of themes. The analyses were conducted separately by the two first authors following the heuristic framework of Smith et al. (2022). Initially, all transcriptions were analysed separately before moving to the full material. Specifically, we focused on the subjective lived experiences and perspectives of each interviewee in their unique context before proceeding to the general cross-case analysis of the complete dataset. In essence, each interviewee was initially treated in the analysis as a “single-case study”. In other TA approaches, transcripts are usually considered a single dataset, starting from the first stage of the analysis to identify overarching patterns across the full dataset.

First, the transcripts were read and analysed line-by-line several times, to allow the researcher to actively engage with the data. During this initial stage, extracts of interest were marked and exploratory notes were taken. Some of these notes were merely descriptive, while others were linguistic or conceptual. Then, the analysis involved exploring associations and patterns of meaning across the most important aspects of the exploratory notes in each transcript. These were clustered into “experiential statements”, which reflected interviewees’ experiences and their perspectives of the experience, as well as researcher interpretations. The associations between the “experiential statements”, relevant to the study aim, resulted in an initial structure that integrated the most important and interesting aspects of each interviewee account. This led to the development of “personal experiential themes”, with each including a number of sub-themes. These analytic steps were repeated for all transcripts.

The next step involved investigating, at a broader and higher level, the commonalities and divergencies, as well as connections and patterns, across the personal experiential themes and each sub-themes from every transcript. This cross-case analysis yielded a reconfiguration and renaming of some themes and the development of higher-level “group experiential themes”, with each including a number of group-level sub-themes. These sub-themes reflect the convergence and diversity of the interviewees’ experiences, while maintaining the idiographic focus by demonstrating how different participants reflect this particular theme. Themes were retained based on their meaningfulness in representing interviewee experiences and perspectives and their relevance for the study aim. Finally, a dialogue between the two first authors around the results from their individual analyses, as well as reviewing possible interpretations of interviewee extracts, decisions regarding what themes to retain and their labels, and the design of the final thematic structure, added to the coherence and the validity of the findings.

Results

The in-depth analytic process resulted in four group experiential themes, each including a number of sub-themes (Table 1): (1) Adjustment difficulties to life as fully retired; (2) Good health as a precondition to work and a consequence of working; (3) The intrinsic joy of working and the importance of feeling competent; and (4) Work and organization-related factors contributed to well-being at work and facilitated an extended working life.

Table 1 Thematic structure.

1. Adjustment difficulties to life as fully retired

1.1. Lack of interests and reduced social network outside work

1.2. Retirement as stagnation and “the end of the road”

1.3. Preference for phased retirement

2. Good health as a precondition to work and a consequence of working

2.1 Good health and work ability as a precondition to post-retirement work

2.2. Work as a health booster and a “free zone” from aging

3. The intrinsic joy of working and the importance of feeling competent

3.1. It is not (only) about the money – the intrinsic joy of working due to valued job characteristics

3.2. Occupational self-efficacy

4. Work and organization-related factors contributed to well-being at work and facilitated an extended working life

4.1. A positive and supportive social climate and a good relationship with the managers

4.2. Feeling welcome and recognized within the organization – an age-friendly environment

4.3. Flexibility, control over working time, and opportunities for recovery

4.4. Possibilities for using compensation strategies to maintain work ability

Adjustment difficulties to life as fully retired

The nursing assistants had not actively planned for retirement and the majority had retired fully before returning to work some months after. The adjustment to life as fully retired had been difficult, and a gradual exit from the working life was considered preferable to a sharp exit, like the one they mentioned having experienced in the past.

Lack of interests and reduced social network outside work

Living alone and not having hobbies or other interests to spend time with was an important reason to continue working after retirement. Olof reflected on how work took an important place in his life: “I live alone […] and this probably contributes to that I work. If I’d had a family […] it would probably have made me to work less. I live alone, and then job becomes more important.”

Nils felt that continuing working served to counteract the sense of emptiness he felt after retirement: “[continued working] first and foremost because, what should I do otherwise, lie at home and stare at the ceiling? […] If you have no interests that occupy all the day… what else should I do?”.

Retirement as stagnation and “the end of the road”

Retirement had a negative valence, and the nursing assistants felt it was difficult to identify with the typical image of a retired person, which was associated with elderly age, passivity and emptiness, as expressed by Olof: “I can’t sit at home and watch TV and drink beer… I didn’t really know what to do [after retirement], it felt like fatal to retire. […] And, psychologically, you link retirement to death, that you will soon die [laughs]”.

The feeling of stagnation and the “end of the road” associated with retirement also becomes clear in Anders’ reflections:

Because if you stop working, it’s like turning off all lights in the place where you are. You close all the doors, and then you’re in there alone. […] [choice to continue working] it was that I didn’t want, I didn’t just want to ‘stay’. Because retirement means getting to a turning point, and staying there. Or hitting a dead-end. […] Like it ended there and then there is nothing.

Preference for phased retirement

The abrupt transition from full-time work to full-time retirement was perceived as difficult and, after a “honeymoon period” at home, the idealized image of life as a retiree was challenged. The nursing assistants found it hard to substitute the place work had had in their lives and became restless. Some were contacted by the unit and invited to work on an hourly basis, while others started to look for a job.

I stopped working and then three months later it was Christmas, and then I thought, …, ‘I can’t go on like this. It doesn’t feel good. I want to do something’. […] it was nice [to be out of work] for a few months […] but then just before Christmas… ‘no, before it goes too far… I’ve got to work. I feel I have to do that’. [Carl]

Sarah experienced retirement as an unpleasant, confusing and unforeseeable experience and said she was unprepared for the changes that being retired brought about in her life. She did not anticipate retirement to be so difficult, and after two months in which she “stood and looked at the walls”, she felt that it was enough and called her old manager to ask if they had any work for her. The nursing assistants’ preference for phasing out to retirement is clearly expressed in the following quote from Sarah:

[to retire] was a bit like to be barking up the wrong tree (laughs), but now I’ve fixed it, it rolls [started working again]. […] That’s why I tell people who are going to retire, ‘you have to plan it carefully, and not do what I did’.

Good health as a precondition to work and a consequence of working

Having a good health and the ability to work were prerequisites to continue working, with health also being seen a positive consequence of continued work.

Good health and work ability as a precondition to post-retirement work

Although experiencing a few health problems, the nursing assistants did not feel these limiting their job performance, and they thought they had a good work ability despite their age. Having a good health and to have energy to work were, in fact, important prerequisites for engaging in post-retirement work, as Emma noted when asked why she had decided to continue working: “Why should I go home? As long as I can move and I am healthy. [….] as long as I can walk, and I am clear-headed… [….] because if I no longer have it then I cannot be here…”.

Work as a health booster and a “free zone” from aging

While health seemed to be a prerequisite to work, to continue working was felt as a health booster that allowed maintaining mental and physical health and to slow down aging:

[to work] is that what gives me the strength and hope that I can do something good all the time [….]. It means health, physical and mental health, because when you work, you walk. You talk, you think [….] you pull it all together. [Anders].

The camaraderie with younger colleagues reduced thoughts about aging, sickness and death. Carl, who had experienced a serious illness some years ago, felt that work contributed to his physical and mental health, as he used work as a coping strategy to handle his health concerns:

[work] in that case slows it down [his thoughts about the disease], that’s what’s great. You feel… partly when I work, I don’t think about it, I’m healthy, I’m positive, huh. […] When I work, I don’t have to stay at home thinking. It’s a way to escape from it [thoughts about the disease], but in a good way.

Work was experienced as a “a free zone from the retired role”. By keeping his identity as a worker, Carl did not feel as old as he was and distanced himself from being seen as a retired person:

I think it has to do with this that you don’t feel as old as you really are. On the contrary, I still have, I’ve a picture of me, I still work. On the way to work, nobody knows that I’m a retired man.

The intrinsic joy of working and the importance of feeling competent

Being able to add to their pension and afford some extras was an important motivation to continue working. Nevertheless, the intrinsic joy of working and the valued job characteristics were perceived as main drivers. Moreover, to feel competent at work played an important role in the decision to continue working and thus increased job satisfaction.

It is not (only) about the money – the intrinsic joy of working due to valued job characteristics

The nursing assistants stated that financial security was a driver for prolonging working life. This related to the extra income making an addition to their pension and thus reduced financial concerns and was a factor that contributed to their quality of life. In line with her colleagues, Ingrid shared her worries regarding her low pension: “I’ve actually been terrified about this with the economics too. You know, I can’t, I’ve never, I can’t be a whiner and stingy, I can’t handle it. Regardless of how little I would have… [if she would not work]”.

However, the nursing assistants experienced more freedom in their work after retirement than before, as they had a safety net and had the possibility to survive on their retirement pension if they would stop working. Work was no longer considered an obligation and as a means of survival as it used to, which increased job satisfaction. Ingrid, for instance, felt less irritated and tired than before retirement, and explained the difference between working on an hourly basis as a retired worker and being a full-time employed:

Now it [to work] works well, as if it is different when you are not forced to, when you don’t work full-time and are not forced. So now it feels very good and is very nice. […] maybe it’s this [not having to work], that you feel that it [the job] is easier …. […] it becomes easier, you feel that this obligation […]. it feels different, and it’s purely psychological, I promise. […] It feels so much easier, it’s so much more fun.” [Ingrid]

Most stated that they would like to continue working even if they won big on the lottery. Despite it being important, increasing the monthly budget was not the primary reason to work, but rather a valued by-product of working. Ingrid referred to it as a “silver lining”, and travelling was considered a luxury that work would allow. As Anders shared:

I work because I think it’s fun. Not only for the sake of the money, because some think that it’s only for the money. Money is important, it gives me more freedom. But it [to work] is mostly because it increases… it’s a spice in life.

When asked about the strongest motives for continuing working, Ingrid explained: “It’s also about economics, yet it doesn’t come first. […] No, it’s a joy to be able to work, for me it’s so important. And I can’t be too docile, that is, I have to be useful”. Furthermore, the nursing assistants described a high work engagement which included feeling enthusiasm and dedication to work.

I’m so privileged in this way […] compared to many others, not least because I have a job that I enjoy a lot and that I can work with that, even though I’m retired. This is a luxury, I should say. […] I love to work; I should say I love my job. I don’t love to work in general, it is this job that I love. [Olof]

The nursing assistants reflected upon a number of valued characteristics of their jobs that they perceived contributing to self-fulfilment and to the motivation to remain at work. As his colleagues, Nils did not experience his job to be too demanding: “[…] I don’t think that it [the job] puts too much demands on us, assistants […] [why continued working] […] above all because I don’t think this [job] is hard.”

Work was also perceived as positively challenging, interesting, and varied. Sarah and Olof, respectively, expressed the joy of meeting different patients every day and listening to their stories and experiences: “[…] there are so many different human lives, and so it is interesting to listen to and participate in the conversations… […] is actually a very interesting job”; “I usually say that psychiatry is life, death, and love. […] so, you get a broader, deeper knowledge, when you talk to many people in different life situations. It’s hugely rewarding, very interesting, I think.”

Anders, in turn, valued the positive challenges he perceived in his job:

[…] I have to [be challenged], the engine has to be running […]. So, work is challenging, because each patient is a challenge, each patient is different. I’ve never met two patients who were sick in the same way, or said the same things, or whined about the same things. […] everything with everybody is special […] that’s fantastic. [Anders]

Also, the nursing assistants felt that the best part of their job was the contact with patients. Being able to care for the vulnerable made their job highly rewarding. Anders explained that work made him feel an inner joy and the feeling that a patient’s condition was improving was extremely gratifying:

Especially when the patient starts to trust you […]. And then when the person, that a week earlier was sad, and complaining and everything, and suddenly you see that the person starts smiling and starts asking about things […]. It is fantastic to see the difference.

Similarly, the nursing assistants experienced helping patients as a bidirectional transaction that gave them their strength back, as expressed by Ingrid when asked what she appreciated more in the job as a nursing assistant: “It’s the patients, because… it’s odd, because they’re the ones that give you this energy and, that, well, it’s worth much more than money.”

Occupational self-efficacy

The nursing assistants emphasized that they thought they were experienced workers and perceived that their work performance had improved with ageing. Sarah, for example, said that it had been very easy to come back to work after retirement, as it was just to keep going with the old job, since she was able to do it. As his colleagues, Carl assumed that one of the strongest reasons for remaining at work related to the accumulated experience and knowledge that reassured him that he could do his job properly without too much effort:

[Skills and experience] are very important [for continuing to work]. I mean, I rely on my routine, and on my experience. It’s part of me, it’s a lot of work that you’ve done […] my overall experience with people […]. I mean, I don’t know the patients when they get there, but I’m still good at dealing with them. And then I think that I can get an idea pretty quickly. […] That’s like, you follow a routine, automatically. But it always feels good. I rarely go there and think ‘ohh, how am I going to handle this?’ I'm always sure that this will work out.

Work and organization-related factors contributed to well-being at work and facilitated an extended working life

Work and organization-related factors were considered to contribute to job satisfaction and to the ability and willingness to remain at work.

A Positive and supportive social climate and a good relationship with the managers

The social climate at work was experienced as positive and warm, and the nursing assistants felt that there was a good social cohesion in the team.

I like meeting people who are positive, if they were cranky, then maybe I would change units […]. They [colleagues] are like a safety net. The job is also a safe haven, because we’re a team that knows what to do. If you don’t feel at home there, it becomes much more difficult to work. [Sarah]

The nursing assistants were also very satisfied with their managers, nurses and doctors, and described them as competent, as good listeners, and as responsive and present at the workplace. To feel trust and to be seen by the managers was very important and, in general, it was an important factor that contributed to their work motivation and willingness to continue working: “I think [name of the manager] is very good as a manager, when he has time, he comes out to chat, how are you? How are you today? How are you feeling? So, he asks questions.” [Carl]

The nursing assistants emphasized the collaboration and open communication between the different occupational groups, which was considered extremely important for the quality of patient care and decision making in complex situations.

The doctors listen carefully to our reports, because we are the ones who meet the patients first, and then it is important what you say, because then it is very important what the resident doctor says to the senior doctor, what decision to make. If someone says so and so, then it will so and so. And then, it’s very important that you provide the correct information or make a fair evaluation. We have a very good collaboration with the doctors. [Emma]

Feeling welcome and recognized within the organization – an age-friendly environment

The nursing assistants felt that the unit had a positive attitude towards older workers and that it was very open to extended working lives. Post-retirement work was common at their workplace and nobody found it difficult to find work. Also, they would have the possibility to change to another unit within the organization if they wanted to.

[…] it’s important [that the organization is positive to have older employees continue working after retirement], this is why we work, because they want us. And I think that’s good, because it feels so good when you get to work, and then the top manager comes and (…) says ‘hello, nice to see you’ […] it’s nice. It’s nice that we have some retirees, it’s good that the managers are positive. [Anders].

[…] as a whole […] I think that most [younger colleagues] think that [working after retirement] is good. They call us to ask for help; I’m convinced that […] they are happy that we work. […] nobody is pissed or annoyed, they don’t talk about you being old. […] when I’m there it feels like I’m part of the gang, together with the others […]. Nobody says anything like ‘oh, this one is just a substitute’ […]. They know who I am, and I know everyone […]. That’s pretty good, […] there’s no retirement stamp. And that’s the pleasant part, you’re one of them. You’re treated as a non-retired. [Carl].

The positive feedback from the patients, colleagues and managers, and the feeling of being respected, needed, and valued for their experience and work performance increased the nursing assistants’ job satisfaction and self-esteem, and added to the motivation to continue working. Ingrid, for example, would miss the recognition from the patients if she would not work: “[what does patient care give you?] Probably some kind of recognition, I think. […]. To be needed, that they like you, that you do a good job, that you do well, that you’re acknowledged […] it’s wonderful, it’s truly wonderful.”

Flexibility, control over working time, and opportunities for recovery

Typically, the nursing assistants received a predefined schedule (usually including periods of 8 h), or were on-call in case the unit needed extra staff. The reduced workload and control over working time was something they wished for themselves and appreciated as one of the relevant drivers to engage in and enjoy post-retirement work: “[…] I feel privileged. That I’ve a job, I can decide for myself. Whether I want to work or not. […] I’m still in this marathon, but on my terms. Mentally and physically.” [Anders]

The irregular working time was preferred to a rigid schedule since it provided them with a higher sense of autonomy and freedom:

[being able to choose] is freedom. […] One can for instance say, ‘today, yes, today, no’. […] What can they [the organization] do [to make it more attractive for older people to work]? I feel that, at least for me, it’s the flexibility, I can choose the work shifts I want. [Sarah]

The flexibility in the working time allowed a balance between work and private life that was welcomed by the nursing assistants, as expressed by Emma: “[being able to decide when to work and not] is good. Because I’ve got grandchildren, I have to help her [the daughter] and then I can travel when my husband is free. […] He’s seven years younger than me.”

Some of the nursing assistants mentioned being frequent travellers and valued the possibility of being away for longer periods of time. This was made possible by working more during certain periods. Anders, for instance, described how he switched between work and travel, with this increasing his motivation to work:

I can work. How much have I worked… quite a lot. […] Now I’ve worked because I get so much free time, then I can work 140 hours in March for example. Since I know that I will soon be free, and travel to [a certain country], I go there, I meet new people, different nationalities […]. I work, intensively perhaps, and then I leave everything, again, and do something, go on vacations. And then I long to back here [job].

For other nursing assistants, the advantages of having control over working time was more related to possibilities to recover after work, and to feel free to say no to work without feeling uncomfortable or suffering any consequences. Not feeling forced to work seemed to reduce some of the negative consequences of work, which resulted in work seeming less demanding. Control over working time was mentioned to counterbalance the job demands and to increase the opportunities for recovery, as described by Carl:

When I work as I do [on an hourly-basis], I have time to forget it [the work demands]. It feels good, because I forget about it, and then I get back in as good as new again. […] when I’m not working full time, I’ve time to get my energy back, now I don’t work on Saturday, then I have time to rest. Normally [when working as a full-timer] you are only free one day, and then you have to come back again, then I wouldn’t have this. The recovery. It’s like an athlete, you need time to recover.

Possibilities for using compensation strategies to maintain work ability

Being unable to cope with the same workload as earlier or having to avoid certain daily activities was perceived as a negative consequence of aging. However, the nursing assistants described how they had developed strategies to handle issues relating to aging at work and how they took advantage of their current abilities, acquired throughout their long careers. For example, because of reduced muscle strength and physical capacity, they had adopted a more defensive role than before, in challenging situations at the workplace. This may for instance involve violent situations with patients.

Yes, yes, [works differently now than when he was younger] but it’s perhaps in such situations […], when it’s, is purely physical stuff, then maybe you stay more in the background, because I know that I was able to lift this chair 10 years ago, I might be able to lift it [now], but it hurts when I do and then maybe you back off and let someone else do it. […] There can be situations […] something with a patient, that you approach in another way, that I was more active and quicker in the past […]. A different strategy, if it is a more aggressive patient […], I don’t hesitate to go into a violent situation, but I do it differently. You might try to talk, you don’t approach the patient so quickly, but leave a little distance and try so that it won’t become violent […]. [Nils]

Age limits me [at work]. […] And then you have to be aware to avoid challenging this, you should, because you feel that you aren’t as physically strong as before, you start to feel that you get tired faster, eh, you feel the aging. […] then one has to adapt to one’s age. […] Now, it’s my life experience that will help me to continue in a sensible way. A careful way, to be able to continue, because the strength that you had when you were forty, run a lot, I ran every possible race, I don’t do that now. […] But, and since there are other things that help me, I am careful […] It’s the same job as a mental health nursing assistant as it was 10 years ago, and it’s more about inner strength than external. I may be physically weaker, but the mental strength never ends. [Anders]

Yet, managers had facilitated the adaptation of the working tasks, which allowed individuals lacking technical skills or with no motivation to deal with administrative tasks, to focus on working with the patients. To Olof, not having to handle the IT-system and spend time in front of the computer was felt as a relief: “Now I only work with patients, and do very little admin work, […] it’s great. No, it’s the best imaginable, given my main interest [to work with the patients], this is as good as it gets. It couldn’t be better.”

Discussion

This interview study aimed at exploring in-depth how a group of retired nursing assistants working in inpatient psychiatric care experienced the transition to retirement, their motivation to engage in post-retirement work, as well as their experiences of working after retirement. The nursing assistants provided rich descriptions and reflections on their lived experiences, and the study findings suggest an interplay of factors shaping their perceptions on the transition to retirement and their engagement in post-retirement work. Taken together, the findings were organized in four superordinate themes: (1) Adjustment difficulties to life as fully retired; (2) Good health as a precondition to work and a consequence of working; (3) The intrinsic joy of working and the importance of feeling competent; and (4) Work and organization-related factors contributed to well-being at work and facilitated an extended working life.

Adjustment difficulties to life as fully retired

The nursing assistants included in the present study experienced their transition from full-time employment to full retirement as abrupt and challenging. Retirement was perceived as stagnation and the “end of the road”, due to an insufficient social network outside the workplace, and lack of daily routines and non-work activities, which had negative effects on the nursing assistants’ mental health and adjustment to retirement. These findings align with previous research showing the multidimensionality of the retirement transition, which typically involves developmental challenges, such as the loss of the work role and the social ties of work, and difficulties finding a satisfactory post-retirement life (Van Solinge & Henkens, 2008; Zhan et al., 2019). Given this, it is not surprising that retirement planning that goes beyond financial plans and also includes the meaning of post-retirement life contributes to an effective psychosocial adjustment and post-retirement well-being (e.g. Rosenkoetter & Garris, 2001; Yeung & Zhou, 2017).

While the nursing assistants did not plan for their retirement, they thought, in hindsight, that it would have been better to do so. In particular, they considered that a progressive reduction of their working time would have facilitated a smooth transition into retirement. The nursing assistants did not find a satisfactory post-retirement life and, after some time as full retired, they “unretired”, and returned to the hospital. Post-retirement work was then a coping mechanism and adaptive strategy that helped them to manage the losses that followed full retirement (Van Solinge et al., 2021), promoting a more gradual and successful adjustment to retirement. Furthermore, to return to work allowed them to maintain their work identity and provided them with a renewed sense of purpose and social belonging, which they found difficult to get in their private life as fully retired. This theme may be linked to the continuity theory (Atchley, 1989), which has been applied as a framework to the study of the drivers of the engagement in post-retirement work and the adjustment to life in retirement (e.g. Burkert & Hochfellner, 2017; Haslam et al., 2018; Kim & Feldman, 2000; Wang et al., 2008). Continuity Theory proposes that, when making adaptive choices, older adults seek to preserve and maintain existing inner psychological characteristics and familiar physical and social environments, role relationships, and activities (Atchley, 1989). Continuity may reduce the ambiguity of personal goals that may result from changes such as retirement (Atchley, 1989).

Good health as a precondition to work and a consequence of working

In line with the research literature (e.g. Hansson et al., 2019; Sewdas et al., 2017), good health and adequate work ability were perceived by the nursing assistants as a precondition to continue working after retirement. Perceptions of having younger subjective age has been associated with better self-rated health (Stephan et al., 2012). In contrast, categorizing oneself as an “older worker”, among those older than 45 years, has been associated with a stronger desire to retire early (Desmette & Gaillard, 2008). In the present study, feelings of being younger than their chronological age seemed to contribute to the nursing assistants’ negative attitude towards retirement and add to their willingness to continue working.

Individuals’ engagement in post-retirement work depends on them feeling that extending their working lives contribute for their health and well-being (Hovbrandt et al., 2019b). In more detail, the retirees’ health status and their participation in post-retirement paid work has been found mutually interrelated (Müller et al., 2013). This was also the case in the present study of nursing assistants. Similar to previous findings (Kim & Feldman, 2000; Nilsson, 2012; Reynolds et al., 2012; Wang et al., 2009; Zhan et al., 2009), the present study showed clearly that, in addition to being considered a prerequisite to continue working after retirement, keeping up a good mental and physical and mental health was a consequence of working as well. As suggested by Rudolph et al. (2015, p. 230), post-retirement work may allow maintaining an “open-ended time horizon”. In the present study, this was seen in the nursing assistants’ conceptualizations of work as a zone free from aging, while retirement was linked to feelings of being proximal to death. As noted by Fisher et al. (2016), post-retirement work allows older adults to maintain a working status, which may reduce the impact of social and/or personal norms related to age.

The intrinsic joy of working and the importance of feeling competent

The nursing assistants participating in this study seemed highly dedicated and enthusiastic about their work. This follows earlier studies (Wang et al., 2008; de Wind et al., 2016) reporting that job satisfaction and work engagement are positively related to working after retirement. Similar to post-retirement workers in Mazumdar et al.’s (2024) study, who considered retirement as a “freedom from obligation”, the nursing assistants’ positive experiences of post-retirement work seemed to be influenced by them not feeling forced to work and a sense of freedom resulting of the possibility to choose to stop working at any time. This aligns with findings (Platts et al., 2021) showing that the “contained commitments to paid work” (p. 13) were central to the retirees’ decision to continue working through their retirement years. As suggested by Scherger et al. (2012), this may relate to post-retirement work being something else than pre-retirement work. For post-retirees who continue to work, having a pension may change the relationships to work, individual experiences at work, and give a sense of empowerment and independence that adds to individual well-being (Nilsson, 2012).

The involvement in post-retirement work, and the fact that work was no longer considered an obligation and a means of making basic ends meet, reshaped to a certain extent, the meaning of working and added to the significance of intrinsic work motives. As in studies of mental health nurses (Alexander et al., 2015; Holmberg et al., 2018), the present findings suggest indeed that the nursing assistants were mostly intrinsically motivated. This means that they were driven by the intrinsic characteristics of their job as nursing assistants within psychiatric care and the inner joy of the work itself (cf. Gagné & Deci, 2005). Findings from meta-analysis (Kooij et al., 2011) show that chronological age is positively related to intrinsic work motives, such as helping people or contributing to society and holding an interesting work. In contrast, there is a negative relationship between age and the strength of extrinsic work motives, such as status or income. However, in addition to the intrinsic aspects of the job, the present findings suggest that the nursing assistants were motivated by extrinsic aspects as well. Yet, their accounts follow earlier qualitative findings (Bengs & Stattin, 2018; Loretto & Vickerstaff, 2013; Platts et al., 2021; Sewdas et al., 2017) in showing that economics were not the core motivational driver for continuing working. The main income-related motive for the group of nursing assistants included in the present study to keep up their post-retirement work seemed to involve the possibility to maintain a certain living standard and affording something extra, including travel, rather than financial needs in its strictest sense, as also found in other studies (Hokema & Scherger, 2016; Mazumdar et al., 2024). This may be related to the relatively generous welfare regime in Sweden, which provides a basic pension and a financial security for all retirees (Isaksson et al., 2014).

The present findings suggest that work was not considered as particularly demanding. Together with the accumulated work experience and job-related skills, this allowed the nursing assistants to continue working despite having some (minor) health issues. They also described work as challenging, interesting, and varied. This is an interesting finding to consider since previous qualitative studies (Hovbrandt et al., 2019a) have shown that being challenged is a key driver for extending working life. Importantly, when not fulfilled, the positive influence of other drivers—such as ‘to be included’ and ‘to have better personal finances’—would diminish and make older workers consider retirement.

The importance of doing a good job was emphazised by this group of nursing assistants; specifically, this meant that they would help their patients to get better. They also valued the contact with the patients and described how they worked for others and not for themselves and considered this as highly meaningful and rewarding. This aligns with other studies of mental health nursing staff showing that experiencing work as important and meaningful is related to job satisfaction and a choice to remain in the profession (Alexander et al., 2015; Holmberg et al., 2018).

The nursing assistants participating in the present study were working in the same occupation as before retiring, and considered themselves experienced and competent workers, which in turn was considered a benefit of aging. This finding aligns with Taneva et al.’s (2016) qualitative study on the experience of being an older worker, with one of the prevailing themes covering the accumulated knowledge and extensive experience and their increasing of older workers confidence and serenity. The self-confidence that one has the ability to successfully perform the job tasks is referred to in the literature as occupational self-efficacy (Rigotti et al., 2008). Self-efficacy influences the tasks the individual chooses to undertake, and the effort and persistence one exerts on those tasks (Bandura, 1986). Occupational self-efficacy has been associated with work ability (Wallin et al., 2022), job satisfaction, organizational commitment, job performance (Rigotti et al., 2008), and the intention to engage in post-retirement work (Brody, 2005).

Work and organization-related factors contributed to well-being at work and facilitated an extended working life

Organizations have a central role in shaping the opportunities for and the experiences of working beyond retirement (Shultz & Henkens, 2010). In particular, it has been suggested to be important to investigate the organizational characteristics that older workers find attractive in their post-retirement work (Wang et al., 2008). In general, the nursing assistants participating in the present study described their working environment as positive and supportive, which, in line with previous findings (Van Solinge & Henkens, 2014), contributed to their willingness to continue working and to their successful adjustment to post-retirement work. Importantly, the social relationships with colleagues and patients were key drivers for them to return to work after retirement and also contributed to their well-being. This is in line with Veth et al.’s study (Veth et al., 2018), which showed that positive relationships with managers and colleagues had a positive impact on employability, work engagement, and health over time among workers aged 65 and older. Moreover, similar findings have been reported in a study with nursing staff in inpatient care (Holmberg et al., 2018).

Other important aspects mentioned by the nursing assistants involved feelings of recognition and appreciation from the patients, colleagues, and managers. In line with previous research (Armstrong-Stassen & Schlosser, 2011; see also De Wind et al., 2014), this was highly valued and contributed to job satisfaction and self-esteem and the motivation to continue working. Importantly, the nursing assistants participating in the present study valued the flexibility and autonomy to choose the working tasks to be performed and the control over when and how much they worked. This counterbalanced the job demands, increased the possibilities to recover after work, facilitated work–life balance and contributed to higher job satisfaction compared to the years before retirement, something that was found in a study of retired nurses who continued working as well (MacLeod et al., 2021).

The nursing assistants in the present study valued the fact that their managers facilitated the adjustment of work to their interests and abilities and used some strategies to deal with age-related declines, and thus taking advantage of their current capacities. This may for instance be important in demanding situations, such as situations including violence. Here, previous research (Adams et al., 2021) suggests that perceived risks for, or the actual experience of, patient-initiated violence made mental health nurses leave the profession. In the present study, the nursing assistants voiced their concerns regarding violent events at work but also described different strategies to overcome their age-related decreases in muscle strength. Clearly, aging made them use verbal strategies, which they found more effective, instead of using physical strategies. By relying on accumulated knowledge and work experience, the nursing assistants felt confident and the age-related declines had no significant impact on their performance.

These findings may be considered in view of the Selective Optimization with Compensation Model (SOC model; Baltes & Rudolph, 2012), a framework of successful aging which suggests that individuals may use three adaptative strategies (Selection, Optimization, and Compensation) to successfully maximize age-related gains and offset age-related declines in occupational contexts. These strategies may contribute to individuals keeping up their job performance and thereby influence retirement decisions and retirement adjustment. Other studies (Müller et al., 2013) suggest that compensation strategies (i.e. strategies that counteract developmental losses to maintain a certain level of functioning), were particularly effective in buffering the detrimental effects of poor health on older employees’ intention to remain in post-retirement work as compared to selection strategies (which focus on a smaller range of goals and redefine priorities) and optimization strategies (i.e. the acquisition and improvement of methods to achieve one’s goals).

Methodological considerations

Through a qualitative approach, we addressed calls (Galkutė & Herrera, 2020) for qualitative studies investigating post-retirement work, which may add to a more comprehensive view of the topic. This study is based on a small and relatively homogenous sample of retired nursing assistants working in inpatient psychiatric care. This obviously limits generalizability of qualitative findings to the wider workforce and perhaps also to other clinical settings. However, sample homogeneity is a condition for using IPA (Smith et al., 2022); importantly, the approach does not strive for generalizing the findings to the population level, but instead aims to provide an in-depth exploration of individual experiences in a specific context, which would be challenging with more heterogeneous and larger samples (cf. Hokema & Scherger, 2016; Smith, 2004). Rather than representing a population, the study participants represent a perspective (Smith et al., 2022).

IPA relies on subjective interpretations made by researchers, who explore, describe, and make sense of interviewees’ sense-making of their individual experiences. While this may also apply to studies using other types of qualitative methods, including TA, it may be inherent to IPA studies, as IPA takes a clear phenomenological and idiographic approach. Thus, the study findings, to some extent, reflect and are influenced by researchers’ understanding of the topic. In the present study, the analyses were conducted separately by the two first authors. Importantly, their subsequent dialogue focusing on their individual analytical processes, and the design of the final thematic structure, added to the overall coherence and the validity of the findings.

One potential limitation relates to the data being collected before the COVID-19 pandemic. The pandemic has been strenuous for healthcare workers, particularly for nursing assistants and workers in inpatient care (Prasad et al., 2021). Moreover, older age has been identified a risk factor for severe COVID-19, notwithstanding that the influence of age per se is weaker after adjusting for significant age-dependent risk factors (Romero Starke et al., 2020). This has led to recommendations from governments worldwide that older people should stay home to reduce the risk of infection and has consequently reduced the number of older workers (aged 65 years and older) in the Swedish welfare organizations (Swedish Association of Local Authorities and Regions [SALAR], 2021). The age range of the nursing assistants included in this study ranged between 67 and 75 years, and it is possible that they would have refrained from continuing working if they had retired during the COVID-19 pandemic. Although the present findings can be argued to transfer to post-pandemic circumstances, it would be valuable to investigate if and how the COVID-19 pandemic affected experiences of working in psychiatric care and post-retirement career decisions among older nursing assistants.

Implications for practice

As Flynn (2010, p. 309) argues, in relation to delayed retirement, “one size does not fit all”. Thus, strategies aiming at extending working lives should ideally be tailored and consider the heterogeneous needs, values and life priorities of older workers and their personal and social circumstances (Finsel et al., 2023; Mazumdar et al., 2024). The analyses of the experiences of the nursing assistants, who continued to work in psychiatric care through their retirement years, may contribute for the design of policies and HR practices targeted at this particular occupational group. Importantly, the nursing assistants did not plan for their retirement and wished to have done so. Preretirement counselling and planning may help individuals to reflect on possible late career paths, thus contributing to a gradual transition between employment and full retirement (Alcover et al., 2014), and allows an anticipatory socialization, that is, to prepare for the next role in retirement while still being an older worker (Conroy et al., 2014). This may benefit individuals as well as organizations, since both can better prepare and plan the near future.

Health and work ability are important preconditions for the engagement in post-retirement work. Organizations have an important role in providing opportunities for older workers to maintain their health and productivity (Ng & Feldman, 2013). This may for instance involve improving their working conditions. As noted by Beehr and Bennett (2015), besides facilitating flexible working, organizations aiming at attracting older workers may also need to make some adaptations in certain circumstances. Research has shown that the use of SOC-strategies may be trained (Müller et al., 2018), and contribute to individuals’ keeping up their job performance and objective and subjective successful retirement (Baltes & Rudolph, 2012). Moreover, this points up the need to focus on health promotion at the workplace throughout the work-life (Liebermann et al., 2013). Findings from the present study suggest that increased financial benefits to extended working lives are insufficient to keep older nursing assistants in the workforce. Importantly, managers wishing to retain their older nursing assistants should strive for enhancing the intrinsic motivation of the older employees in promoting the job characteristics that the older employees consider meaningful to shape an age-friendly climate that values the capabilities and the contribution of the most experienced nursing assistants. Here, respectful and trustful relationships between managers and employees, including the work team, seem to play a key role to continue working through retirement. Thus, the present study underscores the importance of focusing on the psychosocial work environment when healthcare organizations strive to help older nursing assistants to thrive at work and to promote longer and healthier working lives.

Conclusions

This study addressed calls for qualitative studies investigating post-retirement work and explored the transition to retirement, the factors shaping the decision around engaging in post-retirement work, and experiences of working after retirement among a group of retired nursing assistants working in inpatient psychiatric care at a Swedish hospital. Importantly, the use of IPA allowed accessing detailed first-person accounts and facilitated a fine-grained analysis which provided a nuanced and refined understanding of the interplay between various aspects and factors shaping individuals’ experiences of the retirement transitions, decisions regarding engaging in post-retirement work, and experiences of working after retirement in psychiatric care. Important examples of the contributions include the reflections on the transition to retirement, the adjustment difficulties to life as retired and the negative meanings attached to the retiree role, illustrating how these factors motivated engagement in post-retirement work. These findings underscore the importance of retirement planning and its potential contribution to the quality of the transition to retirement. Another important contribution includes the accounts of how older nursing assistants experienced aging-in-workplace in a particularly challenging clinical setting and developed compensatory strategies to maintain their work ability. This would be challenging to capture with a quantitative methodological approach. Finally, older psychiatric care nursing staff is a less studied group, and the characteristics of their job are distinct from that of others within healthcare. Thus, the first-person accounts collected through interviews with the retired nursing assistants add the “lived experiences” of a specific group to existing research. Importantly, our findings may inform further qualitative studies as well as quantitative studies when deciding which questions and variables to investigate. Furthermore, by focusing on a specific occupation in a particular context, the study findings may inform the design of work environments and more tailored HR strategies that facilitate aging-in-workplace and promote nursing assistants’ ability and willingness to extend their working lives in the psychiatric healthcare.

Acknowledgments

The interviews in which this study is based were conducted by the second author and used in her dissertation prepared within the Master’s program in Psychology, at the Department of Psychology, Stockholm University, under the supervision of the first author.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

The study is part of a research project supported by FORTE: Swedish Research Council for Health, Working Life and Welfare under Grant 2014–1662 to the first author.