Seniors Bullying Seniors: A Growing Problem

As the number of older adults grows, it appears that bullying among seniors has become a national problem. Consequently, senior-to-senior bullying sometimes take place in senior centers, nursing homes and assisted living facilities. These are places where seniors spend a lot of time together and need to share resources, whether it’s chairs, tables, TV stations or the staff’s attention.

Senior bullying is defined as an intentional and repetitive behavior involving an imbalance of power or strength (Hazeldon Foundation, 2008).  It is typically characterized as the assertion of one's will to intimidate, embarrass, or humiliate others.

Research indicates that between 10%-20% of residents in an institutional setting have experienced some form of bullying from their peers (Bonifas and Frankel 2012). It causes considerable emotional distress for not only the victims, but also for the other residents and staff. 

“A common response is feeling intense guilt for not intervening, which can contribute to a sense of poor self-worth.  Furthermore, living in an environment where bullying is allowed to occur creates a culture of fear, disrespect and insecurity that can actually lead to increased bullying as individuals retaliate against one another.  Such environments also reduce resident satisfaction because residents feel that staff does not care about their well-being” (Bonifas and Frankel, 2012c).

Victims of bullying

Bonifas and Frankel identify two types of victims: passive victims and provocative victims.  The passive victims tend to show a lot of emotion; are shy, insecure or anxious.  They typically do not read social cues well. Among older adults, such victims may have early dementia or a developmental disorder. Minority status based on race, ethnicity, or perceived sexual orientation can also contribute to individuals being targeted for bullying because individuals who bully have difficulty tolerating individual differences.

Provocative victims can be annoying or irritating to others, for instance, by intruding into others’ personal space. They are perceived as quick-tempered and may inadvertently “egg” bullies on. Among older adults, such individuals may have a dementia-related condition that is more advanced than that of passive victims.

What you can do!

Do your research.  Ask if the LTC community has a policy for peer-to-peer bullying, and if not, encourage them to consider implementing such a policy.  Many organizations involved with seniors have a “code of conduct” policy that bans yelling, obscene language, and other verbal abuse. Some programs require seniors to sign a code of conduct that states that all members will be treated with consideration, respect and recognition of their dignity.

What Facilities can do!

• Convey a clear expectation about what kind of behavior is appropriate create and maintain a culture where bullying is unacceptable.
• Encourage bystanders to act in positive ways when they observe bullying.
• Empower seniors by letting them know they are not alone and that they can look to you for help if they are being bullied.
• Teach bullying victims ways to prevent others from dominating them through assertiveness training that emphasizes the following:

• Standing up for one’s rights
• Managing feelings of anger
• Using direct communication strategies
• Using “I” statements
• Setting boundaries
• Creating win-win situations

• Utilize additional resources like local community agencies and the Statewide Clinical Outreach Program for the Elderly (S-COPE), which may be able to provide assistance or training for the facility on meeting behavioral health needs of residents.

S-COPE is a program that provides specialized clinical consultation, assessment and intervention for older adults who have primary diagnoses of dementia with behavioral disturbances, and who are at risk of psychiatric hospitalization.  S-COPE can provide individual resident assessment before situations reach a crisis point and educate facility staff to better handle these situations in the future.  S-COPE representatives can be reached at 1-855-718-2699 to provide assistance to LTC providers 24 hours a day, seven days a week, including holidays. 

For advocacy in a long-term care facility and many licensed community settings, contact the Office of the Ombudsman for the Institutionalized Elderly at 1-877-582-6995.

For concerns of abuse of a vulnerable adult living in the community, please contact Adult Protective Services of New Jersey at 1-800-792-8820 or NJ EASE at 1-877-222-3737.

References

Bonifas, R and Frankel, M. (2012a). Senior bullying:Guest post, My Better Nursing Home, Posted by Dr. El Feb.8,2012.  http://www.mybetternursinghome.com/senior-bullying-guest-post-by-robin-bonifas-phd-msw-and-marsha-frankel-licsw/

Bonifas, R and Frankel, M. (2012b). Senior bullying, Part 2: Who bullies and who gets bullied? Posted by Dr. El Feb.21,2012. My Better Nursing Home. http://www.mybetternursinghome.com/senior-bullying-part-2-who-bullies-and-who-gets-bullied/

Bonifas, R and Frankel, M. (2012c). Senior bullying, Part 3: What is the impact of bullying?Posted by Dr. El March 6,2012. My Better Nursing Home. http://www.mybetternursinghome.com/senior-bullying-part-3-what-is-the-impact-of-bullying/

Bonifas, R and Frankel, M. (2012d). Senior bullying, Part 4: Potential interventions to reduce bullying.  Posted by Dr. El March 23,2012. My Better Nursing Home. http://www.mybetternursinghome.com/senior-bullying-part-4-potential-organizational-level-interventions-to-reduce-bullying/

Bonifas, R and Frankel, M. (2012e). Senior bullying, Part 5: Intervention strategies for bullies. Posted by Dr. El April 12,2012. My Better Nursing Home. http://www.mybetternursinghome.com/senior-bullying-part-5-intervention-strategies-for-bullies/

Bonifas, R and Frankel, M. (2012f). Senior bullying, Part 6: Strategies for targets of bullying.  Posted by Dr. El May 4,2012. My Better Nursing Home. http://www.mybetternursinghome.com/senior-bullying-part-6-strategies-for-targets-of-bullying/

Hazelden Foundation (208, 2012) see http://www.violencepreventionworks.org/public/bullying.page

Kreimer, S. (2012, March). Older adults can be bullies, too.  AARP Bulletin http://www.aarp.org/relationships/friends-family/info-03-2012/older-adults-can-be-bullies-too.html

LTC providers urged to utilize clinical assessment and intervention offered by S-COPE (1-855-718-2699)

In September, Ombudsman McCracken wrote a letter to all long-term care communities encouraging them to utilize the Statewide Clinical Outreach Program for the Elderly (S-COPE), a program developed by the NJ Division of Mental Health and Addiction Services (under the NJ Department of Human Services) and implemented by Trinitas Hospital.  S-COPE is a program that has been designed specifically to provide specialized clinical consultation, assessment and intervention for older adults who have primary diagnoses of dementia with behavioral disturbances, and who are at risk of psychiatric hospitalization.

Its purpose is two-fold: to provide individual resident assessment before these situations reach a crisis point, and to provide education for facility staff to better handle these situations in the future.  S-COPE representatives are available to provide assistance to LTC providers 24 hours a day, seven days a week, including holidays.

The Office of the Ombudsman for the Institutionalized Elderly (OOIE) fields many cases where elderly residents with dementia and/or mental illness have behavioral problems.  Often we find that interventions could have occurred much earlier to minimize the serious disruption caused to the elderly resident, other residents of the facility, and facility staff.

S-COPE can be reached at 1-855-718-2699.