The United States is an aging society and as such, the problems that plague other segments of our population also appear in the senior demographic, and this includes the issue of “bullying”. Those who work with seniors in nursing facilities, senior centers, retired living communities, medical and psychiatric group facilities and other locations where seniors may socialize report that “bullying” is a problem that is increasingly coming to their attention. While finding specific numbers is difficult, some reports I have read estimate that anywhere from 10 to 20 percent of seniors’ experience “bullying” at the hands of fellow seniors.
But what is it and how do we classify “bullying”?
According to the federal government, “bullying” consists of the following core elements:
Unwanted aggressive behaviors
A perceived imbalance of power
Repetition of the behaviors and the likelihood that such behaviors will continue if left uncorrected
“Bullying” can be done directly (either physical or verbally abusive actions) or indirectly (spreading rumors, false stories or mocking another person).
Don Drake, a retired director of treatment programming at a Boston Hospital and a presenter for Connelly Law Offices, Ltd.’s Community Education Series, has worked with seniors in a variety of settings from addictions to homelessness for over three decades. He has his own thoughts on the issue of “bullying”.
“The word ‘bullying’ has made its way into our lexicon but it is still associated with playground standoffs and juvenile dust-ups. Personally, I dislike using the word bullying when referring to such behaviors involving adults or seniors. Those I have worked with who have been the victim of another senior’s aggressive behaviors feel that bullying does not really describe what they have been exposed to and in some ways, the use of the word softens the impact of what has occurred. I feel we need to call it what it is – intimidation, manipulation, physical and verbal assault – plain and simple. There is nothing schoolyard about such behaviors.”
“It’s also important to understand that the range of these behaviors are different
based on various sub-sets of seniors. For instance, seniors who have a history of addiction or criminality often use these behaviors to get what they want because living on the street or engaging in street activities to get drugs forced them to develop a range of coping behaviors not seen in the average senior. These behaviors are long-term and ingrained. The same holds true with those diagnosed with some forms of mental health disorders.”
Drake reports that he has seen such behaviors for decades but there is an increase in the reports of such activities.
“I’m not sure if the behavior has increased or we are just seeing more of it because we now have many more seniors in programs today than in the past. But in any case, it is unacceptable.”
He relates a story about a client in a treatment program named Tom, a patient in his mid-sixties.
Tom had spent most of his life in and out of shelters, treatment programs and even correctional facilities. He had reached an age where he qualified for a senior living community and moved there from an apartment in Boston’s Mattapan neighborhood. Tom’s behaviors were disruptive from the beginning and he fell back to old behaviors of using street drugs and even trying to sell them to others in the community. He was sent to detox and then into a treatment program with the plan to move him back to the senior living community.
The problems that Tom presented at his living center came with him into the treatment program. He used charm to get female clients to buy him everything from coffee to cigarettes while using physical and verbal threats to get money and other items from males in the milieu.
“Tom even manipulated and coerced staff at the facility to get what he wanted”, Drake said.
In one case, Tom told a staff member, who he had brought into his confidence, a story about not having enough money to buy gifts for his grandchildren. He convinced the staff member to buy a radio from him, at a much higher price than the object was worth, so he could “give my grandchildren a wonderful Christmas”.
There were three huge problems with Tom’s story:
He did not have grandchildren
Staff were not allowed to buy or sell items to or from clients per the policies of the program
The radio he sold was stolen from another patient
Tom used the kind act of a staff member as a way to blackmail the staff into supplying his daily cigarette habit under a threat of telling the supervisor about the purchase of a stolen item that had occurred. The staff member eventually came forward and confessed to violating the policy of the program while Tom enjoyed a laugh at the naiveté of the staff member and his fellow patients in treatment.
A story about senior aggression from WPBF TV25 in West Palm Beach, Florida.
In another case, a female client we’ll call Beth found ways to manipulate other female clients on the unit into allowing her to use their EBT or DEBIT cards, in many cases draining them. When confronted by a social worker on the unit, she began a campaign of targeting that staff member through rumors and subtle threats. In one of Beth’s interactions with the staff, she stated, “I’m going to watch a movie tonight about a nosy social worker who caused problems for one of her clients and was found murdered in an alley. Do you want to watch that movie with me?”
Beth even went so far as to find the staff’s home address on the internet. The staff received a letter with a blank piece of paper inside. Beth then said to the staff member several days later, “I would hate to get something in the mail and not know who sent it. Just knowing that someone knew where I lived would scare the hell out of me!”
What was described above are worse case scenarios but in most cases the activities may take on a much subtler form. These may include:
Negative joking at another’s expense
Condescending eye contact, weird facial expressions or mimicking another’s walk, accent or idiosyncrasies
Intentionally embarrassing someone or exploiting their insecurities
Social exclusion (others are playing cards or involved in an activity and totally ignoring the person)
Sabotaging another’s happiness or well-being (hiding mail, failing to tell someone about an upcoming event, etc.)
But not all cases of aggressive activities are of malicious intent.
The act of transitioning into an elder living community itself may contribute to the
situation. Such a move can be stressful for some leading to the feeling of powerlessness. When this occurs, a senior may try to regain some control back through behaviors that manifest in such aggressive verbal and even physical acting out behaviors. For those with dementia who cannot express their distress in a positive way, such behaviors may also present themselves.
The risk factors that may be present in such situations include:
Being a new member of the community
Being thrust into a situation they are unfamiliar with (e.g., moved from a comfortable living situation into a community setting)
Doesn’t know what to expect from others
Lacks a support system
Is heavily dependent upon others
Suffers from a mental illness
Quiet, shy or passive
Drake continues, “It’s important for the staff who are doing the biopsychosocial assessment share the background of the seniors who are transitioning into the culture with other staff who work with them on a daily basis. To know if someone has a history of criminality or has been involved in a negative lifestyle is important when assessing if the aggressive behaviors are a part of the person’s continued lifestyle or is situational based upon such a radical change in their living situation.”
For staff who work in programs where such behaviors as “bullying” occurs, Drake suggests the following;
The agency or community needs to adopt a no nonsense policy towards this behavior, whether its against other seniors or against staff. The message must be sent that disrespectful and threatening behaviors will not be tolerated in any form. Policies and procedures must also reflect this view. Accountability, responsibility and quick intervention is the key to stopping such behaviors.
The treatment team or program director must get involved immediately with interventions aimed at identifying and changing the behaviors that have been identified as disrespectful and threatening. This includes identifying why the perpetrator has a need for control. In some cases, the behavior may be chronic and ingrained. Early identification and addressing this in a behavioral plan or contract is imperative for the well-being of all concerned.
Finally, those who have been victimized by such a person needs assistance and support and may benefit from being taught skills to protect themselves in such interactions. This may include teaching assertiveness skills that will allow them to stand up for themselves. But there is a caveat to this.
“Teaching assertive skills to victimized seniors is important,” said Drake, “but it is important that this be done by someone with the appropriate skills and empathy. In some cases, seniors may interpret their lack of assertiveness as a personal failing and falsely interpret the fact that they have been victimized as being their fault. To expect someone who has been living for over half a century in a safe and secure environment surrounded by people who loved and respected them and now to suddenly need to learn ways to protect themselves can be an unrealistic expectation. No one should live in fear at any age and it’s not their fault if they do not have these skills or cannot learn them.”
In some cases, changing the behaviors of aggressive and manipulative seniors may not be possible and eviction or suspension from a program may be the best for all concerned. Everyone has a right to live in peace but especially those who are living out their days away from a world they once knew. For all of us who work with seniors, it's important that we provide them with the safest environment and the top notch services they deserve.
Attorney Connelly practices in the area of elder law. This area of law involves Medicaid planning and asset protection advice for those individuals entering nursing homes, planning for the possibility of disability through the use of powers of attorney for the both health care and finances, guardianship, estate planning, probate and estate administration, preparation of wills, living trusts and special or supplemental needs trusts. He represents clients primarily in the states of Rhode Island, Connecticut and the Commonwealth of Massachusetts. He was certified as an Elder Law Attorney (CELA) by the National Elder Law Foundation (NELF) in 2008. Attorney Connelly is licensed to practice before the Rhode Island, Massachusetts, Connecticut, and Federal Bars.