Senior Bullying: Guest Post by Robin Bonifas, PhD, MSW, and Marsha Frankel, LICSW

Posted by Dr. El - February 8, 2012 - Bullying/Senior bullying, Resident care - 30 Comments

Today’s blog post is the first in a biweekly series on senior bullying, bringing research into practice.

What is Bullying?

By Robin Bonifas, PhD, MSW, Assistant Professor, School of Social Work, Arizona State University, Phoenix, AZ and Marsha Frankel, LICSW, Clinical Director of Senior Services, Jewish Family & Children’s Services, Boston, MA

Bullying, defined as intentional repetitive aggressive behavior involving an imbalance of power or strength (Hazelden Foundation, 2008), has been recognized for many years as a problem among children and youth in school systems. Recently “senior bullying” has also been noted to occur among older adults in many senior housing and senior care organizations, such as adult day health programs and assisted living facilities. What does bullying look like among the older generation? Surprisingly, in many ways it looks similar to bullying among younger age groups! For example, it includes verbal, physical or antisocial behaviors that occur in the context of social relationships, and, like youths, victims of senior bullying experience considerable emotional distress. Here are some specifics:

Verbal bullying involves name calling, teasing, hurling insults, taunting, threatening, or making sarcastic remarks or pointed jokes. For example, Mary was overheard at a Senior Center luncheon saying to Grace, “You don’t know what you’re talking about. Everyone knows you’re crazy!” Physical bullying involves pushing, hitting, destroying property, or stealing. For instance, two residents in independent senior housing got into an argument over control of the remote control in the community room.  One punched the other in the face. This was not the first time these two men exchanged words, but the first time it escalated to a physical assault. Antisocial bullying includes shunning, excluding or ignoring, gossiping, spreading rumors, and using negative non-verbal body language. Such non-verbal bullying includes mimicking someone’s walk or disability, making offensive gestures or facial expressions, turning one’s head or body away when the victim speaks, using threatening body language, or encroaching on personal space. For example, John was relocated to senior housing in Massachusetts following the loss of his home in the New Orleans hurricane. Several residents began spreading rumors that he was a longtime homeless man and was the first in a deluge of formerly homeless people who were going to be “dumped” into their building. As a result, other residents began to avoid John.

Contrary to the childhood adage “sticks and stones may break my bones, but names will never hurt me,” individuals who are bullied are significantly impacted by their peers’ negative behavior. Common responses include (Frankel, 2011):

  1. Reduced self-esteem
  2. Overall feelings of rejection
  3. Depression
  4. Suicidal ideation
  5. Increased physical complaints
  6. Functional changes, such as decreased ability to manage activities of daily living
  7. Changes in eating and sleeping
  8. Increased talk of moving out

The situation and type of behavior often determines whether or not problematic behavior is actually bullying. An individual who yells and strikes out at everyone is not necessarily a bully; similarly, behavior may be inappropriate and violate community rules, but not truly be bullying because the dynamics of power and control are absent. It is important to keep in mind that some people exhibit verbal or physical aggression when they are frustrated or upset as a way of communicating their feelings rather than to usurp others’ power. The potential for this situation increases in the context of dementia, due to impulse control problems, communication difficulties, frustration regarding impaired task performance, and misperceptions of potential environmental threats.

At the same time, although some problematic behaviors may not meet the academic definition of bullying, such behaviors can still feel to those on the receiving end as if they were being bullied. For example, residents in assisted living report the following peer behaviors to cause the most emotional distress (Bonifas, 2011):

  1. Loud arguments in communal areas
  2. Name calling
  3. Being bossed around
  4. Negotiating value differences, especially related to diversity of beliefs stemming from culture, spirituality, or socioeconomic status
  5. Sharing scarce resources, especially seating, television programming in communal areas, and staff attention
  6. Being hounded for money or cigarettes
  7. Listening to others complain
  8. Experiencing physical aggression
  9. Witnessing psychiatric symptoms, especially those that are frightening or disruptive

While only behaviors 2, 3, 6, and 8 really qualify as bullying, residents react or respond to such behaviors in the following comparable ways:

  1. Anger
  2. Annoyance
  3. Frustration
  4. Fear
  5. Anxiety/tension/worry
  6. Retaliation followed by shame
  7. Self isolation
  8. Exacerbation of mental health conditions

The similar reactions to both bullying and “bullying-like” behaviors implies that to understand bullying among older adults, it is necessary to develop knowledge about the individuals who exhibit bullying behaviors and individuals who are bullied. Our next blog will address this critical issue.

Robin Bonifas, PhD, MSW

Marsha Frankel, LICSW

The Senior Bullying Series:

Part One: What is Bullying?

Part Two: Who Bullies and Who Gets Bullied?

Part Three: What is the Impact of Bullying?

Part Four: Potential Organizational-Level Interventions to Reduce Bullying

Part Five: Intervention Strategies for Bullies

Part Six: Strategies for Targets of Bullying

Reducing Senior Bullying: Conversation with Bullying Expert Robin Bonifas, PhD, MSW

This 50-minute audio addresses how organizations can implement programs to reduce senior bullying, discussing in detail issues touched upon in Dr. Bonifas’ blog series on Senior Bullying.  Listeners will learn:

How to discover the extent of senior bullying in your facility

Who should be involved in a task force to reduce senior bullying

How to distinguish between bullying and the problematic behavior of residents with dementia

Ways to create a positive environment that encourages caring behavior and thus reduces bullying

Instant Download: Only $10.99

Order Now

30 comments

  • Tracy says:

    I’m happy to say I have not experienced this in my nursing center. Maybe this is more prevalent in an Assisted Living type facility where folks have fewer health problems.

    • Dr. El says:

      I’ve seen it, Tracy, in the nursing home. The most common behaviors I’ve witnessed are loud, negative comments by more cognitively intact residents about their less able peers. I’ve also seen arguments around seating at tables, with more able residents preferring not to sit with those who have difficulty eating. Many times I’ve heard the comment, “She’s in my spot!”, accompanied by a raised voice, angry tone, and sometimes threatening behavior. The staff intervention in that case is generally to move the person in “her spot,” which seems perfectly reasonable, but also reinforces territoriality that’s often accompanied by bullying behaviors.

    • Sue Samek says:

      Tracy,

      Perhaps you are not recognizing it, I have never worked in a facility where it doesn’t happen.

    • bev says:

      its prevalent in 55+ communities. I live in Mesa, Az. in this park for 18 yrs, & 14 are being bullied. Doris Lor placed a nice article in local news- papers, about her park bullying. I’m told I’ll be evicted & have tried to sell my home in years past. The gossip, etc. is unknown but working nights as a RN I wasn’t involved & not a part girl. Lived in 7 states & non prior to Az. have a endured such behavior. I didn’t apply for p popularity contest & amazing, as a nurse I volunteered to help even when treated poorly.

  • Patti says:

    I haven’t seen much of this either from residents. I do see if from their families though. I don’t consider complaints about seating issues, “bullying” though. When I worked at an assisted living center, yes indeed there was bully behavior from residents and their families- the more well to do, the worse the bullying was. I recall a resident’s daughter telling another resident, “Do you know who I am??” and the poor woman said “No”– “I’m the Mayor’s sister. YOU don’t sit at my mothers’ table” and she snubbed off to the front offices to complain. Also the staff endure lots of this behavior as well, from residents (customers) and the families (Customers??)
    It’s all part of the job. We have to have thick skins and be willing to advocate for those who can’t, or won’t, or don’t know they should, speak for themselves. Its a risky undertaking to stand up though…when families complain, staff get fired. There’s a consequence for advocating for the weak and meek.

    • Dr. El says:

      That’s an interesting perspective, Patti. I’ve seen more residents than families behave badly toward staff members, whether or not it’s considered bullying behavior. This is often, but not always, related to dementia or mental illness. Staff members do have to handle a great deal, and training can help them negotiate sticky interpersonal situations.

  • Retired says:

    I have now lived in a ‘senior housing community’ (55 years and older) which is operated by the National Churches Residences. The socioeconomic dynamics range from without a financial resource to those earning a modest income from Social Security or low paying employment. I, as the only male in a residency that’s predominately elderly (65+) Caucasian & female. I have observed the taunting, gossip and bullying that other residents, being 4-5 in a building occupying 50 residents, practice on a daily basis. Unfortunately, NCR management fails to address such behaviors and would rather “have the residents work it out among themselves.” I have found that many residents don’t respect boundaries, but they probably never have.

    • Dr. El says:

      Retired, the gossiping and bullying must be very challenging to be around on a regular basis. Perhaps some of the strategies we’ll be discussing in an upcoming post will be helpful in addressing the issue. Maybe the management would be willing to have an outside speaker come in to discuss ways of reducing bullying behavior, providing strategies for management and for residents themselves. Alternatively, if you have a social worker and/or an entertainment director, maybe they’d be open to having a speaker come in for a talk just for residents.

  • Mary says:

    I’ve been experiencing this, as a 52 year old physically disabled woman, in public housing for the elderly and disabled, for months now. I’m dealing with an alliance of a clique of elderly lady bullies, and a younger man they’ve befriended. He moved in a few weeks before me, and started targeting me a month after I moved in, when I he attempted to get me to give him money. It started as mild verbal taunts, mockery to character assassination, to his screaming at me hysterically in the community laundry room. Since then he’s taken to entering my building on an almost daily basis, to intimidate and frighten me, as I try to avoid him in the common areas, and have restricted my use of the the laundry room to early morning hours. The PHA not only refuse to address this, they make excuses for him. I’ve since learned he has an extensive criminal arrest record, including several convictions for felony domestic assault. Neither HUD, nor the various agencies will help.

    Things aren’t always so cut and dried, including not how some become victims, while others do not. We’re not all confused, suffering from Alzheimers or dementia.. It’s become apparent to me that bullies in these instances, like those in other age groups, will target new people, who haven’t established many friendships as yet. Single women, because even today, are easily stigmatized, even by women who work in housing, nursing home, and assisted living management. I’ve found despite the fact that this man has a lengthy criminal including a habit of violent assault, his behavior is brushed off. There is no oversight, and despite petty guarantees like zero tolerance policies in leases, and inspections, laws are toothless when there is no oversight and enforcement.

    • Dr. El says:

      Mary, it sounds like you might need to contact the police about this matter, and to document the instances of harassment.

  • Tracy says:

    As boomers continue to retire and spend time at communal activity and living centers, this problem will inevitably increase. Unfortunately, there are no mandated reporting mechanisms for bullying among this population nor official policies to address the issue.

    • Dr. El says:

      In conversation with Dr. Bonifas, she pointed out how the school system has evolved from a “kids will be kids” philosophy to active bullying prevention programs. It’s likely we’ll see the same thing in LTC. Another reader pointed out that senior bullying is “resident-to-resident abuse,” which we do have some policies around in the nursing home, though clearly more can be to enhance prevention efforts. Here’s an interesting article on the resident-to-resident abuse in the nursing home: Resident-to-Resident Aggression in LTC Facilities

  • Tracy says:

    Thank you for for forwarding that link. As this research suggests, there are many contributing factors and behaviors that can lead up to such aggression. I question the training (or lack thereof) in the field of Geriatrics for those of us who serve that population. Perhaps with more resources, training and interventions staff will be able to have more effective solutions.

    • Dr. El says:

      Tracy, I”m 100% certain that with more training we can do better, especially in facilities that haven’t adopted the Culture Change model. When I worked in inpatient psychiatric settings, which is a surprisingly similar environment, we focused on the therapeutic milieu — the feeling of the environment. We were aware that we needed to set a tone which calmed our patients, and if they became agitated and quarreled with each other, part of our process was to review what was happening in the environment to contribute to the problem and then adjust it. In the nursing home, the therapeutic milieu is often neglected, leading to agitated residents who disturb their neighbors, making it more likely bullying or resident to resident aggression will occur. For example, it doesn’t surprise me when residents living on a floor where one of their neighbors is left to scream in distress for long periods of time on a regular basis without staff intervention, start yelling at her to shut up. I address issues around improving the therapeutic milieu in my free download, “Stop Agitating the Residents! 17 Secrets From Psych That Will Transform Care on EVERY Shift,” available on the home page.

  • [...] Part One: What is Bullying? [...]

    • Bev says:

      I have lived in a retirement communitiy for 17 yrs & 14 yrs, 13 yrs were being bullies, A counselor told me this was common. I’m a retired nurse & have visited other victims across the country in similar communities. The park I live in has been taken to court for the same in 2 other states. Its amazing how so many other residents partciipate in this activity. I’ve written to the corporation w/o any effective. Evidently I’m the villian & they like me to know that they’ll evict me. I’ve made numerous police reports & have video of home entry, feces put in my house, broken windshields, etc. Nothing believed. Its easier to blame one person, such as I as being the issue then to deal w/it as a group. This is Hometown America parks who are the owners but not able to look into their own mirrors. I do alot of volunteer work & continue to be out there as a credible human being,

    • Dr. El says:

      Bev, it sounds like a very difficult situation and unfortunately one that’s not uncommon, as you point out. Your area office on aging might have resources to help you.

  • [...] will recall from our initial blog that bullying is defined as intentional repetitive aggressive behavior involving an imbalance of [...]

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  • Loved One says:

    A loved one has Parkinson’s and lives in assisted living. Several of the ladies make comments to him such as “you have your pants on backwards” when he doesn’t. His posture is compromised and his hands are crippled so he can’t wear a belt or use zippers, buttons or suspenders. His build is such that his elastic waisted pants slide down and his crack is revealed. He feels like he is back in grade school with them. Today one of them approached me and said she was representing a plea from the residents that he should buy new pants. How would you handle this situation?

    • Dr. El says:

      I tend to take a practical approach to things. I can’t imagine it’s any more pleasant for him to have his crack showing than for his neighbors to have to see it. I’d consider wearing longer shirts or a t-shirt with an open button-down shirt over it which would cover his bottom.

  • Hi! This is my first visit to your blog! We are a
    group of volunteers and starting a new initiative in a community in the same niche.

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  • Sharon says:

    Hello, I am looking for some advice. I work in a nursing home and have done for just under a year. This is my first job as a cares assistant. I would like some help as i’m not sure how to approach this in a professional manner. There is a particular resident who seems to be making not only mine but most staff and residents lives hell. She is constantly shouting at staff (which we all just put up with) but she also shouts, belittles, and is generally just nasty to residents(usually those who are immobile and often cannot communicate). When she is told this is inappropriate and not nice she reports us to our manager and nurse on duty and it would seem that she make the next few shifts highly difficult. No other residents are allowed in ‘her lounge’ and if they do, they must not touch the remote, have the windows open etc.. If anyone goes against this, she will shout scream and get in staffs faces. Management is not supportive to staff and we get called into the office if she complains directly to him, this may be because of the coffee being too strong, her dinner not being served first, other residents being too noisy in which our manager says we must do better. Being quite new in this line of work, I honestly don’t know how to cope and deal with her challenging behavior because unlike other residents who show challenging behaviour she doesn’t have alzheimers, demestia or anything of that kind. I’m honestly lost, I dread to go in to give her care because she petrifies me, I fear to speak out incase I lose my job. Any solutions, advice or tips in how to appropriately deal with this please?

    • Dr. El says:

      Sharon, that sounds like a very challenging situation and unfortunately not uncommon. It’s great that you’ve read the Senior Bullying post and hopefully you’ve read the whole series. It might be useful to share it with your coworkers. If you have a consulting psychologist in your facility, it would be helpful to refer the resident for an evaluation. It sounds as if the resident is trying to gain control over a situation which is probably largely out of her control. She’s also alienating the people who are there to help her. A frequent dynamic in people with a history of substance abuse is for a person who is frightened to frighten everyone else in order to lessen their own feelings of fear. I don’t know if substance abuse is involved in this case, but I frequently think of someone acting like this as someone who is afraid. That helps me have compassion and to approach them differently. Once I worked with a patient (in the psychiatric hospital) who never came to group meetings on time but instead interrupted them late every day, annoying the whole group. I bought a card and “cordially invited” her to the therapeutic community meeting. She was never late again. Maybe she needs an ally and doesn’t know how to get one. The psychologist is a good team member to be an ally because they have experience with this type of behavior, but it’s possible for anyone on the team to take a different approach with her. If you do this, you might want to let the nurse know what you’re trying to do so that if the resident makes complaints you have back-up. Steady, pleasant, if she’s abusive let her know you’ll come back later when she’s more able to talk.

  • Retired says:

    I am still working from home –although thanks to the bullies in active senior housing apartmentsand management’s laissez faire policies, I dont feel as if I have a home. I have lived in three differient senior independent communities and have learned a great deal. Most of it dreadful. As for bullying,it is alive and all too well in each and every one of these communities — inludng the present one that is thought by outsiders to be a nice safe: one, As one tenant on her way to a mixed age apartmentsaid, “This place is not what it looks like.” Ditto.
    I am an active, agile, healthy senor; Since I moved here three years ago, I have been manhandled by other tenants four times. They seem to think that pushing me, shoving me, grabbing me and trying to wrestle me to the ground, or grabbing me by my shourlders and tossing me about is normal. i Am 5’3″ and weight 126 pounds.
    The supposedly professional manager responds ro reports of these incidents by saying, “I am not anyones mother I can’t do anything about a resident to resident problem. Call the police.
    Further, Senior independent communities are dumpsites for familiies who do not want to deal with their elderly who may be in need of assisted living placement. Do you realize that assisted living faciliites may cost over $4-5,000 a month? Our builiding offers apartments for $8-900. per month.
    So one neighbor here abuses me and my small dog but “everyone says she’s crazy. That jus the way she is. ” In other words, shut up.
    Others tell you about their bodily fluida and tell you and tell you and tell you.
    Others abuse me because I am * not* in bad shape. Go figure.
    Oh, did I mention that there is a serious problem with vicious gossip –lack of confidentiality, rampant theft, at least one caretaker who has a criminal record, bullying. ..
    Why don’t I move? Because none I’ve looked at seem to be any better.
    BTW the men in thse places seem to be treated much much better thatn the femaile tenants. I’e never heard of one who has been manhandled by bullies. Of course, bullies from ten to 100 are cowards.. Men are not screamed at in the community room, or gossiped about, or shunned. Or verbally and vicioulsy attacked in moving elevator.
    There is nothing good to say about senior communities.

    • Dr. El says:

      Retired, I’m sorry to hear of your unpleasant experiences in senior communities. As you can read from some of the other commenters, unfortunately, you’re not alone. If you’re being “manhandled,” you might want to document instances of this and contact the police about it.

  • Hildra Tague says:

    Since I retired to Florida I’ve been shocked to see the level of antagonism portrayed by seniors who bully–especially when working as a group. The “social” bullying described in the recent article is truly bad, yet when loyal friends bully in concert together it is more akin to the Mafia than to even the worst playground behavior. The group dynamics of several people bullying together intensifies the effect, and can cause them to show more aggression when their bravado is bolstered by buddies.

    We live in a wonderful place, but the coop’s “politics” could use some revamping, since there is a board-approved pattern of clear, intense, and repeated rejection of anyone who suggest changes. In this case, several owners are only wanting the coop to be run in compliance with the law! Our Georgian Court North is managed by Board President who is acting as a Community Association Manager, but as he is unlicensed the State has ordered him to Cease & Desist, but with full support of many owners he continues this illegal practice.

    There is great concern about looking the other way while a few seniors bully both younger and older residents who are part of the minority voice seeking change toward becoming legal. This involves yelling slurs, screaming at owners who express differing opinions, hate notes on residents’ doors

    and official bulletin boards, as well as making the laundry room into an unsafe place for these individuals.

    Even the parking lot has been a background for bullying. Yelling epithets, standing behind cars trying to pull out, and one senior even biked circles in front of a gay couple trying to park their car in order to enter their home while several people watched and did nothing to help. One of the main bullies even told a dissenting former board member she’d “sure better sleep with one eye open”!

    This pattern over several years has caused some to tiptoe around quietly, avoiding conflict or even taking abuse at times, while some others have decided to band together to work for change. According to public records, Broward county found our president guilty of claiming homestead in two states, and the State of Florida has sent the case about defying the Cease and Resist order to the General Counsel for possible criminal prosecution. (DPBR case # 20013032379). Other investigations are ongoing.

    There is a vital need for programs to be developed to help with prevention and awareness of Senior Bullying. It is my hope as a teacher that the program also will include the possibility of criminal prosecution since some who bully are not concerned with the feelings of others. Some who bully don’t realize their loyalty to each other could become criminal. Perhaps a good training target for the prevention programs would be Boards.

    Such intimidation not only affects the emotions and health of those being bullied, but when the seniors doing the bullying have power over their victims as in condos or coops, it can destroy the feeling of being welcome and safe in your own home! Since a Board of Directors has the power to threaten residents with fines and can enter homes at will, their actions can bring life-changing fear which takes a heart-rending toll on the very lives of their victims. When Board members turn from advocates for the owners into adversaries, they can wield frightening control of large sums of money and the quality of lives of others.

    • Dr. El says:

      It sounds like a very unpleasant situation, Hildra, and I’m glad to hear there are some residents banding together to work for change. Your local department of aging services might be a resource in addressing this issue.

  • Margaret Walsh says:

    I live in a Hud building as well. It has been hell since I moved in with management. He is the biggest bully I have ever met. I am so depressed, and have no where to go, since I knew my retirement would not be a large amount I put myself on a waiting list to get in here. I was unaware what it would be like to live in senior housing, since I was never a senior. I have been robbed, threaten to move, and had eviction notices put on my door for changing my lock. He talks down to me, he throws things and I live in fear everyday. I am so depressd

    • Dr. El says:

      Margaret, as I’ve suggested to other commenters with similar experiences, your local office on aging may be a resource to help you handle this difficult situation.

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