By:
Shay Jacobson, RN, MA, NMG, LNCC, CLNCP

Martha Kern

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The word “bully” typically evokes memories of childhood, when older, bigger kids preyed upon younger, weaker kids, simply because they could.

It’s hard to fathom that bullying resurfaces, or takes a new form, when we find ourselves in communal living environments as seniors.

A recent Cornell University study showed that one in five senior-living respondents indicated they had been bullied at least once in a four-week period. The forms of bullying reported in the study break down as follows:

  • Sixteen percent were cursed or yelled at;
  • Ten percent had their rooms entered or rummaged through;
  • Six percent were hit, kicked or bitten;
  • One percent experienced sexual incidents.

Didn’t We Outgrow This Behavior?
Bullying can occur in any environment where the balance of power is perceived to be uneven. In childhood, older, bigger kids are widely viewed as more powerful than younger, smaller children. In our senior years, it can be just the opposite – older residents, who may have less ability in terms of ambulation and cognitive agility, may find themselves at the bottom of the social strata.

Bullying behaviors in senior living environments often show up in the form of exclusion. Bridge groups form and don’t let others play. A group of long-term residents reserve tables in the dining room and ban newer residents from sitting there. Insults may be exchanged and gossip can be shared. Residents may whisper about someone who was moved to the dementia unit.

While many victims of bullying are passive and at the low end of the pecking order because they are viewed as weak, others may, through behaviors they cannot fully control, inadvertently provoke others. A resident whose boundaries are poor, who has lived alone for years prior to coming to the community and has diminished social skills, who breaks rules and cuts the line owing to cognitive impairment, may find themselves left out or shunned because they are misunderstood.

The Culture of the Building
Because bullying can impact both victims and bystanders, it’s important to examine possible causes and aggravating circumstances. Establishing an environment where respectful treatment is valued and rewarded takes some effort. Policy changes may need to begin with staff members. In an era when nursing home staff members have been prosecuted for photographing residents in the shower or during other private moments and posting these images on social media, it is essential to maintain policies requiring respectful interactions and the preservation of dignity at every level of the organization.

If staff members argue openly, talk to or about one another in disparaging terms or behave unprofessionally, residents may adopt the same tone with each other and with those who work in the building. Zero-tolerance policies for cursing, ridicule, seat-saving and other common forms of bullying, both with staff and residents, may go a long way toward creating a more respectful environment.

It is also important to give the objects of bullying behaviors a safe place to report their experiences and to feel heard and supported. Retention of residents hinges to a vast degree on their sense of assimilation and fitting in – failure to address social problems and bullying could easily result in a resident’s decision to leave and seek a friendlier atmosphere elsewhere.

Social Engineering
While some bullying behaviors may stem from intolerance, low self-esteem and/or a difficult disposition, it is also believed that boredom is a contributing factor. Busy, engaged people have less time in which to worry about or pick on other people. It’s also true that developing activities around common interests, such as gardening, crafts, or music, helps residents find people with whom they have shared interests and can forge positive relationships. Residents who have friends in the building make less attractive targets for bullies.

Keeping a close eye on group activities and interactions in the common areas, particularly the dining room at mealtime, will help identify cliques or individuals who are most prone to excluding or harassing others. Staff members should be trained to intervene and enforce a code of conduct that disallows or even penalizes seat-saving, ridicule or cursing.

Residents, too, should be encouraged to report acts of intimidation or aggression that they witness against others.

Staff members must also be watchful for the involvement of resident family members. When residents complain to family members about the bullying behaviors of other residents, family members will sometimes attempt to correct the behavior themselves by approaching the offending resident. These scenarios can escalate and cause a bad situation to grow far worse. If building management responds appropriately and effectively when the behavior is first noted, family members should not feel compelled to take matters into their own hands and possibly cause the situation to deteriorate still more.

Though it can be difficult to initiate culture change in a building, ignoring blatant disrespect among staff members and/or residents can be quite costly in the long run. A loss of residents is a loss of revenue. Situations can intensify to the point of physical violence, in which case a senior community could be sued by the victim’s family.

The problem cannot be solved without acknowledgement and intervention. Everyone in the building should know what to do when they see one resident or staff member disrespect another. They should feel safe to report it, feel confident that something will be done to stop it, and believe that their rights and needs are as important as those of others.

©Lifecare Innovations, Inc.