Tim R. Johnston, Director of National Projects, SAGE
We all need to be part of community. Whether that community is rooted in our geographic area, certain interests, friendship, or something more formal like a senior center or assisted living community, human beings crave connection and interaction across the lifespan.
While much of the push to create community focuses on the positive effects such as mutual support, collaboration, and fun — being in community also requires navigating tension, different personalities and desires, and at times hostility or hurtful behavior. No two people will get along all of the time, and part of creating community is forming social bonds flexible enough to handle and heal the hurts, tensions, bumps and bruises as they occur.
Sometimes these tensions can take the form of bullying. People outside of the aging network are often surprised to learn that senior centers, congregate meal sites, and senior living communities face the same forms of bullying we see in elementary schools. Cafeteria dynamics, gossiping, physical intimidation, cliques, and cyberbullying are a part of life in community settings, and we need to be sure we see and respond to this bullying as it happens.
There is no one definition of bullying, but many researchers and activists consider a behavior to be bulling if it satisfies three criteria: it is an intention harm, committed by a person with more power than the target of the bullying, and there is the threat of future harm.
In my capacity running the SAGECare LGBT cultural competency training program, I am often called upon to consult on cases where a person is being bullied because they are lesbian, gay, bisexual, or transgender. Cases such as that of Marsha Wetzel show the horrible treatment faced by some LGBT older adults who come out (or whose LGBT identity is disclosed without their permission) in their communities. The LGBT community has made significant advances politically and culturally, but many LGBT older adults fear mistreatment or abuse and go back into the closet because they do not trust that their neighbors or the staff will support them in being out.
While LGBT people do face real and disproportional levels of bullying and bias — bullying can happen for any reason, from race to religion, personality type to the quality of your clothing. What can we do to make sure that all members of our communities can live without the threat of bullying, while also remembering that marginalized populations often face more bullying and bias?
Researchers like Dr. Robin Bonifas are starting to write books and materials specifically addressing bullying between older people. There is no one-size-fits-all solution, but a combination of training, culture change, policies, and empowerment techniques can help to prevent and resolve bullying in senior communities. Together we can do the hard work to build a world where we are all treated with dignity and respect.
I’m really glad this discussion is happening. The issue of class or income differences sometimes comes up in LTC settings as well. I once observed a conversation at a dinner table in a CCRC SNF where a woman who had lived in the low-income HUD 202 on campus was berating a woman whose deceased husband had been chairman of the board of the CCRC and had lived in one of the big cottages. Social constraints can weaken, especially at higher levels of care, and the gloves come off as people are thrown together in new settings where people have not come to know each other well. In my experience as a nursing home administrator and change agent, here are the things I have found to help mitigate bullying: 1) create small neighborhoods or households with permanently assigned interdisciplinary work teams that have resources, training, authority and accountability, and really get to know they people they work with and among; and 2) have frequent getting-to-know you circles where residents and staff and family members have a chance to tell each other about themselves. That includes people of every ability level, including memory loss and confusion. At least once a week. Action Pact’s “Person First” program is a good example. Magic happens when connections and community are cultivated intentionally and regularly. So much goodwill gets generated.
Great point, Bev, about the importance of residents being given the opportunity to really get to know each other. Thank you for your comment.
Such an important topic! We sure can see bullying in all types of elder care settings from independent living to assisted living and within long-term care homes. This type of bullying, I believe, is the result of internalized ageism. We are a culture that “others” older adults and when we hear things like, “I’m not like them!” or “I’m not like those old people”, (and much worse), we can also hear the deeply ingrained and false notion that growing old is associated with ailments, frailty, cognitive loss etc.
Working with staff as mentioned in the comments is paramount to helping every older adult in our care be treated with dignity and respect. Additionally, by reducing this bullying and ageism, we are also directly improving health and longevity (as they are linked!) Thank you Tim and Cathy!
Great point about ageism as a possible cause of bullying, Michelle. Thank you for your thoughtful comment.
Bullying related to race should be addressed as well. Outside of a long-term care community, there have been strides made with living in diverse communities. However, in a long-term care setting the amount of interaction and closeness increases. If a resident is living with Dementia there maybe things said or done due to worsening cognitive abilities. As an African-American who works as a consultant in nursing homes, I have not been able to find any literature or training programs for long-term care staff. They need guidance on how to help diffuse situations as well as how to manage their own feelings. Unfortunately, I will not be attending the conference but I look forward to any information and or resources you can provide.
Diane – you are right. We have to be open to realizing that bullying happens in all different contexts – and we have work to do in understanding this and finding ways to educate everyone.
As mentioned in the article, most staff don’t know the characteristics of bullying well enough to identify when it takes place. Although in many aspects similar to our required trainings on abuse, bullying is very different because it is usually between peers. These differences need to be incorporated into our trainings.
Absolutely, Janis. Tim’s session at the conference on identifying and supporting the needs of LGBT Older Adults and their caregivers is also an important topic.
Excellent points. I would add that the same thing happens daily to people living with dementia. In fact, the concern about potential bullying is one of the prime arguments for segregating people with dementia in elder care. But the answer isn’t to lock people away out of sight; it is to deal with the issue–as you say–with education, empowerment, deep knowing relationships, and destigmatization.
We agree, Al. Thank you for your comment.