By Emilee Evans, Legal Intern

As noted in last week’s blog post, bullying is used to make an individual feel powerful by making another individual feel vulnerable and powerless. Being the target of bullying can be intimidating. By seeing this behavior through the perspective of residents of long term care facilities, hopefully cases of bullying will be easier to identify.

The end of this post will include resources to use if you are able to identify yourself as a possible target. In consideration of October being Domestic Violence Awareness Month, we would like to bring bullying within long term care facilities to light.

Bullying or aggression in long term care facilities depend on many factors. As reported by residents, many residents become aggressive at certain times of day, in certain areas, with specific people, etc. A study showing groups of both staff and resident participants report that most cases of aggression tend to be in dining rooms, resident rooms, hallways, and the main lounge/TV lounge. The same study also found that aggressive situations usually occur during the afternoon or evening (Rosen, pg 3). More findings about what “triggers” aggression will be discussed in the next blog.

The major types of aggression reported by residents tend to be verbal aggression: yelling, cursing, telling others to “shut up”, etc. Physical aggression also occurs. Physical aggression includes: pushing, punching, hitting with an object, etc. (Rosen, pg 4). Often, bullying in long term care facilities can take the form of emotional aggression. One resident explains: “There are people who have been here for 23 years. So they do what they want. Often, patients are treated roughly or disrespectfully…by those residents, who think they’re gods. They think they’re allowed to do whatever they want. Sometimes the employees help to create that atmosphere…there’s one woman here who is really impossible to live with…she has a motorized chair and runs into everyone in the elevator. No one says or does anything… I’ve seen three or four incidents, and she’s going to end up injuring someone” (Charpentier, 348). When individual residents enforce their “seniority” on other residents by making them feel powerless, it is difficult to gain a voice and assert oneself.

Because of the complexity of bullying and aggression in long term care facilities, there are many YouTube videos teaching assertiveness skills which can be found below (Bonifas).

The Art of Assertiveness: Part 1 

The Art of Assertiveness: Part 2 

The Art of Assertiveness: Part 3

The Art of Assertiveness: Part 4 

The Art of Assertiveness: Part 5 

In addition to these videos, it helps to know your rights as a long term care facility resident.  By residing within a nursing home certified by CMS (Center of Medicare and Medicaid Services), you are entitled (but not limited) to:

• The right to be treated with dignity and respect.
• The right to be informed in writing about services and fees before you enter the nursing home.
• The right to manage your own money or to choose someone else you trust to do this for you.
• The right to privacy, and to keep and use your personal belongings and property as long as it doesn’t interfere with the rights, health, or safety of others.
• The right to be informed about your medical condition, medications, and to see your own doctor. You also have the right to refuse medications and treatments.
• The right to have a choice over your schedule (for example, when you get up and go to sleep), your activities and other preferences that are important to you.
• The right to an environment more like a home, that maximizes your comfort and provides you with assistance to be as independent as possible.

Medicare.gov has more information regarding your rights as a nursing home resident, at Your Rights and Protections as a Nursing Home Resident.

More advice is also offered by Bonifas and Frankel through the My Better Nursing Home website and the Senior Bullying Series.

Next week’s blog will include information and advice for nurses and from a nursing perspective, in prevention of bullying of older adults within long term care facilities.

References:

Bonifas, Robin and Frankel, Marsha. “The Senior Bullying Series Part I:  What is Bullying?” My Better Nursing Home: Resources to Create Long-Term Care Where EVERYBODY Thrives, February 8, 2012. Accessed October 2, 2017.

Charpentier, Michèle, Soulières, Maryse (2013). “Elder Abuse and Neglect in Institutional Settings: The Resident’s Perspective”. Journal of Elder Abuse & Neglect, 25:4, 339-354, DOI: 10/.1080/08946566.2012.751838.  http://dx.doi.org/10.1080/08946566.2012.751838

“Resident rights.” Medicare.gov – the Official U.S. Government Site for Medicare. Accessed October 03, 2017. https://www.medicare.gov/NursingHomeCompare/Resources/Resident-Rights.html.

Rosen, T., Lachs, M. S., Bharucha, A. J., Stevens, S. M., Teresi, J. A., Nebres, F., & Pillemer, K. (2008). “Resident-to-resident aggression in long-term care facilities: Insights from focus groups of nursing home residents and staff”. Journal of the American Geriatrics Society, 1–10. doi: 10.1111/j.1532-5415.2008.01808.x