Trouble in the Train Yard

Dealing with Difficult People/Senior Bullying

Presented by: Susan Tatum, Gina Grosenbach & Linda Hecht

2015 Nebraska NAHRO fall conference

Common Characteristics of Difficult People and Senior Bullies

Possible reasons for the behavior

Impact on Staff and Residents

Interventions and Techniques

Presentation Overview

When you think about dealing with difficult people does a face

or name come to mind?

Often we may identify someone as a difficult person because:

We are having difficulty working with them

They lead us to do things we regret

Erratic behavior

Surprising behavior

Unpredictable behavior

Difficult PersonCommon Characteristics

◦ Quick to anger/flying into a rage

◦ Aggressive, loud voice, demanding

◦ Manipulative, convincing you to do the work for them

◦ Very withdrawn/passive

Behavior that is unsolicited to the victim:

Verbal◦ Teasing◦ Insults◦ Name-Calling◦ Nit-Picking◦ Threats

Physical◦ Hitting/Pushing◦ Stealing◦ Destroying Property◦ Throwing Things at People

Senior BullyingCommon Characteristics

Anti-Social◦ Spreading Rumors◦ Exclusion/Ignoring◦ Mimicking◦ Offensive gestures

Passive◦ Emotional◦ May not read social cues well◦ Shy, insecure◦ Often anxious

Provocative◦ Annoying or irritating◦ Quick tempered themselves◦ May egg on the bully

Targets of Senior BullyingCommon Characteristics

May be irritable due to:◦ Lack of sleep◦ Pain◦ Sadness/Depression

Being “grumpy” or having a “grumpy personality” is not being a bully.

Personality conflict is not bullying

May be exhibiting aggressive behaviors when feeling threatened

Sometimes behavior that is frightening or disturbing may be thought of as “bullying”

Behaviors exhibited by seniors with dementia or mental illness can be mistaken for bullying

Is this really bullying?

Conscious/Unconscious behavior

Keeps people off-kilter/confuses them

Way to control situation

Avoid responsibility

Naturally disagreeable

Difficult PeopleReasons for Behavior

Have you ever been a difficult person?

Underlying Reasons:

Mental Health Issues Feeling Overwhelmed Job/Home Stress Poor Service Lack of Understanding

◦ Language Barriers◦ Functioning Levels

Difficult PeopleReasons for Behavior

Underlying need for power and control Often insecure Find it funny when others feel threatened, fearful May find communal living, sharing space and

limited resources difficult Prior prejudices can play a big role May have been bullied or abused themselves Most likely they have been a life long bully Age related loss of independence, income,

relationships

Senior BullyReasons for Behavior

Impact On Staff

React in ways we are not happy with Feel like we are not effective in our jobs Can reduce job satisfaction Dread appointments or meetings with the person Makes us feel:

◦ Uncomfortable◦ Frustrated◦ Exhausted◦ Guilty◦ Scared◦ Angry

React in ways they are not happy with Dread seeing the person Makes them feel:

◦ Uncomfortable◦ Frustrated◦ Isolated◦ Lonely◦ Guilty◦ Scared◦ Angry◦ May increase anxiety or symptoms of depression

Impact On Residents

So what can we do?

It can be very difficult not to defend yourself!

Thoughts such as:◦ “I can’t stand this crazy, insulting behavior”◦ “I will not be treated this way”

Afterwards we usually regret the confrontation

What were we thinking?◦ We probably weren’t◦ We were having an emotional reaction defending

ourselves

Standing up for yourself in an effective way:

Resist the urge to be defensive/win the argument Accept the situation/agree to disagree Listen to what they have to say with time limits/end the

conversation if necessary Understand it’s not you, it’s them Prepare for projection Identify tenant supports

◦ Case Manager◦ Family/Guardian

Establish boundaries

Interventions & TechniquesDifficult People

What are boundaries?◦ Clearly established limits◦ Being friendly, not friends◦ Clear understanding of the limits and responsibilities of

your role as a service provider.

Why are boundaries important?◦ Avoiding burn-out (“compassion fatigue”)◦ Avoiding the “rescuer” role◦ Opportunity to role model healthy communication and

professional relationships◦ Assist with staying focused on your responsibilities

Create an environment that promotes empathy◦ Research shows 50% of the time, when a bystander

speaks up, the bullying stops◦ Offer strategies for residents to utilize when bullying is

observed Develop a culture of respect

◦ Regular trainings and discussions about the challenges of communal living

◦ Notice acts of kindness and publicly reward them◦ Acknowledge tenants that go out of their way to be kind

or make others feel welcome

Senior Bully Interventions & Techniques

Ensure bullying will not be tolerated◦ Policies and procedures that guide behavior and

encourage reporting of bullying incidents◦ Clear rules and consequences◦ Enforce lease violation

Residents are held accountable and responsible for their behaviors ◦ Set limits on bullying behavior◦ Offer an appropriate outlet to vent frustrations

Senior Bully Interventions & Techniques

Coach residents on how to handle snubs and aggression Ignore with dignity – okay to walk away Evaluate and make changes to rules to decrease the power

of the bully Make your opinion clear but without aggression Host programs to build resident skills:

◦ Assertiveness training◦ Tolerance◦ Building friendships◦ Building empathy◦ Communication skills◦ Setting boundaries

Empowering Residents

Questions, comments or discussion?

Thank You!!

What to do when Seniors Bully!

Linda K. Shumaker, R.N.-BC, MA

Pennsylvania Behavioral Health and Aging Coalition Suicide Prevention Network USA – � www.spanusa.org Pennsylvania Behavioral Health and Aging Coalition – � www.olderpa.org Alzheimer’s Association – � www.alz.org ADEAR – � adear@alzheimers.org Family Caregiver Alliance – � www.caregiver.org Geriatric Mental Health Foundation – � www.gmhfonline.org

�http://www.nbcnews.com/id/41353544/ns/health-aging/#.USJM36XC1H1

�http://www.thebesttimes.org/aaa/elder_abuse/0811_senior_bullying.shtml

Resources & References

�http://www.mybetternursinghome.com/senior-bullying-guest-post-by-robin-bonifas-phd-msw-and-marsha-frankel-licsw/

http://www.arizonageriatrics.org/assets/2013/2013springconference/2013%20spcf_3%20-%20bonifas-senior%20bullying-phx-tuc.pdf

http://www.mentalhealthsupport.co.uk/AdultBullying.html

  www.seniorhomes.com/p/bullying-in-senior-living-communities

  http://www.mybetternursinghome.com/category/senior-bullying/

  http://nobullying.com/how-to-combat-adult-bullying/

  http://www.masspreventssuicide.org/webinar-library/

http://www.neighborhoodlink.com/article/Association/Practical_Dealing_Difficult_People

http://www.wikihow.com/Deal-With-Impossible-People