Box 2 – Bullying of older adults

Context

The first Concerted Action Plan to Prevent and Counter Bullying 2015-2018 was made public in 2015 [79], following extensive consultation of stakeholders [80]. The action plan covers bullying at all ages. Of the 53 measures it contains, nine are specifically intended for older adults [79]. However, bullying, as experienced by seniors, is a little-known and poorly-documented problem in Québec and around the world.

Implementing an action plan for a problem that, in theory, is very similar to the problem of mistreatment gives rise to conceptual issues (How can we differentiate between bullying and mistreatment?) and practical issues (How can we ensure the coexistence of specific actions aimed at countering one or the other of these problems?) in a context where mistreatment is a social problem that has been the focus of specific actions for roughly 30 years [81].

This box briefly takes stock of existing knowledge on bullying of older adults. It is based on preliminary findings of research conducted in Québec, as well as on an international review of literature published since 2009¹⁴. Owing to the current state of research and the limited number of scientific publications on the topic of older adult bullying, the results presented in this section should be viewed mainly as avenues for further exploration.

Definition and scope

Although there are many definitions of bullying, none of them are specific to older adults. Several are based on bullying in the workplace or at school (American Psychological Association, 2016, cited by Goodridge et al. [83]; Einarsen and Skogstad, 1996, cited by Andresen and Buchanan [84]; Rayner and Keashly, 2005, cited by Bonifas [85]). Québec’s action plan uses the definition provided in the Education Act (s. 13, para. 1.1):

Any repeated, direct or indirect behaviour, comment, act or gesture, whether deliberate or not, including in cyberspace, which occurs in a context where there is a power imbalance between the persons concerned and which causes distress and injures, hurts, oppresses, intimidates, or ostracizes [79].

Discussions held and briefs filed during a forum on bullying reflect subtle differences deriving from the bullying experiences specific to different populations, as well as from the settings where the problem occurs. A definition specific to bullying of older adults has been proposed on the basis of current knowledge about mistreatment of older adults:

[TRANSLATION]
Older adult bullying is a single or repeated and generally deliberate act or lack of such an act or action, occurring directly or indirectly within a relationship of power, authority, or control between individuals, with the intention** of negatively affecting or harming one or more older adults [86].

Although this definition contains elements that seem common to bullying at any age, it mentions certain subtle differences specific to older adults. A wide range of actors can be involved in bullying of older adults, regardless of whether the relationship between them is based on trust. The bullying can be repeated or occur only once, but it always has consequences for the victim. Think, for example, of a person who is ridiculed every day or is threatened with the withdrawal of services, even only once. 

Risk factors

Table 7 - Characteristics of older adults at risk of being bullied or at risk of bullying

Bullying of older adults can extend beyond the framework of the dyadic relationship between a bully and a victim [86]. In fact, it can occur between groups of people [85] and take place in the presence of witnesses [83]. A key factor is that bullying is necessarily part of a broader context where aspects of a social nature (e.g. media coverage [93]), a political nature (e.g. implementation of the Concerted Action Plan to Prevent and Counter Bullying 2015-2018) and a cultural nature (e.g. ageism [91]) can have an impact on not only the incidence and recognition of bullying but also the actions taken to prevent and counter it.

Consequences

Bullying experienced by older adults can have psychological, physical and social consequences. Table 8 provides a few examples.

Table 8 - Consequences of bullying for older adults

Bullying can have long-term consequences even when it is experienced at an early age. In fact, it is more common for older adults with a history of childhood bullying to have suicidal ideation throughout their life than it is for seniors who were not bullied in childhood [98].

Since bullying occurs in a social and interactional context, it also affects people who witness it [83], in addition to having repercussions on the living environment in general [85]. For example, in group living environments such as CHSLDs, bullying can cause feelings of fear or insecurity among a number of the residents; reduce participation in social activities; lead to a low level of satisfaction with the living environment or workplace; reduce commitment to and feelings of loyalty toward the facility; increase staff turnover; and create more situations of bullying (Frankel, 2014, cited by Bonifas [85]).

Prevention

To our knowledge, no prevention or intervention programs or activities in the area of bullying have been validated and documented in Québec or internationally. However, since 2015, the Governmental Action Plan to Prevent and Counter Bullying has funded dozens of initiatives in Québec, several of which have been aimed at countering older adult bullying¹⁶. The most common prevention and intervention programs consist of awareness-raising activities designed to inform the general public and to propose possible actions, particularly in group living environments.

A growing number of possible avenues for prevention and intervention are being documented internationally. For example, in CHSLDs, emphasis is being placed on the importance of:

• Assessing situations of bullying in these centres;
• Training staff and residents to identify such situations;
• Strengthening positive interactions among residents;
• Involving all actors in the implementation of positive activities intended to create an empathetic environment [99].

Although some programs, such as the Senior Culture Program [100], are designed more specifically for older adults, it is important to mention that bullying can be part of an organizational culture and that this problem must be addressed through measures intended directly for managerial and other staff [101]. Therefore, all intervention programs to combat bullying in group living environments must include components designed specifically for each of the three main types of actors: older adults who are bullied, older adults who bully and the organization as a whole [102].

Clarification of the difference between the concepts of mistreatment and bullying

Similarities

This box on bullying, together with the previous sections on the definition, risk factors and consequences of mistreatment, reveal the many similarities between bullying and mistreatment. In fact, a study on this question has highlighted the ways in which these two social problems resemble one another in regard to the following [86,103]:

• Personal, family, social, political and cultural contexts;
• Risk and vulnerability factors;
• Settings in which these problems occur;
• Interaction (two or more people);
• Violence or neglect;
• Single or repeated acts;
• Consequences;
• Cyberspace.

Therefore, prevention and intervention programs and measures put in place to counter mistreatment or bullying can have an impact on both problems at the same time. This is the case, in particular, of complaint mechanisms, user committees, the Elder Mistreatment Helpline and awareness campaigns [103,104]. Focusing on preventing and combatting ageism is also a good way to act on both problems. Indeed, it is recognized that ageism is related not only to mistreatment [38,105] but also to bullying [91].

Distinctions

Nevertheless, as shown in Table 9, mistreatment and bullying also have their own specific characteristics. Understanding their distinctive features is crucial to reading situations correctly, that is, to being able to determine whether mistreatment or bullying is taking place.

Table 9 - Specific or essential characteristics of mistreatment and bullying