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american society on aging conference

Senior Center Takes Steps to Battle Bullying

June 8, 2018 by Judy Goddess

picture of dr. patrick abore

Dr. Patrick Arbore, from the Institute on Aging, teaches seniors and staff recognize and handle bullying. (Photos by Judy Goddess)

SENIOR BEAT – If we’re not surprised to hear about bullying in the schoolyard, why then are we shocked to learn that bullying occurs among seniors, too? No room for bullying in our image of the smiling grandma bearing cookies or the gentle grandfather imparting fly fishing tips to his young grandson?

But some seniors do bully. And it starts early.

“Young bullies just become older bullies,” said Dr. Patrick Arbore, founder and director of Elderly Suicide Prevention & Grief Related Services at the Institute on Aging. “Bullying is a learned behavior. Unless someone called a stop to this behavior or the bully is fortunate enough to develop insight into what is considered relational aggression.”

Recognition of  senior-to-senior bullying has been slowly surfacing in retirement homes and senior centers across the country. It was first formally identified as a phenomenon in 2013 by Robin P. Bonifas, an assistant professor in Arizona State University’s School of Social Work.

Identifying troubling behavior

A couple of years ago, staff at San Francisco’s largest multipurpose senior center – more than 300  seniors attend the center each day – began struggling with how to handle behavior they were starting to notice: gossip, seniors refusing to allow those with disabilities to sit at their lunch table; loud remarks about a frail elder’s appearance; unkind comments about a new member’s outfit; nastiness to staff. Often, but not always, the person being picked on was older and frail; sometimes, they were just different or seemed vulnerable.

At the recent American Society on Aging conference in San Francisco, Valorie Villela, director of The 30th Street Senior Center in Noe Valley, described how their center met the challenge. Villela began by asking the more than 70 social workers and geriatric case managers crowded for the forum, “How many of you have experienced bullying in your programs?” A chorus of hands affirmed what is increasing recognized as a problem in programs and facilities serving seniors. Bonifas estimated 10-20% of seniors have experienced senior-to-senior aggression, mostly verbal, in an institutional set­ting.

Staff members ‘at a loss’

“Staff members were at a loss,” Villela admitted. “Staff didn’t expect it, weren’t trained to recognize it and didn’t know what to do about it, so they minimized the bullying. They told victims not to mind it, that it will blow over and things will work themselves out.

And, she admitted, “interventions take up a lot of staff time and interactions with a bully can be difficult.”

Some targets of bullying were so intimidated they stopped attending the center. With ever fewer options to be around other people, they could become more susceptible to loneliness and social isolation. The center’s first response, suspending the bullies, didn’t address the target’s need either.

This was not the caring community, the welcoming environment Villela thought the center presented.

So she invited Arbore to help them develop an awareness and more effective ways to deal with bullying, or at least reduce its negative impact.

A real public health problem
photo of anti-bullying flier

Fliers help get the message across.

“Bullying is a very real social and public health problem that’s been in the shadows for years,” Arbore said. “It affects the victims, their families, the people who care for them – and even the bullies themselves.

“Bullies want power. Unlike bad behavior, such as rudeness, or elder abuse, which is motivated by personal gain, bullying is about domination with intent to harm. Mean young people become mean old people. Personality features become entrenched over time. So, as they age, bullies only get better at it, unless there is some sort of intervention.”

With input from center staff and senior clients, Arbore came up with a two-phase pilot project. First: train staff to understand and recognize bullying, and intervene appropriately. Next: help seniors recognize, respond to, and report bullying. Anti-bullying posters offered behavioral guidelines and response procedures.

“The staff at 30th Street aren’t trained as psychotherapists,” Arbore said, “but they are trained to support, help, and empathize with both the person who bullies and the person who has been bullied. There is no quick fix or magic bullet. However, we do not want to underestimate or devalue the critical importance of boundaries, civility, kindness, and empathy.”

Helping the bully, too

Today, a bully may be referred to appropriate help, e.g., therapy or case management, instead of being suspended. Seniors at the center who have gone through a nine-week course on the problem of bullying are quicker to acknowledge the victim’s pain and offer support.

Katherine Escobar

“The training helped us recognize that pushing to be first in line, name calling, gossip, being mean to staff, not allowing someone with a walker to sit next to you – behavior we’ve all noticed – are signs of bullying,” said Katherine Escobar, who facilitates the course for Spanish-speaking seniors. “It helped us understand the bully and gave us more tools on how to respond.”

The two-year project, which began in September 2016, received funding from the San Francisco Department of Aging and Adult Services. Villela is seeking funds to continue the effort.

“We want to have policies and procedures in place so the seniors will feel welcome at 30th Street. We are committed to hospitality. We want seniors to feel confident they will be treated with respect when they come to our center.”

Filed Under: SF Senior Beat Stories Tagged With: 30th street senior center, american society on aging conference, dr. patrick abore, elderly suicide, institute on aging, Noe Valley, public health problem, Robin P. Bonifa, senior bullying

My Experience at the American Society on Aging Conference

April 3, 2018 by Jan Robbins

The American Society on Aging held its annual conference in San Francisco in March. (Photo by Robin Evans)

SENIOR BEAT – I was excited. Never having been to a major conference of any kind, I felt fortunate to land a press pass to the American Society on Aging annual conference last month in San Francisco.

My first session was Monday morning at 9 a.m., so I set my iPhone alarm for 6:30. But I had never used the alarm and didn’t trust it would work –  I’m such a Luddite. I woke and 5 a.m. and dozed and woke off and on until the alarm went off – as scheduled.

The conference was held at the Hilton Union Square, which I was sure  was right on Union Square. So I got off the subway at Stockton Street and walked up the hill to discover not the Hilton but the Hyatt. The doorman pointed me toward Mason Street. Heading up Geary Street, I worried I was getting too far afield of Union Square. This time, I asked a woman on the street for directions. “I’m from out-of-town, honey, why don’t you look it up on your phone,” she said.

“Oh, sure,” I stammered, quite abashed.

Then there it was – right around the corner at 333 O’Farrell.

Frazzled but jazzed

By that time, I was frazzled, but glad I had set out early.  Monday was registration day. I envisioned long lines – and wasn’t disappointed.

The next question on my conference journey: Is there a special line for the press? The monitor I asked didn’t know, so she set out to find out. Tailing her until she found the appropriate registrar, I was elated to find myself at the front of the line. What a coup!

I loved my badge. I felt it was a symbol of belonging to this large sea of humanity: 3,000 people from each of the 50 states and the District of Columbia gathered to share information to help older Americans and their families. (Conference attendees represent a population diametrically opposite of that segment of Congress constantly beating the drum for cutting social services, including Medical and Medicare.)

Reframing aging or freeze-framing?

My first seminar was called “Disrupting Aging,” although it was really about disrupting ageism. The former seems to imply you can freeze-frame yourself at 65. The session was a collaboration of the American Association of Retired Persons of Connecticut and the nonprofit education company Borrow My Glasses. Together they created a simple interactive video and card game that flips aging on its head. Like Humpty Dumpty, you put it all together again – but with a brand-new perspective. The women presenters were passionate, up-beat, creative and gracious. I was jazzed.

After lunch, I jack-rabbited around to a couple of seminars, quickly exiting ones that were uninteresting to me. Monday afternoon’s general assembly was fun and informative, but perhaps not in the way its title implied: “How Technology is Reinventing Aging.”  It featured a discussion of developing technology in the field of aging. A woman from a health care company moderated a panel of young to middle-age tech innovators.  One of them was from Great Call, which makes Jitterbug phones but also fall-detecting wearables, such as bracelets.

And on hand to offer feedback throughout the discussion – from a generational point of view – was researcher Kate Lorig, a professor at the Stanford University School of Medicine and director of the Stanford Patient Education Research Center.

Back to the drawing board, boys

Although she found no fault with the bracelet, for other products focusing on surveillance, her comments ranged from “It makes me feel dumb; I don’t like being told what to do; It threatens my privacy;” to “The directions are incomprehensible” and “OK, boys, back to the drawing board.”

Her sentiments were underscored by a short video showing an older man outsmarting smart technology: a cane that beeped to signal time for a walk; a fork that evaluated his food intake; and a bed sensor making sure he got enough sleep. He eventually tires of the surveillance – as would I.

He finds a neighborhood kid to walk his cane. A pile of books on his bed fakes the sensor into thinking he’s turning in at the designated time. At dinner, he eats pasta with a regular fork, while stirring the smart fork in a pile of vegetables – on a separate plate. The boisterous audience response indicated most people in sync with his frustration.

Every conference has its exhibit hall. This one was no exception. There were many helpful vendors making attendees aware of products such as a tele-rehabilitation solution that suits patients who have had a stroke, and Parkinson’s and orthopedic problems; chef-designed meal-delivery services; and adaptive telephone equipment.

Along with the helpful agencies and research companies, anti-aging companies were at work marketing ways to keep skin wrinkle-free with moisturizers and electrical face-lift equipment.  One moisturizing company was selling white truffle day moisturizer. Truffles are a fungus sniffed out in nature by pigs and dogs. On the usual unpronounceable list of ingredients, white truffle came in 20th.

Identifying malnutrition

I finished the conference with two inspiring sessions, on malnutrition among older adults and stigmas still attached to mental illness.

Affecting all socio-economic classes, malnutrition is hard for medical personnel and caregivers to recognize. There are no screening tools, thus no ways to evaluate or intervene. Yet research shows 25 percent of Medicare recipients have “food insecurity,” which means they don’t have reliable access to a sufficient quantity of affordable, nutritious food.

Doctors don’t always ask patients about their food intake because they can’t offer solutions, according to Uche Akobundu, senior director of Nutrition Strategy and Impact for Meals on Wheels. Panelists representing other national agencies said their organizations are developing tools to help doctors and caregivers identify populations at risk for malnutrition, educate them and help them improve their nutrition.

Demystifying mental illness

The last session focused on the innovative ways a group of social workers from New York City incorporate mental health services into their senior centers’ Asian population. In that culture, where negative emotions have been identified with insanity, the stigma is particularly dire. In an effort to build patients’ trust, mental health workers participate in senior center activities, becoming friendly with potential clients.

My conference days came to an end. I was sad and hopeful: Sad to leave this group of people dedicated to the well-being of others, but hopeful that many good changes in the world of aging are being cultivated and put into action.

I was particularly moved by a social worker on last panel as she recited a Jewish proverb she lives by, “If you’re saved one life, you’re saved the world.”

Filed Under: SF Senior Beat Stories Tagged With: aarp, american association of retired persons, american society on aging conference, borrow my glasses, Congress, disrupting aging, food insecurity, great call, jitterbug, kate lorig, malnutrition, Meals on Wheels, Medical, Medicare, mental illness, older americans, reframing aging, reinventing aging, san francisco, senior, stanford, stanford school of medicine, stigma, Uche Akobundu

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