Seniors Behaving Badly in Assisted Living

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Disagreements, fights and controlling behavior among humans is inevitable. It arises naturally in every arena of daily life. Seniors in assisted living communities are no exception. Conflicts range from small misunderstandings to full-fledged flare-ups. It could be conflicts with staff members or between residents.

Nearly 2,800 complaints are reported each year to the Department of Health and Services' Administration on Aging regarding fighting in long-term care facilities – and this is only the cases that are reported.

“No matter the situation, learning how to deal with conflict, rather than avoiding it, is crucial,” says Carolyn Becchio, Community Relations Director Emeritus Senior Living in Bonita Springs, Florida. When conflict is mismanaged, it affects the people involved and disrupts the neighbors. But when handled in a respectful, positive way, conflict can turn positive and strengthen the bond between two people – as well as restore harmony in the rest of the community.

Personality conflicts at assisted living

Oftentimes, it’s a personality conflict between the assisted living caregiver and the resident, Becchio says. “Maybe a resident doesn’t like to be spoken to loudly. A senior might feel the caregiver is too bossy, while another senior thinks a caregiver is too reserved.”

She gives an example of a senior man who is gruff and assertive, and doesn’t respect a person who is too timid. He sees an opportunity to mistreat the caregiver. That resident might need a stronger caregiver who takes control, because that’s what the resident respects. However, that same technique might not work with other residents. Becchio stresses it’s not necessarily the caregiver’s fault. “You can have the best caregiver who 99 percent of the residents love, but one resident can’t stand her. Sometimes, a certain caregiver works really well with a certain resident, because they know how to handle that person. When you learn how the senior likes to be treated, you can smooth over conflict, or pair the resident with a caregiver who has similar personality traits.”

Mean girls and bullies at assisted living

Just like in high school, assisted living can have its share of mean girls and bullies. Cattiness and aggressive tendencies are not automatically erased as people age.It can be derogatory comments made loud enough for other residents to hear, saving seats in the dining room so a certain resident can’t sit at a table, or all-out shouting matches.

Sometimes, the resolution is as easy as separating people in the dining room, Becchio says. Usually, sitting both residents down with a manager and having a frank discussion diffuses the situation.

The staff may also try to make sure that the person who is feeling ostracized meets at least one companion, someone they connect with and can build a friendship. Having a strong social network that doesn’t include the foe promotes a happier life for seniors.

If the bullying is happening secretly when staff isn’t around, but your parent has complained to you, alert the staff of the assisted living facility right away, Becchio says so the situation can be dealt with. Conversely, the staff should alert family members of any ongoing problems.

Control issues

Sometimes, social manipulation, exclusion and disruptive behaviors have more to do with acquiring power, a feeling of control, at a point in life when older people can feel powerless, says Becchio.

She cites an example of a resident who refuses lunch or dinner nearly every day. “No matter what is placed in front of her, she never likes it; she always wants an alternative.” The staff accommodates such requests – even if they know the behavior is related to control issues.

But if the controlling behaviors are disruptive to other residents and staff, serious measures must be taken to try and resolve the situation. Again, a private meeting with the resident is often helpful. If the behavior continues, bringing a respected family member into the mix can help.

Other causes of behavior problems at assisted living

If these techniques do not work and the bad behavior continues, a psychiatric evaluation may be necessary. Becchio says a resident care director or director of nursing may assess the resident for the onset of dementia. Common symptoms include emotional outbursts, fear, anxiety and abusive language. Some medications, as well as depression can be the cause of changes in personality. Becchio says the ultimate goal is to find out what is causing the behavior and treat accordingly.

How assisted living handles bad behavior

It's hard for many seniors to be dependent on strangers, so it's not uncommon for older adults to complain about their new caregivers, especially initially. Whether or not these complaints are well founded, it's important to hear them out and try to help resolve them.

Becchio says an all-staff meeting is held on a regular basis, with everyone from directors, activities managers, personal caregivers, dining room staff and housekeepers in attendance. Any behavior problems or conflicts are discussed.

Several tactics can help to resolve the problem:

  • Knowing the resident and understanding his or her personality
  • Identifying and eliminating triggers that cause outbursts
  • Addressing resident’s fear and concerns in a supportive manner

Assisted living can evict a disruptive resident

If all attempts to resolve the problems have been exhausted and the bad behavior continues, an assisted living community does have the right to evict a resident. Becchio says this has never happened at Emeritus in Bonita Springs. But every assisted living facility has clauses in its contract that specify in what situations a resident may be asked to leave ("terminate their residence"). Most of the reasons for this have to do with disruptive behavior, dangerous behavior, or the resident not meeting residency requirements for the facility as defined by the state.

Perhaps it shouldn't surprise us that this negative behavior arises in senior residences — people are people, after all, wherever they live. But everyone is entitled to a harmonious place to live. And part of the assisted living staff’s job is to ensure that environment is maintained.

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3 Comments

I've been my MILs caregiver for the past 4 years with little or no help. I just had hip replacement so we were FINALLY able to get part time help. My problem is my MIL is very combative when changing and bathing her and my husband who isn't here thinks its funny. She hits and fights with trying to get her clothes on. She's a maximum assist and does not walk at all and has dementia and is 89 yrs. my husband will not put her in a SNF. Everyday is a struggle to chg and bathe her.
My mother was the bully. She would constantly make derogatory and mean statements about/to her roommate. There was nothing that could be done to stop it - and no, it wasn't alzheimer's or dementia.
Within the assisted living facility that I work in there is a resident that presents Narcissistic/Sociopathic/Personality Disorder... verbal/mental abuse towards caregivers and fellow residents (at the very least fellow residents are a witness to such abuse)... resident refuses a pysch eval... social services are aware... The facility has lost over 25 caregivers, just due to him... reputation of facility has been diminished greatly, just due to him, to the point that all the good caregivers stay away from filling out an application to work at our facility... and still this resident has not been removed from the facility??????