Elder Law Prof Blog

What Are Your Examples of Scarecrow Laws?

I'm working on a book chapter about filial support laws, where families (usually adult children) may be surprised to learn that their state or their country has a seldom-used law that mandates financial support or maintenance for indigent family members. In working on this chapter, I was considering using the concept of "scarecrow laws" as a metaphor.  This label can apply to laws which are seldom enforced but legislators resist repeal because the very existence of the law might serve as a warning -- a scarecrow -- about the consequences of bad behavior.

While working on the metaphor, I came across an interesting application from Shakespeare's play, Measure for Measure.  In Act 2, Scene 1, we hear a harshly ambitious deputy administrator calling for the ultimate punishment -- beheading -- of Claudio, a man convicted of a crime.  But the law in question, prohibiting sexual relations outside of sanctioned marriage, is "rarely enforced."  One of Angelo's subordinates objects to the harsh sentence. Angelo responds:

We must not make a scarecrow of the law,

Settling it up to fear the birds of prey,

And let it keep one shape, till custom make it 

Their perch and not their terror.

The irony is that Angelo also seeks to violate the same law with a woman who has attracted his attention, but he discounts his own admission as, so far, mere temptation.  

Shakespeare's use of the scarecrow characterization raises a legitimate question.  Should laws, little known and rarely enforced, be removed from the books, or allowed to remain, perhaps on the justification they serve as moral guidance?  

Old Age Doesn't Have to Be a "Downer"

Professor Richard Kaplan sent me a link to a recent book review in the Wall Street Journal ‘Breaking the Age Code’ Review: Riding High Into the Sunset.

Social psychologist Becca Levy spends much of “Breaking the Age Code” doing exactly that, weaving together case studies and her own research to demonstrate that old age doesn’t have to suck at all. The expectation that aging means decay, Ms. Levy shows, is actually a major reason it so often does—our negative view of aging is literally killing us. Chipping away at this widespread and deeply ingrained conviction has a measurable effect on health after just 10 minutes. ... n 2002 Ms. Levy combined results from the Ohio Longitudinal Study on Aging and Retirement with data from the National Death Index to reveal that, on average, people with the most positive views of aging were outliving those with the most negative views by 7½ years—an extraordinary 10% of current life expectancy in the United States. 

The author discusses factors that make us prone to negative views of aging, and in particular, the prevalence of ageism. However, the author goes on to address how to change our thinking to "break the age code."

Ms. Levy finishes with a vision of paradise: “A place where ageism does not exist.” But this is no idle fantasy, it’s Greensboro, Vt. She stops for homemade lemonade with an 81-year-old writer for the local paper and swims at Caspian Lake with a real-estate agent in her 80s. When older people and society around them are “harmonized in a productive way,” Ms. Levy continues, it shows how “aging can become a homecoming, a rediscovery, a feast of life.” Or—as Grandpa Eddie puts it after his adventure has left him closer to Spencer than ever before—“Getting old is a gift.”

I'm ordering the book!

 

Important Report on Nursing Homes from the National Academies

I've been a bit behind on posting and although this report was released 8 days ago, I wanted to be sure readers were aware of it. The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff was released by the National Academies on Sciences, Engineering, and Medicine. Here is the description

Nursing homes play a unique dual role in the long-term care continuum, serving as a place where people receive needed health care and a place they call home. Ineffective responses to the complex challenges of nursing home care have resulted in a system that often fails to ensure the well-being and safety of nursing home residents. The devastating impact of the COVID-19 pandemic on nursing home residents and staff has renewed attention to the long-standing weaknesses that impede the provision of high-quality nursing home care.

With support from a coalition of sponsors, the National Academies of Sciences, Engineering, and Medicine formed the Committee on the Quality of Care in Nursing Homes to examine how the United States delivers, finances, regulates, and measures the quality of nursing home care. The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff identifies seven broad goals and supporting recommendations which provide the overarching framework for a comprehensive approach to improving the quality of care in nursing homes.

You can download the report as pdf or read it online for no charge. You can buy a hard copy from this link.

Thanks to Morris Klein for alerting me to the release of this report.

Sad News: The Passing of Civil Rights Advocate Lani Guinier, Reportedly of Complications of Alzheimer's

I read the news late on Friday of the passing of Lani Guinier and it was especially sad to learn that family members reported her death, at just 71, was due to "complications of Alzheimer's disease."  That report made me realize that I hadn't heard from her on the important civil rights issues of the last few years -- and this history probably explains why.  Nonetheless, her teaching, her writing, her advocacy in court and in the field on behalf of civil rights, on voting rights, on student empowerment (often on behalf of women in law school classrooms, urging them them to speak out) will continue to impact the nation.  In her 2002 book, The Miner's Canary -- sitting nearby on my shelf --  cowritten with Gerald Torres, the conclusion resonates with equal strength in 2022:   

We credit the civil rights movement and the liberal legal model to the extent that each created a space for progressive politics and reduced racism as conventionally defined.  This tolerance model has made alliance possible that were once unthinkable.  But the civil rights movement too often seems to measure progress by looking backward; we want to shift the focus to where we are going, not how far we have come.  In the past, conventional ideas of race were deliberately tied to issues of social policy in order to make programs of general concern sound like special pleading.  Our response is to reclaim race in order to "complete" democracy."  

With grateful feelings, and remembering her as a role model for so many, we will miss her.  

Have You Taken A "Getting Old Inventory"?

Jane Brody wrote an article a few weeks ago for the New York Times, How to Age Gracefully. The catalyst for the article is a new book, “Stupid Things I Won’t Do When I Get Old, the title of which really appealed to me!  The book inspired her to take an "inventory of my life and started at the top, with my hair. I’d been coloring it for decades, lighter and lighter as I got older. But I noticed that during the pandemic, many people (men as well as women of all ages) had stopped covering their gray. And they looked just fine, sometimes better than they did with hair dyed dark above a wrinkled facade. Today, I too am gray and loving it, although I can no longer blame my dog for the white hairs on the couch!"  She also changed her attitude about her clothing and use of makeup. She also discusses things she won't stop doing just because of her age, some of which observers might consider risky behavior. As she observes, "[s]ooner or later, we all must recognize what is no longer possible and find alternatives... [and has] vowed to stop talking to whoever will listen about my aches, pains and ailments, what [the book's author] called the “organ recital.” It doesn’t provide relief — in fact, it might even make the pain worse. Rather than instill empathy, the “organ recital” likely turns most people off, especially young ones."  She discusses two more major hurdles she will tackle, clutter and driving.  She offers this quite lovely advice for us "Live each day as if it’s your last, with an eye on the future in case it’s not...."

Highlights from Touro Conference on Aging, Health, Equity, and the Law (9.13.21)

Touro College's Jacob Fuschberg Law Center hosted a fabulous half-day, interdisciplinary program on Aging, Health, Equity and the Law.  Among the highlights:

• A perfect kickoff with opening remarks on the theme of the conference from Syracuse Law Professor Nina Kohn, who outlined the civil rights of older persons, reminding us of existing laws and the potential for legal reforms;
•  A unique "property law" perspective on the importance of careful planning about ownership or rights of use, in order to maximize the safety and goals of the older person, provided by Professor Lior Strahilevitz from University of Chicago Law School;  
• Several sessions formed the heart of the conference by taking on enormously difficult topics arising in the context of Covid-19 about access to health care, including what I found to be a fascinating perspective from Professor Barbara Pfeffer Billauer  from her recent work in Israel. She started with an interesting introduction of three specific pandemic responses she's identified in her research. She then focused on how "Policy Pariah-itizing" has had a negative effect on health care for older adults, with examples from Israel, Italy, and China.  I was also deeply impressed by the candid presentations of several direct care providers, including nursing care professionals Esperanza Sanchez and Nelda Godfrey, about the ethical issues and practical pressures they are experiencing; 
• Illinois Law Professor Dick Kaplan offered  timely perspectives on incorporating cultural sensitivity in Elder Law Courses.  His slides had great context, drawing in part from an article he published about ten years ago at 40 Stetson Law Review 15;
• Real world examples about tough end-of-life decisions involving family members and/or formally appointed surrogates, with Deirdre Lock and Tristan Sullivan-Wilson from the Weinberg Center for Elder Justice leading breakout groups for discussions.

I know I'm failing to mention other great sessions (there were simultaneous tracks and I was playing a bit of leap-frog).  But the good news is we can keep our eyes out for the Touro Law Review compilation of the articles from this conference, scheduled for Spring 2022 publication.  I know it was a big lift to pull off the conference in the middle of the fall semester.  Thank you!

What Happens When You Are "Widowed," Not by the Death of Your Spouse, But By Alzheimer's?

New York Times Magazine has an Ethicist Columnist and recently the topic was "My Stepdad Has Alzheimer's. Can My Mom Date Someone Else?"

The adult child who raises the topic explains that her mother was a long-standing, full-time caregiver for her husband, who's early-onset diagnosis of Alzheimer's had deepened to the point that he was transferred to a more appropriate, assisted-living setting.  Lonely and missing companionship, the mother began dating another man.  On the one hand, the ethicist was tackling the concern about the appropriateness of the couple "dating."  The deeper concern, however, appeared to be that the man the mother was dating might not be a good choice, and potentially even an unsafe choice, and the family disapproved.

On the question of "dating" while still married to a spouse with dementia, the ethicist, Kwame Anthony Appiah (who teaches philosophy at NYU), makes the startling, but apt, observation about de facto widowhood:  

Making sure that a spouse is cared for is one commitment that marriage entails and, having served as a full-time caregiver, your mother has clearly done so, at real personal sacrifice. But we should not want our spouses to abjure the companionship of others once we are no longer available to them. Indeed, nobody in your family has the right to expect this of her. The painful truth is that her status is ethically equivalent to that of a widow.

The comments posted after the article in response to the ethicist's discussion are also interesting, including what sprang to my mind, a recommendation of  a sensitively-made movie directed by Sarah Polley, based on the author Alice Monroe's novel with the same title, Away from Her. 

 

New Documentary on Death With Dignity

Published recently in the Washington Post,  Diane Rehm tackles ‘death with dignity’ again, this time in a new documentary. "In 2016, Diane retired from NPR station WAMU after working there for more than 30 years. Since then, she has championed what she and other advocates call “death with dignity.” On Wednesday, PBS will broadcast her new documentary, 'When My Time Comes.'"  The article is a Q&A with the author about her book and the resulting documentary. Check it out!

Social Isolation and Loneliness in Older Adults Opportunities for the Health Care System

The National Academies of Science, Engineering and Medicine has issued a new report,  Social Isolation and Loneliness in Older Adults Opportunities for the Health Care System.

Here's the description

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual’s circumstances and perceptions.

A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults.

Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

You can download a pdf of the book for free, or order a hard cc here.

Ann F. Baum Memorial Elder Law Lecture

Happen to be in the vicinity of the U. of Ill. School of Law on Monday? If so, be sure to stop by to listen to the Ann F. Baum Memorial Elder Law Lecture at noon est.  The speaker is  Omri Ben-Shahar - University of Chicago Law School who will speak on Personalized Elder Law.

 

New Book on Estate Planning

Looking for that perfect gift for the Boomer in your life?  Check out this new book, just for Boomers.  Harry Margolis has published Get your Ducks in a Row: The Baby Boomers Guide to Estate Planning. The book is available for purchase on Amazon.

The website provides this summary

If  you’re over 55, you probably know you need an estate plan. What you might not know is how to create one. Questions about cost, confusion about options, and difficulty talking about subjects like disability and death can make the process of preparing for the future seem overwhelming. That’s probably why most people put it off—even though the results of doing nothing can sometimes be devastating.

What you need is a guide that explains the process clearly and comprehensively, in terms you can understand and actually use. Get Your Ducks in a Row: The Baby Boomers Guide to Estate Planning tells you everything you ever wanted (or perhaps never wanted) about estate planning.

Written by elder law and estate planning expert Attorney Harry S. Margolis, Get Your Ducks in a Row: The Baby Boomers Guide to Estate Planning takes you through the estate planning process step by step. Whether you’re currently creating a plan, getting ready to start, or looking for an explanation of documents you’ve already signed, this book will provide the information you need, including:

• Answers to the most common estate planning questions
• Common estate planning terms, demystified
• The Five (or Six or Seven) Essential Documents everyone over 55 needs (and how to fill them out)
• An overview of more complex estate planning scenarios
• Help deciding when it’s time to consult an attorney
• And more...

Featuring practical advice and easy-to-follow examples gleaned from the author’s 30-plus years of experience in elder law and estate planning, Get Your Ducks in a Row: The Baby Boomers Guide to Estate Planning will help you take control, make a plan, and ensure your family—and yourself—a secure and comfortable future.

The book is divided into 3 sections:  (1) "The Five or Six or Seven Essential Documents, (2) Special Situations in Estate Planning and (3) Creating a Plan.  Each section has a number of chapters addressing relevant topics. I particularly liked chapter 6, "'Bonus' essentials," which covers beneficiary designations, digital assets, bank and investment accounts, life insurance and more.  The conclusion notes that all of us need to have an estate plan, but many folks don't--for various reasons---, and there are limits, and risks, to folks doing their planning without an attorney's guidance. Harry closes the book with this: "[f]inally, it's time for baby boomers to plan. It can make all the differ3ence for your family. don't wait. Enjoy the process."

PS, In the interest of full disclosure, I've known Harry for a long time. He's a prolific writer in the field of elder law.

Do You Have A When I Die File?

Do you have your estate planning documents done? Made funeral arrangements? Think you have everything covered? Well, did you make a "when I die file?"  According to an article in Time magazine, Why You Need to Make a 'When I Die' File—Before It's Too Late this file is likely

the single most important thing you do before you depart. It may sound morbid, but creating a findable file, binder, cloud-based drive, or even shoebox where you store estate documents and meaningful personal effects will save your loved ones incalculable time, money, and suffering. Plus, there’s a lot of imagination you can bring to bear that will give your When I Die file a deeper purpose than a list of account numbers. One woman told us she wants to leave her eulogy for husband in the file, so she can pay homage to him even if she goes first.

Without such a file, the process of compiling the information can be time-consuming and emotionally draining for the family. Here are some of the tips from the article

First, call the companies behind your cable, internet, cell phone, club memberships, and anything else that bills for services on an ongoing basis and add your partner or kids to the account as a joint owner. If billing accounts are not in both your and a loved one’s name, your survivors will end up spending hours on the phone and in offices begging bureaucrats to shut them down or convert the accounts to their name so they can manage them. Think of every frustrating call you’ve had with your cell provider, and then multiply it by 10.

***

Here are a few of the things you’ll put into your “When I Die” file:

□ An advance directive that’s signed (and notarized if necessary)

□ A will and living trust (with certificate of trust)

□ Marriage or divorce certificate(s)

□ Passwords for phone, computer, email, and social media accounts

(We recommend using an online password manager to collect them all, sharing the master password with someone you trust, and then designating emergency contacts within the program who are allowed to gain access.)

□ Instructions for your funeral and final disposition

□ An ethical will

□ Letters to loved ones

There is more information about the file in the book on which this article is based, Beginner’s Guide to the End. 

French Right to Die Case Comes to an End

Previously I had blogged about the legal battle over removing life support from Frenchman, Vincent Lambert. The New York Times reported recently on his death, Vincent Lambert, Frenchman at Center of Right-to-Die Case, Dies at 42.

His family and his spouse disagreed on his wishes. "His wife, Rachel Lambert, said that he had clearly stated that he would not wish to live in a vegetative state. His parents argued that ending his life support amounted to the murder of a disabled person. Siblings and other family members took different sides in the dispute."  As the article notes, "[e]uthanasia and assisted suicide are illegal in France. But the law allows patients who are terminally ill or injured with no chances of recovery to decide to stop treatments if the measures “appear useless, disproportionate” or if they seem to have no other effect than 'artificially maintaining life.'"  An article about the final court decision is available here.

In a related matter, the Judge for the Florida Schiavo case has written a chapter for a book, as explained in this article:

Inside the Terri Schiavo case: Pinellas judge who decided her fate opens up.  You should read it.

Ageism in Medicine? One Doctor's Thoughts

Kaiser Health News (KHN) ran a story last month, A Doctor Speaks Out About Ageism In Medicine.

Society gives short shrift to older age. This distinct phase of life doesn’t get the same attention that’s devoted to childhood. And the special characteristics of people in their 60s, 70s, 80s and beyond are poorly understood.

Medicine reflects this narrow-mindedness. In medical school, physicians learn that people in the prime of life are “normal” and scant time is spent studying aging. In practice, doctors too often fail to appreciate older adults’ unique needs or to tailor treatments appropriately.

The story focuses on a new book by a doctor, “Elderhood"  which is "an in-depth, unusually frank exploration of biases that distort society’s view of old age and that shape dysfunctional health policies and medical practices." The rest of the article is a Q&A interview with the author focusing on her idea of "elderhood", how she sees her concepts working, and ageism.  Using an anecdote, the author offers it as an example of "ageism: dismissing an older person’s concerns simply because the person is old. It happens all the time."  Here is another example the author offers

Recently, a distressed geriatrician colleague told me a story about grand rounds at a major medical center where the case of a very complex older patient brought in from a nursing home was presented. [Grand rounds are meetings where doctors discuss interesting or difficult cases.]

When it was time for comments, one of the leaders of the medical service stood up and said, “I have a solution to this case. We just need to have nursing homes be 100 miles away from our hospitals.” And the crowd laughed.

The interview does have some optimistic insights, including "the age-friendly health system movement, which is unquestionably a step in the right direction. And a whole host of startups that could make various types of care more convenient and that could, if they succeed, end up benefiting older people."

Advance Directives: Counseling Guide for Lawyers

The American Bar Association Commission on Law & Aging has published the   Advance Directives: Counseling Guide for Lawyers. The website explains the usefulness of the guide: "designed to assist lawyers and health care professionals in formulating end-of-life health decision plans that are clearly written and effective... The guide provides detailed information on how to bridge the chasm between lawyers and health care providers. It helps lawyers to provide guidance that is more in harmony with the clinical and family realities that clients face. The foundation for it is a set of eight principles to guide patients and clients through the advance care planning process." The three sections include the planning principles, a checklist for attorneys, and resources.  All are available for download individually, or the entire guide may be downloaded for free or purchased from the ABA.  The guide contains a lot of helpful info for attorneys, including checklists for a first and second interview, a sample letter to the client's doctor and a HIPAA access form. Check it out! 

 

It's Friday: Words About a Poet in His 9th Decade

Donald Hall, poet, essayist, husband of poet Jane Kenyon, and more, died this year at the age of 89.  As someone who appreciates both poems and horses, I found one of Hall's middler-year poems, Names of Horses, an early touchstone. It reads just as well as a tribute to old age as it once did for me as a bittersweet ode to a form of civilization passed by.

The New York Times critic Dwight Garner writes a cranky review of  Hall's last book, published posthumously, making sure we remember that Hall was both prolific and, well, cranky: 

Hall lived long enough to leave behind two final books, memento mori titled “Essays After Eighty” (2014) and now “A Carnival of Losses: Notes Nearing Ninety.” They’re up there with the best things he did. He apparently managed to sidestep a rendezvous with dementia, and seemed to suffer only mildly at the end from what Christopher Hitchens, quoting a friend, termed CRAFT syndrome, printable here as Can’t Remember a Fizzling Thing. These books have flat-footed gravitas, a vestigial sort of swat that calls to mind Johnny Cash’s stark final records with the producer Rick Rubin.

 

Which isn’t to say they are not also full of guff. About a third of “A Carnival of Losses” is threadbare and meandering, memories of dead relatives and journeys abroad and anthologies past. But the other two-thirds are good enough to make clear that Hall did not live past his sell-by date as a writer. He brings news from that moment in life when the canoe is already halfway over the waterfall.

For more, read A Poet Laureate Sends News From the End of Life.    

 

The Future For The Aging Demographic?

The National Academies Press has released Future Directions for the Demography of Aging.This volume contains the proceedings of a workshop and the overview explains

Almost 25 years have passed since the Demography of Aging (1994) was published by the National Research Council. Future Directions for the Demography of Aging is, in many ways, the successor to that original volume. The Division of Behavioral and Social Research at the National Institute on Aging (NIA) asked the National Academies of Sciences, Engineering, and Medicine to produce an authoritative guide to new directions in demography of aging. The papers published in this report were originally presented and discussed at a public workshop held in Washington, D.C., August 17-18, 2017.

The workshop discussion made evident that major new advances had been made in the last two decades, but also that new trends and research directions have emerged that call for innovative conceptual, design, and measurement approaches. The report reviews these recent trends and also discusses future directions for research on a range of topics that are central to current research in the demography of aging. Looking back over the past two decades of demography of aging research shows remarkable advances in our understanding of the health and well-being of the older population. Equally exciting is that this report sets the stage for the next two decades of innovative research–a period of rapid growth in the older American population.

Part 1 looks at trends in health and health disparities, Part 2 examines the implications of social and environmental factors, Part 3 covers families and intergenerational issues, Part 4 covers employment and retirement, Part 5 discusses cognitive issues and disability, Part 6 reviews global aging and Part 7 offers new approaches. You can purchase the softcover book here, download a free pdf of the book by clicking here or read the book online.

 

AARP's 2018 Where We Live: Order Now!

AARP's 3rd edition (2018) of Where We Live: Communities for All Ages is available for pre-order now.  You can request one hard copy free, following these instructions

1. Email [email protected] with the subject line: Where We Live 2018

2. In the email body, include:

• your name

• street address 

• town/city, state, zip code

• publication number D20439

Bulk orders may also be possible. If you prefer to read the report online, a link to the pdf of the report will be available on June 13, 2018, here.

Sci Fi Friday: Recommending Short Story "Today I Am Paul"

Of course, I'm supposed to be finishing my exam grading.  Instead, while stopping by my office, I find a copy of a short story from one of my colleagues.  The accompanying note says,"Not even my sci-fi 'escape' is untouched by elder care issues.  Thought you'd get a kick out of this."

And indeed, I do.  I definitely recommend "Today I Am Paul," by Martin L. Shoemaker.  The author draws upon his personal experiences in visiting his mother-in-law in a nursing home to craft a true tale ... with a difference ... as the narrating caregiver is an android.  

While my printed-page-loving self recommends reading the short story, I also found a great podcast of the story being read aloud by Kate Baker and I'm linking it here, from Clarkesworld Magazine.  

I now plan to use this story to introduce my Elder Law course in the autumn.  So much to talk about, including the roles of family, caregivers, technology, fear.....   I suspect my co-blogger Becky Morgan, with her often expressed enthusiasm for tech including driverless cars, will appreciate this story too.  Happy reading or listening for Memorial Day weekend!

Many thanks to Dickinson Law Professor Matthew Lawrence for this unique, caring experience.  

"Bullying in the Nursing Home" -- Getting Beyond the Headlines

News publication sites affiliated with USA Today and the Associated Press have been running a recent piece on "bullying" among older persons, often with a provocative headline such as "It's like 'Mean Girls,' but everyone is 80": How nursing homes deal with bullies.   The title undoubtedly catches many a reader's eye, simply because of the heightened discussions of bullying at a national level, including Melania Trump's recent announcement of her Be Best platform for younger persons.  The topic isn't actually all that new from a journalism perspective.  Paula Span wrote on "Mean Girls in Assisted Living" for the New York Times in 2011, and the same publication carried a granddaughter's Op Ed on "Mean Girls in the Retirement Home" in 2015.   

On a parallel track, and perhaps more disturbing, are reports of bullying among nurses, a profession normally associated with empathy and caring.  See e.g., "When 'Mean Girls' Wear Scrubs," a 2013 post on DiversityNursing Blog, tracking a several studies and a book.  

More important than the clever headlines, however, are the reports of affirmative efforts to counter the bullying, which at the older end of the spectrum of life, seems to focus on name-calling, gossip, and ostracising behavior, rather than physical intimidation.  From the most recent USA Today writer's article:  

After the cafeteria exiles and karaoke brouhahas, the 30th Street [Senior] Center [in San Francisco]  teamed up with a local nonprofit, the Institute on Aging, to develop an anti-bullying program. All staff members received 18 hours of training that included lessons on what constitutes bullying, causes of the problem and how to manage such conflicts. Seniors were then invited to similar classes, held in English and Spanish, teaching them to alert staff or intervene themselves if they witness bullying. Signs and even place mats around the center now declare it a “Bully Free Zone.”. . . 

 

Robin Bonifas, a social work professor at Arizona State University and author of the book “Bullying Among Older Adults: How to Recognize and Address an Unseen Epidemic,” said existing studies suggest about 1 in 5 seniors encounters bullying. She sees it as an outgrowth of frustrations characteristic in communal settings, as well a reflection of issues unique to getting older. Many elderly see their independence and sense of control disappear and, for some, becoming a bully can feel like regaining some of that lost power.

I think that last line rings true.  I've certainly seen older adults sudden strike a "meaner" demeanor as their freedom is limited by physical  health issues and as their frustrations increase.  But I also think it can be important to assess whether a "mean" trait -- or at least a "meaner" dynamic -- is a reflection of cognitive impairment, such as disinhibition associated with certain types of neurocognitive impairments.   

On an even more worrisome level, is there a danger of misinterpreting fear or irritation as "meanness," perhaps arising from compelled interactions in a congregated living situation?   In one instance, I've seen an older woman who had regularly chose to sit with the same group of 3 other individuals at meals for several weeks, suddenly reject one member of their informal club.  It took careful listening to realize the rejection was actually uneasiness bordering on fear -- on some level not completely rational -- but associated with that targeted individual's tendency to wander at night into others' rooms and thus to lead the "mean girl" to try to keep the other away from her around the clock.  Targeting the "bullying" behavior could be addressing the wrong problem in the latter case.  

Finally, I think there is a danger associated with the admittedly clever tendency to use the "Mean Girls" movie as the analogy for older bullying, thus implying this is only an issue (and problem) associated with women, not men.  As a later paragraph in the most recent article makes clear, bullying behavior among older adults is not "just" about women. But perhaps that is obvious from the larger national news?