Dealing with Dementia in the Workplace
In the last couple of years, I have
watched both my parents deal with dementia: first, my father who died last year
after dealing with Lewy body dementia in the last years of his life, and more recently,
my mother, who is currently living in “memory care” assisted living because of
Parkinson’s-related dementia. While it has been difficult watching my once very
bright parents deal with severe cognitive declines, I recognize that they were both
fortunate in that they did not begin to suffer from dementia until they were
well into their eighties.
But what happens when someone
begins to experience cognitive decline while they are still working? As the
workforce ages, with many talented men and women in their sixties and seventies
who bring years of experience to their jobs, employers are increasingly having
to deal with a much smaller group of older employees who have not been so
lucky. While only a small percentage of sixty- and early-seventy-year-olds
suffer from Alzheimer’s disease or other forms of dementia, a larger number of
these older workers may suffer from the mild cognitive impairment that often
precedes these more serious forms of dementia. How should an employer respond
when a once valuable employee begins making many serious mistakes that cause coworkers
to question his perception or decision-making skills? This can be especially
important when the employee has a high level of responsibility in the
organization—safety manager, auditor comptroller, director of technology, or
attorney—where the employee’s diminished capacity could create real risks for
Generally speaking, you should never make any
inquiries into an employee’s health or condition. We tell our clients to focus
only the employee’s declining performance as in, “We have noticed that you are
making far too many mistakes …” and leave it to the employee—if the employee so
chooses—to identify any disability or medical condition that may be causing the
performance problems. But an employee with mild cognitive impairment who has
chosen to continue to work may be the least likely to acknowledge the problem.
Nor is this the conversation that most supervisors or human resources managers
want to initiate. Confronting a once brilliant colleague with your concerns
that they may be cognitively impaired is certainly not an easy thing to do.
While I cannot offer a simple
script for handling these situations, having been down this road a few times
with clients, I can share my experience:
- Plan and think about any meeting before you have
it. Who is (or are) the best person (people) to talk with the employee? Make
sure it is someone who has the sensitivity to handle this type of situation. Once
you decide to meet with the employee, it is important that you be honest about
the changes observed and explain why you are concerned. This is especially
important when dealing with employees who owe a special duty to the company.
They need to understand the risks that their lapses may create for the company.
- When you meet with the employee, give the
employee an opportunity to acknowledge the changes and see if they share any of
your concerns. Often, the best way to get someone to acknowledge a problem is
to give them time to do so. Don’t rush the meeting, and resist the urge to fill
any silences. Sometimes, if you give people some time to respond to your
questions, they will.
- If the employee shows some awareness of the
problem, ask if the employee has talked to this family physician or spouse or
significant other about this.
- Come prepared to offer the employee support. Whoever
handles the meeting should be well-versed in the company’s benefits and this
particular employee’s entitlement to those benefits: Is there an Employee
Assistance Program? How much paid leave does the employee have accrued? How
does the disability plan work? What about retiree benefits?
- Learn something about dementia and some of the
progress that has been made in treating it before meeting with the employee.
While I would advise against saying you think that the employee is suffering
from mild cognitive impairment, or even suggesting a diagnosis, if the employee
raises the issue or even acknowledges that they have been diagnosed with mild
cognitive impairment, showing that you have some knowledge about the disease
may be greatly appreciated, although don’t claim to be an expert if you are
- Depending on how the conversation develops, you
may want to consider asking the employee if you can involve the employee’s spouse
or significant other in the discussion of their performance problems,
especially if the employee acknowledges the problem. While
this approach is not typical for any litigation-averse lawyer to suggest (proposing that a spouse come to a meeting at work), this is one of those
unique situations where the standard rules may not apply.
isn’t a checklist for avoiding litigation. Ultimately, your concern should be
the employee’s well-being and, if it is, I don’t think you will need to worry