June is Brain Awareness Month. With rising rates of dementia, many of us might find ourselves in a position to help a colleague — if we know what to do.
This material has been updated from a previous post titled “I’m Concerned that My Colleague Might Be Developing Alzheimer’s. What Should I Do?” (October 2014), which now redirects here.
As the workforce ages and baby boomers move toward and enter retirement, there has been an increase in cases of dementia among those active in the workforce. Alzheimer’s disease is the most common cause of dementia. It is a progressive disease that worsens with time and affects the person’s mental functioning in multiple areas. Symptoms often include impaired memory (e.g., difficulty remembering common words, people, recent events), declining mental functioning (e.g., difficulty doing simple math, disorganization, confusion), and changes in mood and behavior (e.g., mood swings, agitation, social withdrawal, personality changes, change in sense of humor). Alzheimer’s disease is usually thought of as a disease that occurs in older adults (onset after 65 years old), but a small percentage of cases occur in those under 65 (called younger-onset).
If you are concerned about a friend or colleague, the first thing to do is to talk with them to see if there is another reason for the changes that you are observing. For example, memory issues and changes in mood are commonly caused by poor sleep (other possible causes include medication side effects, alcohol abuse, stress, anxiety, and depression, just to name a few). For example, anyone with small children at home will know firsthand how poor sleep can dramatically impact your memory and word-finding abilities. Therefore, approaching your colleague with your objective concerns, and asking if they have noticed the same changes, is a good place to start. Often, people who are developing dementia might minimize, rationalize, or try to compensate for the changes in their functioning. This, along with a fear of the unknown, can sometimes result in the person feeling defensive or anxious. In addition to these factors, attorneys experiencing cognitive decline are also concerned about their financial wellbeing, their reputation, and their identity as a lawyer. This is why a supportive, kind, and genuine approach is best. If you do not feel as though you have a close relationship with your colleague (and you think approaching them might not be seen as helpful), I recommend involving trusted colleagues/friends/family members of the colleague for which you are concerned. An example of an appropriate conversation can be found here.
But let’s be honest, most people who observe a colleague declining in their ability to practice will most likely do nothing. It’s normal to feel like “someone else” must know more about the situation than you, or that “someone else” who knows the person better is probably handling it. In reality, it is part of our professional (and personal) responsibility to take action to help a colleague who is struggling. Early intervention and treatment leads to better outcomes. Intervening sooner rather than later can result in addressing smaller problems before they become larger problems, getting the treatment they need, coming up with creative supports to allow the person to continue working in a different capacity, or actively planning for retirement/handing cases off to another lawyer. Helping a colleague address issues of cognitive decline will offer them the opportunity to respond in a manner that protects their professional reputation, their dignity, and it helps to protect the public who rely on competent representation.
At times, an impaired lawyer might not be receptive to the concerns voiced by a colleague or friend. These situations are especially difficult for the attorney involved and those trying to help. While the best outcome or response from your colleague is not guaranteed, avoiding the problem usually makes it worse. If your colleague is receptive to your concerns, recommending that they get a physical examination from their primary care physician (PCP) is a great starting point. To be diagnosed with dementia, a person needs to be evaluated by a neurologist (which can be facilitated by their PCP).
If you feel unsure about how to help a colleague in need, give us a call at LCL and we can work with you to come up with some helpful options. As a very last resort, you may need to seek help from the Board of Bar Overseers (BBO) to help define the obligations of everyone involved. A softer-touch approach might be to recommend that your colleague contact us, which may facilitate them obtaining the health care necessary to allow them to adjust to their new situation.
Regardless of the eventual outcome, it is always best to act on your concerns rather than ignore them or hope that someone else will step in. At the very least, talk to other colleagues to see if others share your concerns. Next, a simple statement of concern can be the impetus for change. For example, my colleague could approach me and say, “Hi, Shawn. How have things been going for you lately? I’ve noticed that you’ve been having a little difficulty with remembering common procedures that we use every day. Is everything OK?”
If you have questions about how to approach a colleague in the legal profession that you are concerned about, we’re just a phone call away — (617) 482-9600.
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Lawyers, law students, and judges in Massachusetts can discuss concerns with a licensed therapist, law practice advisor, or both. Find more on scheduling here.