I have long said that to the extent I have any wisdom, most of it is the consequence of my mistakes and my abundance of scar tissue. This article reflects both, and my speculation is that much of what I say will resonate with most of the readers as well. While it is not a new medical reality, the fact that our population is aging and many older people remain in positions of responsibility, coupled with an explosion of memory care facilities, has caused this topic to have increased visibility on our personal and professional radar screens. In my circle of friends and colleagues, this has become a significant factor in our personal lives and in many of our workplaces.

For this article, I will use the term “cognitive decline” to describe various behaviors associated with varying degrees of confusion or memory loss. I certainly do not have the ability to discuss the various medical conditions that cause or contribute to cognitive decline. I am a consummate layman on medical issues.

For me personally, the last couple of years have placed some serious challenges on my plate related to persons in cognitive decline, one involving a decades-long dear friend and the other a wonderful nonprofit organization that I have long admired and been associated with. In both instances, there was an appreciable delay in recognizing the reality of cognitive decline, and an increase in the severity of the consequences because of the delayed recognition.

The first involved a retired career federal investigator. He was a man of considerable means, a collector of weapons and historical memorabilia, and a person with a well-deserved reputation of repetitive corny jokes. As someone who was close to him, I was among the last to recognize the cognitive decline — no doubt influenced by years of hearing foolish jokes and because I was involved solely in social activities with him, without exposure to his actions in financial or detailed types of interactions. When I recognized the condition, with the help of others, I spent quite a lot of time wrestling his car and driving privileges away from him, trying to identify and resolve some really bad financial transactions, and finally finding and removing the many firearms from his home following a near-catastrophic accidental discharge. Within days we were able to get him into a memory care facility, and within several months he passed away. I remain saddened and ashamed of my delay in recognizing my dear friend’s condition.

The second situation involved a wonderful nonprofit organization where I have a decades-long history of affiliation. Because of long personal and professional associations with the president and the chief financial officer (CFO), and the fact that most of the trustees are busy people with other careers, the board pretty much deferred without question to the actions of the president and the CFO, both of whom had some level of cognitive decline. I am once again ashamed to acknowledge that, up until the last couple of years, I was among the trustees who had their heads in the sand. Although it took a couple years of digging, insisting, interviewing and ultimately gaining control of financial records, the board ultimately determined that the president and CFO had long been making financial decisions, many of which were really bad, without knowledge or approval of the board of trustees, which the bylaws mandated. Add to this situation a greedy trustee who covertly ingratiated himself with the above duo to provide unnecessary or inflated services, and the fact that the president’s daughter, whom he had hired to perform some administrative services, gradually stole a considerable amount of money from the organization via her father’s organizational credit card.

Unfortunately, as I look back on my law enforcement and military careers, I now see more clearly several situations where cognitive decline may well have played a role — not only involving troublesome behavior on the part of leaders, but also contributing to the decreased diligence of members of the organizations. Although I’ll save those situations for subsequent columns, I can reflect on several law enforcement support councils where cognitive decline, greed, weak oversight and mischief came together to create very problematic situations for the agencies.

The only thing worse than a troublesome situation is a troublesome situation that we ignore and fail to learn from. Not having seen much on the cognitive decline topic in the law enforcement arena, but recognizing that it is becoming a major issue in all professions, I offer the below described expensive lessons on this topic. While seemingly simple and obvious, the issue of cognitive decline becomes more recognizable when the several factors are viewed collectively. I wish that I had possessed the following knowledge and perspectives earlier in my career.

Is cognitive decline restricted to older persons?

No, but the reality is generally that, as we age, the likelihood of some degree of cognitive decline increases. In the event of behaviors consistent with cognitive decline in younger persons, don’t rule it out, but also be sensitive to other factors, such as weak training or flawed leadership.

Is cognitive decline easily recognizable?

No, and that is among the reasons why it is such a difficult issue to identify and address. A reality of life, quite aside from medical cognitive decline, is that as we all age there are predictable factors involved, such as slowing down a tad, often spending additional time reflecting on issues and, my favorite, occasionally stumbling with names. Being able to distinguish between the normal aging process and impactable cognitive decline is nearly impossible, because we all decline with age; it is just a matter of when and to what degree! This transition period is often referred to as mild cognitive impairment (MCI).

What are the recognizable signs of mild cognitive impairment?

Mild cognitive impairment is signaled by behaviors — often self-acknowledged by the individual — where there is some slippage in the memory function or slight delays in processing some information. However, these changes are realistically not serious enough to adversely impact daily life or usual activities.

What are the recognizable signs of mild cognitive decline?

As a person advances in cognitive decline, the symptoms may include forgetting things more often, missing planned events, interruption in trains of thought, “drifting” in conversations, difficulty in conversations and following instructions, and some flawed decisions.

What are the impediments to recognizing cognitive decline?

A person in cognitive decline who exhibits the above symptoms will be recognized by others with whom they are in contact. In my experiences, the biggest factor that stands in the way of recognition is when persons actively work to conceal the decline from others. This can take several forms, such as a member of a family organization, a long-term secretary or a loyal employee. Most often, however — again, based on my experiences — the concealment is for selfish reasons by persons or employees who may lose positions, accounts, contracts or organizational standing if the person in decline is replaced in the organization.

There is no shortage of historical examples of people or organizations who have worked hard, and often effectively, in concealing the serious cognitive challenges of prominent individuals. Without discussing partisan bias, the most recent example of the serious concealment of cognitive decline has been with the president of the United States, where millions of people were denying what they were observing based on partisan politics. A classic example for the law enforcement profession was the decades-long director of the Federal Bureau of Investigation who in later life ruled with a bizarre manner through several presidential administrations.

Organizations for which cognitive decline is particularly critical

The issue of cognitive decline is a factor in every organization, but more conspicuously so in some special instances. Some of the occupations where the recognition of cognitive decline results in immediate actions include the airlines for pilots, medical associations for physicians, the federal government for air traffic controllers and financial institutions for investment personnel.

Recognition and courage

In its simplest form, leadership involves recognizing and solving problems, and the issue of dealing with a key person who occupies a position of responsibility and who appears to be declining cognitively puts these skills to the test, along with perhaps the most critical skill of all: courage. Those of us in positions of responsibility have the right, but more importantly the duty, to create and maintain appropriate workplaces, and I can think of few factors more important than the intellectual and behavioral stability of leaders.

I am hard-pressed to think of a more challenging task than addressing and resolving the issue of a leader in cognitive decline, especially if they are your boss, but you have to do it! There is no instruction manual for this task, and every approach may be fraught with pitfalls, but that is where good judgment, interpersonal relationships, professional credibility, organizational skills, finesse, courage and common sense are all likely required for an appropriate resolution.

There is a reason for gold watches and emeritus designations! 

Good luck!