Employees' mental health is a big concern, especially now because of the negative impact the pandemic has on mental health. But what do you do when an employee seems to be forgetful? What about when you notice a decline in their ability to do their job?

For example, what about an employee who

  • Forgets procedures they've done for years?
  • Seems confused?
  • Gets lost going places they've been to before?
  • Repeatedly asks the same questions, even if they've received the answer?

These are all signs of the onset of dementia. The World Health Organization estimates that 5 to 8 percent of people over 60 suffer from some form of dementia, but it can begin much earlier--in people's 30s, 40s, or 50s. So, what do you do if you notice an employee who seems to be struggling?

Approach it from a performance standpoint

It's unlikely that you are qualified to diagnose dementia in any form, but you are capable of diagnosing a performance issue. So, before you jump to any conclusion about someone's mental capabilities, start with performance. For instance, you can say, "Jane, you've been doing this job for five years, and yet you seem to be struggling with the procedures. We need to fix this. Do you have any ideas?"

Let the person bring up that they are struggling with memory before you make that call. Sometimes they will, and then it's easy enough to suggest they meet with their doctor. 

Follow ADA guidelines

Sometimes, of course, the employee will deny having a problem. If you can clearly see one and (the and is very important) it's interfering with their work performance, you can require an exam. The Americans With Disabilities Act (ADA) prohibits employers from requiring medical exams except when it is  "job-related and consistent with business necessity."

By documenting how the employee's forgetfulness affects their job, you can require a medical exam. Before doing this, consult with your HR department (if you have one) or your employment attorney (if you don't have an experienced HR person). You want to make sure you follow the law.

The guideline from the Equal Employment Opportunity Commission is that when the employer "has a reasonable belief, based on objective evidence, that: (1) an employee's ability to perform essential job functions will be impaired by a medical condition; or (2) an employee will pose a direct threat due to a medical condition," you can require an exam.

Make a reasonable accommodation

The ADA requires that employers who have 15 or more employees make every effort to accommodate people with disabilities. To do this, you should go through the "interactive process" with your employee. This is a back and forth where you search for a solution and supports that an employee may need.

Neither you nor your employee may know where to begin finding a proper accommodation--it's new to everyone. JAN, the Job Accommodation Network, suggests starting with these questions:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee's job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Has the employee been consulted regarding possible accommodations?
  6. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  7. Do supervisory personnel and employees need training?

Remember, you need to work with your employee to come to a good solution, and that solution needs to be based on their doctor's guidelines. The important thing is that a diagnosis of dementia--in any of its forms--doesn't mean automatic termination. There are lots of options, and businesses should be supportive.