Imagine these scenarios: In the course of a regularly scheduled meeting, you notice that your employee has grown visibly thinner. Or colleagues tell you their observations of disturbing memory lapses and mental mistakes; or the employee’s conversation becomes sprinkled with potential indications of depression or even suicidality.

You ask the employee about it, and encourage him or her to make an appointment for evaluation or medical assistance, but then what? If you are seriously concerned, can you call a family member? How do you avoid violating privacy and confidentiality while still taking action you believe is in your employee’s best interest?

There is a simple but highly effective way to resolve this dilemma that goes one step farther than the usual emergency contact forms that are standard issue in business: Ensure that each of your employees signs something I call a Diminishing Capacity Letter^TM. This means scheduling a meeting with every current employee, and also making it part of the onboarding process for new employees. A simple template is as follows:

“I, [name], give [HR officer’s name(s); company name; location] permission to call the following people in case of illness, emergency, or if they notice any diminishment in my physical, cognitive, mental, or psychological capacity.”

The form then has space to list at least three people, with their name, address, relationship to the employee, and contact information. Your employee signs it, preferably in the presence of a notary public, who dates and notarizes the document. Every year, you revisit the form to see whether names or contact information need updating.

Once the form is in place, you no longer need to worry about violating privacy or confidentiality. The employee has explicitly given you permission to call specific people, not just for emergencies or medical illness, but also if you are concerned about the cognitive or mental state.

Causes of diminished capacity

While it is typical to think diminished capacity is related to aging or dementia, never assume you know the cause. There are other reasons for cognitive difficulty that have nothing to do with dementia, such as interactions of medications, infections, a vitamin B12 deficiency, emotional trauma or grief, and more. Regardless of the cause, it is always important to first talk to the employee and then to follow up with their contacts if the employee does not respond promptly and appropriately.

When you call, remember not to make a diagnosis, i.e. “I think your mom might be heading toward dementia.” Instead, list what you see. “I am calling to let you know that people at the company observed some disturbing signs in contacts with your mom. She asked the same question three times in 25 minutes, even though I’d answered it each time, and it took her an unusually long time to remember her son’s name. This may be nothing, but I want you to be aware of it in case you or other family members observe similar things.”

Be sure to document your observations and the phone call itself as evidence that you are doing everything you can to protect your employee. Be a wise guide for your employees in all the situations they may encounter.

Instant Insights /

How employers can express concerns without violating confidentiality

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