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When Business Leaders Show Signs of Age, Mental Illness

By Lisë Stewart

Pssst… “I think you may be sliding…”

How to prepare for and have THAT tough conversation

Larry and I glanced at each other, both with puzzled looks of concern. Our client, Mike, was rambling.

He had just repeated the same story for the second time and he was very obviously struggling to keep up with the thread of our conversation. He shifted in his seat a lot and seemed uncomfortable with the discussion, which he tried to cover with odd, inappropriate grinning and joking. As we glanced around the room, we could see that others were uncomfortable too. All except for Ann, who looked at us with a hard stare as if to say “see, this is what I have been telling you! He is losing it!”

Observing someone you know showing signs of age or mental illness is one of the hardest parts of being a trusted advisor. As Sugar Ray Robinson famously quipped:

I always said I’d quit when I started to slide and then I woke up one day and saw I done slid!

Sugar Ray Robinson

Unfortunately, many of us don’t realize that we are “sliding” until it has become very apparent to others. What is worse, most people won’t say anything when the signs begin to emerge. People don’t want to be offensive or hurt the feelings of those that they care about. And, of course, it is a hard thing to talk about, quantify or explain.

I have had the difficult experience of being the bearer of this information several times – to beloved family members and clients alike. It has never been easy, but I have learned some important lessons along the way. First, remind your clients that it ALWAYS works best to deal with emotional issues BEFORE emotion becomes the issue.

What to do before a problem develops:

In working with your clients, before a problem develops, consider the following:

  1. Develop, as part of their family charter, partnership agreement or cultural covenant, to define their desired process for sharing performance feedback. Encourage them to bring this up and talk about how they would want to approach certain issues such as a breakdown in physical or mental health, substance abuse, signs of memory loss or cognitive impairment, loss of interest in the business, etc. Just making it okay to discuss these issues and putting ideas down on paper can make the entire process more palatable when or if it presents itself.
  2. Work with individual leaders to identify their concerns about aging. Discuss their experiences with others as they have gotten older. What did they notice about their own parents and grandparents? How did they deal with the situation as they observed the mental or physical decline of family members? What worked and what didn’t work? How would they like their experience to differ from that of their relatives or friends?
  3. Develop an agreement with your leaders about how they would like to be approached if someone else notices a change in their behavior or abilities. How would they like to learn about this and what would kind of support would they like? Talk to them about the range of options for getting tested, working with a specialist to determine what might be the cause of the change.

The most important aspect of this preparation is to begin to crack open a conversation that very few people ever have but that most of us face at some point in our lifetime. Until we make it an acceptable subject to talk about, removing some of the secrecy and shame, then we cannot positively change the way we deal with this potential life altering trajectory.

What to say to clients who show signs of mental illness:

What happens if you notice problems beginning to surface in a client? It is not surprising how often this occurs, particularly given the market we serve. When I am faced with this situation, here are a few of the approaches I tend to consider:

  • First, I try to get the lay of the land. I look around to see if there is another trusted individual in the organization or in the family with whom I could engage in a sensitive conversation.
  • If so, I begin very gently, by asking how things are going and what changes, if any, they might have observed in the leadership or management of the company. I look for subtle cues that perhaps they have concerns or they have noticed a shift.
  • I might try to soften the conversation by saying something like “I work with quite a few client companies where leaders are getting up in years. A concern that often surfaces as part of a transition discussion is what to do if people in key positions begin to show signs of memory loss or cognition issues. Have you ever discussed that topic in this company?” Sometimes this gentle question cracks open a flood of conversation. Then we talk about strategies, discuss options for working with specialists and I may even coach them about how to approach the conversation with the person in question.
  • If I can’t find another trusted person, then I have to assess whether I have a responsibility, right or role in bringing the issue to the attention of my client. I usually decide that if I don’t speak up, then it is likely that no one will, at least not until it has been detrimental to the business.
  • In some circumstances, I have been able to lighten or soften the message by using humor: “okay Joe, I can see you suffer from the same problem I have of not remembering where I was yesterday or what I had for breakfast, let alone what I was supposed to do for this meeting! I know that I have had to start writing everything down so that I can continue to fool most of the people most of the time! I am wondering what kinds of things you have been doing differently as you get older – have you got any tips?” Then I use this as a launching pad for a more in-depth conversation.
  • If humor isn’t the right vehicle, and I need to take a more straightforward approach, I begin slowly, by speaking from my own experience. I might say something like “Mike, you and I have been working together for a little while now and I have noticed something in your communication style that I am curious about. Can I share my concerns with you?” “I have noticed that you repeated the story about your ski trip several times this morning and that you forgot a number of the tasks that we discussed yesterday. Do you have any sense of what might be behind this shift in your communication?”
  • If I get a confused or befuddled response, or the client seems surprised but not angry, I might press ahead by saying “I know that if I were acting differently than I usually do, I’d like someone to point it out. And, I respect you a lot and thought you might like to be aware of the change. I know that hearing this can be distressing.” In this way, I am speaking from my personal perspective, then I am validating my client and finally I am demonstrating empathy. It is now up to the client to decide what to do with the information. I usually just sit quietly and see where they want to go.
  • However, if the client reacts angrily, and I have had this happen, I know that this usually stems from fear or embarrassment. This is when I have to use my very best Verbal Akido skills (as taught in the FBAC class). I might say something like “Yes, I know, I would be so distressed to have someone point this out and yes, you might be absolutely correct that I don’t have my facts straight. All I know is that I like and respect you very much and so I wanted you to know that I am seeing a change that I think you might not like. I am happy to drop it, but I also thought I owed it to you to be transparent and honest.”

These are difficult conversations and sometimes we might get it wrong or we might misunderstand… and that’s okay. What is not okay is sweeping behavior under the carpet when it might be having a disastrous impact on the family and the business. In the best of all possible worlds, try to discuss this with your clients before it becomes a problem.

But, if it is already a problem, first work to develop trust and build a strong relationship – then gently open the door to the issue. And, make sure you have done a little research regarding local service providers who may be able to help. Find a good Gerontologist in your area and be ready to make a recommendation. If you are not an expert in this area, be sure to suggest that your client speaks with someone who can help and then be there to offer support as needed.

Empathy and understanding is the key in this situation. After all, I will certainly want plenty of kindness and understanding when I start putting my car keys in the refrigerator and my wallet in the toaster.

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