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Imagine that you are a frontline fundraiser and are asked by your leadership to reach out to a nonagenarian woman about making a philanthropic gift. You manage to connect with this potential donor by phone. During the course of a 10-minute phone call the woman asks who you are and why you are calling multiple times. She cannot follow along with the conversation and cannot confirm basic contact details such as her address.
You get a gut feeling that this is not someone you should be asking for a charitable gift, so what do you do?
This is a very real scenario faced by Tara Adams and Anthony Pomonis who led a session “Cognitive Impairment in Donors: What You Need to Know” during last year’s AFP ICON conference in Seattle.
It was this very situation that started Adams down the path of researching the issues involved in fundraising with elderly donors who are showing signs of cognitive impairment. She connected with Pomonis, who had his own harrowing experience with an elderly donor in cognitive decline. Both presenters discovered within their own journeys the complete dearth of resources available to frontline fundraisers and other advancement staff who wish to learn more about how to handle the ethical and legal concerns when faced with this type of experience.
Cognitive impairment is a general term that refers to a collection of signs or symptoms that impact a person’s memory, attention span, judgment, and problem-solving skills. When these symptoms reach a critical threshold, they often result in a medical diagnosis of Alzheimer’s Disease or one of the many forms of dementia.
The Alzheimer’s Association created a top 10 list of signs of cognitive decline, which include the following:
- Memory loss that disrupts daily life
- Challenges in planning or solving problems
- Difficulty completing familiar tasks
- Confusion with time or place
- Trouble understanding visual images and spatial relationships
- New problems with speaking or writing
- Misplacing items and losing the ability to retrace steps
- Decreased or poor judgment
- Withdrawal from work or social activities
- Changes in mood or personality
These top 10 signs can take many forms. For fundraisers, you may notice issues of memory loss, such as forgetting about a scheduling fundraising visit or telling the same story multiple times in the same sitting. Donors might have difficulty understanding how much money they are committing to in a multi-year pledge or commit to a larger gift than they can afford because they do not comprehend the impact of that gift on their overall finances.
For event or alumni relations staff, you might notice an older donor getting confused or agitated at a large event, or that an older donor who used to attend every meeting and event for your organization suddenly stops showing up with no explanation.
Recent stories involving these signs and symptoms involve actor Bruce Willis who began having issues with speaking and was diagnosed by his medical team with aphasia; however, within the course of a year his diagnosis was elevated to full frontotemporal dementia.
The diagnosis happened relatively young — Willis was in his mid-60s. But it is not entirely uncommon to begin to see the start of signs and symptoms of cognitive decline in this age group of donors. According to the Blackbaud Institute, the average age of a major gift donor in the United States is 65, which is also the average age that the first signs of cognitive impairment might also begin to appear. The age group of 65 and older is growing in size in the United States, with the Baby Boomer generation entering this phase in their lives.
Your portfolios are likely comprised in large part of prospects and donors in this age range, and that number will increase in coming years. This means that the chances of encountering older donors with cognitive impairment issues will also increase over time. The Centers for Disease Control and Prevention (CDC) estimates that around one in nine people ages 65 and older are currently showing outward signs of cognitive impairment, and that number increases in one in seven for people ages 72 and older. Think about the number of people in your portfolio today who fit into these age ranges. It is likely that you have at least a couple of donors showing signs of cognitive decline whether you realize it or not, and if you have not already encountered this scenario it is increasingly likely that you will at some point in your career.
What can you do if you start to notice the signs and symptoms of cognitive impairment in one of your older donors? The first step is to recognize that this is not a situation where you need to make decisions in a vacuum. Seek input from others, both internally and externally, on the best way to approach the issue. Second, do not try to diagnose a prospect or donor with cognitive impairment if you have not been told directly. Third, determine what touchpoints are appropriate between your organization and the donor moving forward, and establish a plan to review these touchpoints on a regular basis.
Cognitive impairment only increases in severity over time, which means that what might have been appropriate one year ago, or even six months ago, might no longer work for the donor.
