Health Problems That Come With Age Aging Lawyer Population (Silver Tsunami) Stress and Mental Health Signs of Depression What is Mild Cognitive Impairment? What is Dementia? What Are the Warning Signs of Dementia that Are Associated with Alzheimer’s Disease? How Can I Help Someone If I Observe These Problems? Further Resources
Health Problems That Come With Age
All of us are vulnerable to the health problems that come with age, both mental and physical. These problems—such as depression, grief, emotional trauma, or problematic substance use—can affect our mental health. Aging can also trigger a decline in our ability to think, changes in our behavior or personality, or problems with our mobility, function, and other conditions that affect our ability to work. It can show up as a noticeable decline in mental abilities, including memory and thinking skills. You may forget someone’s name or where you put your car keys.
Although some changes are a natural result of aging, it differs for each individual. It may not be severe enough to interfere with daily life, but people who have mild cognitive impairment are sometimes at greater risk of developing more severe forms of dementia.
At advanced stages, dementia can interfere with long-term memory, or the ability to make a decision or judge an issue. An individual can forget the names of loved ones, or become so confused that they can’t make up their minds. However, it’s important not to confuse age-related conditions with other health issues that produce similar symptoms.
Lawyers should be aware of how aging can bring about changes in their health. They also need to be able to spot health problems in others and be cognizant of how to react when a lawyer is struggling with mental or physical health problems. Spotting these problems will become more important as the State Bar’s older members mature in coming years.
Aging Lawyer Population (Silver Tsunami)
The State Bar’s 2020 demographic survey showed that there are 253,968 active and inactive attorneys in California, 189,971 of which are active attorneys. The average age of active attorneys is 50, and more than 16 percent are over the age of 65 (State Bar data as of April 1, 2020).
According to the National Association of Bar Counsel, Association of Professional Responsibility Lawyers, Commission on Lawyer Assistance Programs, and the Second Joint Committee in Aging Lawyers Final Report–April 2014: (1) these percentages are expected to escalate dramatically in coming years as a “silver tsunami” of baby boomer lawyers reach retirement age; (2) the good news is there will be an increase of experience, insight, and wisdom that can be shared with new attorneys, but the bad news is there will be an increased risk of attorneys with age-related impairment and insufficient preparation for transitioning away from practice before a crisis occurs; and (3) the State Bars need to identify steps to effectively assist aging attorneys.
Stress and Mental Health
Attorneys are less likely to take care of themselves than medical doctors and other professionals. That inattention can often lead to emotional distress, and if not managed or treated, it can harm an attorney’s professional practice, clients, colleagues, and even personal life.
People under extended periods of stress may be unable to concentrate, make decisions, or even think clearly. They may be constantly active, but accomplish little. Chronic stress can also render itself as inappropriate anger or impatience, overreaction to minor problems, anxiety, fear, irritability, or resentment.
Stress may also contribute to the onset of clinical depression, especially for individuals whose brain chemistry makes them more susceptible. A study published in 2016 conducted by the ABA CoLAP and the Hazelden Betty Ford Foundation indicated that 28 percent of attorneys and judges suffer from depression.
As a group, legal professionals also have a preference for analytical thought (believed to come from the left side of the brain) versus emotional feelings (right side of the brain), and are trained to be objective and solve problems.
Attorneys often apply the same analytical approach to their personal problems and are reluctant to focus on their inner emotional lives. Some attorneys believe they should be able to handle personal problems just as effectively as they handle their clients’ legal problems. Concerned colleagues, friends, and family members therefore need to encourage a depressed attorney to seek help from a doctor or mental health professional.
Signs of Depression
It’s normal to feel blue every once in a while, but depressed and potentially suicidal individuals often exhibit changes in mood, appetite, and energy level, and these changes often last for more than a few days. For colleagues, friends, and family members who notice these changes over a long period of time, it should be a matter of concern.
Common symptoms of depression include:
If you or someone you know has these symptoms, encourage them to see a doctor or health professional. There may be a physiological reason for it, such as a disease or chronic health condition that can spur depression.
A mental health professional may help them get treatment. They may recommend psychotherapy, medication, or a combination of the two. People with depression often begin to see positive results within a month of beginning treatment.
What is Mild Cognitive Impairment?
According to the Mayo Clinic, mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It can involve problems with memory, language, thinking, and judgment that are greater than normal age-related changes.
If you have MCI, you may be aware that your memory or mental function has “slipped.” Your family and close friends may also notice a change, but these changes aren’t severe enough to significantly interfere with your daily life and usual activities.
Mild cognitive impairment may increase your risk of later developing dementia caused by Alzheimer’s disease or other neurological conditions, but some people with MCI never get worse, and a few eventually get better.
What is Dementia?
Dementia is not a specific disease. It is a set of symptoms triggered by a loss of brain function that can affect memory, thinking, language, judgment, and behavior. An individual may not be able to do normal activities, such as getting dressed or eating. They may be quick to anger or forget things they just learned.
The American Academy of Neurology estimates that in the United States, 14.7 percent of people over the age of 70 experience dementia. The most common cause of dementia is Alzheimer’s disease, which is a disease from which 5.3 million Americans suffer, and is the sixth most common cause of death in the United States (American Medical Association, American Academy of Neurology Institute and American Psychiatric Association, 2017).
Dementia is caused by changes in the brain that happen over time. In addition to dementia, there are many other health conditions that can lead to a similar drop in mental acuity, including:
A person with dementia may show signs of confusion and personality changes. As it gets worse, they may become lost, have difficulty doing basic tasks, and see things that aren’t there.
If this person shows increasing signs of confusion or changes in behavior, encourage them to see a doctor or another health provider. A health care professional will perform a physical exam and may order a series of tests to rule out other causes. They may also call upon a neurologist, neuropsychologist, or other health specialist to run further tests.
What Are the Warning Signs of Dementia that Are Associated with Alzheimer’s Disease?
A person in the early stages of dementia or Alzheimer’s disease may seem healthy, but is actually having more and more trouble making sense of the world around them. Family members are often the first to sense that something is wrong. They may notice that their loved one has difficulty paying bills, gets lost often, or repeats questions during conversation.
The following is a list of symptoms that have been identified as commonly observed in individuals with early stage Alzheimer’s disease. According to the Alzheimer’s Association, “10 Early Signs and Symptoms of Alzheimer’s” are:
How Can I Help Someone If I Observe These Problems?
If you or a colleague, friend, or loved one has experienced any of these symptoms, urge them to contact a health professional, such as a personal physician or a neurologist, and schedule a complete evaluation. You may want to help them schedule the appointment or contact the doctor yourself.
It’s important to get an early diagnosis for many reasons. Many conditions can reduce mental acuity for periods of time, and some of these conditions are easily treated. Some cases of dementia are reversible, and early diagnosis increases the chances of successful treatment.
The Alzheimer’s Association has a guide to assist you: 2020 Alzheimer’s Disease Facts & Figures
Whatever may be the cause of the dementia, it is best to find out sooner rather than later. It may be caused by Alzheimer’s disease or another condition, such as multiple sclerosis. There is no cure for Alzheimer’s disease, but the medications now available to treat Alzheimer’s disease can help some people maintain their mental abilities for months or even years.
With a medical diagnosis, the person will be better able to organize financial matters, establish a durable power of attorney and advance health care directives, deal with other legal issues, create a support network, and even consider joining a clinical trial or another research study.
For a legal professional with signs of cognitive impairment, early diagnosis affords the attorney an opportunity to participate in decisions, such as appointing a successor attorney or closing the law practice, rather than waiting until such arrangements become the responsibility of colleagues or family members.
A lawyer with more severe forms of dementia may want to consider limiting or ending their law practice while they are still capable of doing so. For guidance with this process, please consult the Guidelines for Closing or Selling a Law Practice.
For a family member, friend, or colleague, accepting certain signs of aging as something other than normal and deciding to take action can be a big hurdle. The affected individual may even resist seeking medical help.
It may help to seek advice from a professional about how to address these concerns with your friend or family member. The State Bar of California is here to help. If you have questions, please contact the Lawyer Assistance Program at 877-527-4435 or LAP@calbar.ca.gov.