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Sensitive Stewardship And Donors with Dementia

Donors older than age 65 give a disproportionately large percentage of total gifts in the U.S. In fact, according to multiple data sources, 47 percent of top gift donors in 2016 were between the ages of 60 and 79 years old, and 30 percent were 80 years of age or older. The Baby Boomers are hitting their 70s, and the donor population is rapidly aging.

Approximately 10 percent of individuals older than 65 experience dementia, according to The American Speech-Language-Hearing Association (ASHA). Prevalence increases with age, and about half of those older than 80 will have this diagnosis. These data highlight the fact that the population of top gift donors is also the population that most frequently experiences dementia — making the stewardship of donors with dementia an important and timely issue for professional fundraisers.

Robert P. Hofmann, MA, CFRE, senior development officer at the University of Minnesota Duluth School of Fine Arts and Jolene Hyppa Martin, Ph.D., CCC-SLP, assistant professor at the University of Minnesota Duluth College of Education and Human Service Professions, reviewed some of the issues during a session at the Association of Fundraising Professionals (AFP) annual International Fundraising Conference being held this week at the Ernest N. Morial Convention Center in New Orleans, La.

Dementia is not a “disease” that is diagnosed by an x-ray or a blood test. Dementia is a term that is used to label a condition characterized by a collection of symptoms including deficits in memory, attention, language, communication, planning, judgment, decision-making, problem solving, sensory systems, and more. Not all persons with a diagnosis of dementia will have all of these symptoms, but all will have some of them.

By contrast, Alzheimer’s is a disease. It is a pathology that attacks the brain. Not everybody who has Alzheimer’s has dementia, and not everybody who has dementia has Alzheimer’s disease. However, Alzheimer’s disease accounts for somewhere between 50 percent and 80 percent of dementia diagnoses, making it the most common cause of dementia. Other causes for dementia include Pick’s disease, Parkinson’s disease, AIDS, vascular problems, and metabolic problems.

Generally, the symptoms involved in dementia vary depending upon the cause of the dementia. But it is important to know that dementia and Alzheimer’s are not the same thing, so professionals should not assume that people who have dementia have Alzheimer’s or use the terms interchangeably.

Professional fundraisers adhere to strict ethical standards and should never engage in soliciting from persons with dementia. However, some professional fundraisers might find themselves in a position where they need to continue to steward a respectful, professional relationship with a long-time donor who is experiencing memory loss, while also working with the donor’s appointed representatives.
Individuals with dementia should be respected and socially included — not isolated. Consequently, it would also be problematic and inconsistent with donor-centered methodology if professional fundraisers ended relationships with individuals who have dementia in favor of only interacting with the individuals who now represent the donor’s financial interests.

Professional fundraisers need to have the ability to continue to steward respectful, inclusive relationships with this population. As such, professional fundraisers need to know what to do when encountering donors who exhibit signs of dementia, how to recognize the signs of dementia, and how to navigate relationships with donors who experience this condition.
Here are five tips to help prevent a communication breakdown. The tips are based on several sources on this topic, which you might wish to reference (e.g., ASHA, 2017; Bayles & Tomoeda, 2013; Jootun & McGhee, 2011; Lubinski, 2006; Ripich, Wykle, & Niles, 1995).

Tip 1: Manage the environment. Managing the environment means that you need to take responsibility to proactively reduce background noise and other distractions, ensure adequate lighting, and face the person with dementia so they can see your “body language” and facial expressions. These are important cues that will help a person with dementia comprehend your message. In the case of Don and Carol, you might ask the host to seat you in a quieter, well-lit section of the restaurant.

Tip 2: Orient and introduce. Orient and introduce means one needs to introduce oneself and others. Don’t assume that a person with dementia will remember your name or organization. Next, introduce the topic, and then repeat key information to aid the individual with dementia in maintaining orientation to the conversation. For example, you might say, “Hi Don, I’m Steve Jones from the School of Fine Arts. I want to thank you for your support of the Collins Music Hall. The Collins Music Hall recently presented the opera Carmen because of your generous gift.”

Tip 3: Reduce pronouns. To understand a pronoun, you need to remember its referent. That taxes memory and attention. An example would be, “Susan Long sends her regards. Susan is meeting with architects today. The architects are designing a new practice studio in the Collins Music Hall.” This is better than, “My partner sends her regards, and she’s meeting with the architects who are designing a new practice studio for the music hall.”

Tip 4: Provide non-transient cues. Speech is transient. It is here for a moment, and then gone. To understand speech, you have to remember what was said long enough to process it. Non-transient cues can help a person with dementia comprehend conversation more effectively, because these cues are more permanent.

We all benefit from non-transient cues. For example, using a PowerPoint presentation helps people remember a speaker’s last key point. Non-transient cues that can be very helpful in the previous examples can include a fundraiser wearing a nametag that lists his or her name and affiliation. Another helpful non-transient cue might be the latest brochure featuring photos of the Collins Music Hall and the artist’s renderings of the new practice studio.

Tip 5: Reminisce about the distant past. Talking about the here-and-now is great, especially when there are non-transient cues, conversation pieces, and a context to support the discussion. But when you want to talk about the past, reminisce about the distant past.

Generally, more recent memories are harder for people with dementia to recall, so when talking about the past, ask about growing up on the farm, not about last week’s shopping trip. Avoid questions such as, “What have you been up to lately?” or “Did you do anything special for the holiday last week?”
Instead, reminisce about the distant past, like this: “Don, you grew up in the Mankato area right? I bet you have wonderful memories of Mankato…Did you enjoy fishing on the rivers in the Mankato area?”

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