When concerns about a senior leader’s capacity arise, HR faces one of its most difficult challenges
Trump’s medical exam made headlines on Tuesday. But the question it raises is one HR professionals have been navigating long before Washington made it a national conversation: who steps in when a leader’s ability to do the job comes into doubt?
It is, in practice, one of the thorniest situations in the profession. The power dynamics are uncomfortable, the legal risks are real, and in most organizations, there is no clear playbook.
“It’s totally different and really inconsistent,” said Laurie Ruettimann, a former HR executive turned consultant with more than 30 years of experience.
Senior leaders aren’t all in the same boat
Before HR can act, it helps to understand that not all senior leaders face the same situation when their capacity comes into question.
At the C-suite and board level, Ruettimann explained, there are often formal mechanisms already in place. Many executives have physical examinations written into their employment contracts as a standard benefit, covering screenings that go well beyond what most employees receive. Board members may face mandatory retirement ages embedded in governance documents.
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“When you're over a certain age and you're a senior leader, you're almost in a different class," Ruettimann said. "If you're a senior leader doing the work that quote unquote, Donald Trump is in our government, there's a different set of rules that may apply to you both favorably but also may limit your tenure on the board."
The implication for HR is significant. At the board and C-suite level, there is at least some infrastructure designed to surface health concerns before they become a crisis. Below that level, organizations are largely on their own.
The slow fade
When concerns arise about a senior leader further down the org chart, the response tends to be more informal, and more complicated. One common approach, Ruettimann said, is to gradually reduce the person's responsibilities until they choose to leave.
She described a former colleague of hers named Pete, a man well into his 70s who remained in his position at Total Rewards because he was the only person who fully understood an old defined benefit plan. Over time, he began having more bad days than good days.
“We tolerated it because Pete was the only guy who really understood the old defined benefit contribution plan,” she said. “It was like, ‘oh geez, if Pete dies, what are we going to do?’”
Eventually, Ruettimann said Pete’s responsibilities narrowed, with the expectation that Pete, or someone in his family, would decide it was time to stop.
“Diminishment of duties and responsibilities until that person exits are very common,” Ruettimann said.
The right way to handle it
Ruettimann outlined a more defensible process, one that centers on documentation, manager accountability, and a careful use of available resources.
The first step, Ruettimann said, is data. Before any conversation takes place, HR needs to be tracking patterns in performance, attendance, and behavior over time. Without that record, any intervention becomes legally and professionally vulnerable.
The second step is ensuring the conversation happens between a manager and their direct report, not between HR and the employee. HR’s role is to prepare the manager, not to lead the discussion.
“It’s not really an HR conversation, it’s a manager-employee conversation to make sure that whoever is leading this older individual is fully on board and sees the data and is like, no, I need to have a conversation about performance,” Ruettimann said.
The third step, if health or cognition appears to be a factor, is to use the employee assistance program as an opening. Rather than raising medical concerns directly, which can expose the organization to discrimination claims, HR can frame the conversation around performance and point the employee toward available support.
“We notice your performance is dipping, and we know you’re a really valued worker here. Do you need to talk to someone at the EAP?” she said, describing the approach. “Which opened a broader conversation.”
READ MORE: Are employee assistance programs worth it?
The legal risk of getting this wrong is not abstract.
“Absolutely,” Ruettimann said, when asked whether age discrimination claims are a real concern. “Which is why you don’t do it unless you’re sure you have the data and you’ve worked to put together a script with potentially someone who’s got legal expertise on your HR team.”
The Age Discrimination in Employment Act protects workers over 40, and any performance management process involving an older employee that lacks consistent documentation is an organization’s liability waiting to happen.
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The workforce is aging. Is HR ready?
That said, Ruettimann cautioned against overstating how common the problem actually is. The reality, she said, is that older workers are often pushed out long before their capacity becomes a question. Layoffs have been structured to incentivize exit at the older edges of the workforce, and ageism does the rest. Eighty-year-old marketing managers, she noted, are not a common feature of American workplaces.
But she didn’t dismiss the issue either. As financial pressures lead more workers to delay retirement, and as the fastest-growing segment of the U.S. labor force edges toward 75 and older, the situation HR professionals currently navigate in isolated cases could become more common. The organizations that build a process before they need one will be better equipped when the moment arrives.
