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What real estate agents need to know about cognitive impairment

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As a real estate agent, it’s increasingly likely that you will encounter clients facing cognitive challenges. According to the Centers for Disease Control and Prevention (CDC), in 2022, 4 percent of adults aged 65 and older reported ever having received a dementia diagnosis, with the percentage increasing to 13.1 percent among those aged 85 and over.

However, the same study suggests that these numbers may actually be 40 percent to 60 percent higher due to underreporting, as many survey participants with dementia may not be aware of their diagnosis or may choose not to disclose it. Given that older adults are a significant segment of the housing market, it’s essential to recognize and address the unique needs of these clients with empathy and professionalism.

Real estate is personal

For many older clients, selling a home isn’t just about finances or transactions; rather, it’s about their lives, their memories and their future. As an agent, you have the unique opportunity — and responsibility — to serve them with care and integrity, especially when they may be facing challenges they haven’t openly shared with you.

Sometimes, people seem perfectly fine. It’s only when they’re under the pressure of big decisions, changes in routine or the stress of a major life transition that cracks begin to show. Maybe they struggle to follow the conversation or seem overwhelmed by simple steps. Maybe they forget appointments or seem unsure of why you’re meeting. These moments can be subtle, but they matter.

Recognizing red flags

As an agent, it’s not your job to diagnose anyone, but it is your job to be observant. Certain behaviors might indicate cognitive impairment or underlying health issues, such as a urinary tract infection (UTI) or the aftereffects of a stroke, especially in stressful situations like downsizing.

  • Missed or forgotten appointments: If a client forgets they had an appointment with you — or why — even after confirming, this could be more than just an oversight.
  • Difficulty following along: Struggling with timelines or processes can be another sign. You might notice them taking overly detailed notes or repeatedly asking for instructions to be explained.
  • Noticeable hygiene or appearance concerns: If a client shows up disheveled, unshowered or wearing the same clothes repeatedly, it could signal that they’re having trouble managing basic activities of daily living (ADLs).
  • Heightened anxiety: Everyone feels a little nervous about contracts and big decisions, but if a client’s anxiety seems extreme or significantly different from what you’ve seen in previous meetings, it could indicate something more than typical nervousness. Be especially mindful if their anxiety affects their ability to participate in discussions or decision-making.

None of these signs automatically mean a client has cognitive impairment or significant health challenges, but they should prompt you to pause and consider how to best support them.

How to handle these situations

When something doesn’t feel right, trust your instincts. Your role isn’t just about getting the transaction done — it’s about treating your client with care and dignity.

  • Gather emergency contacts early: During your initial consultation, ask who they’d want you to contact in case of an emergency. This not only helps in case of unexpected events but also provides a bridge if cognitive challenges arise later. Having this information upfront can make a world of difference if things take a turn.
  • Suggest a trusted companion: If you notice a client struggling, ask if they have a friend, family member or neighbor who could join them at future appointments. Position it as a helpful extra set of eyes and ears for the complexities of the transaction.
  • Keep detailed notes: Good recordkeeping is essential. Document key conversations, financial discussions, and decisions, along with your observations. This protects you and ensures the client’s needs are met with transparency and care.
  • Escalate when necessary: If a client’s impairment becomes more obvious, consult your broker or legal counsel for guidance. In some cases, engaging professionals like social workers, senior living advisors, or healthcare providers may be necessary to ensure the client’s safety and well-being.

Be the agent you’d want for your family

The truth is, no one wants to think about these scenarios happening to someone they love. But if it did, you’d want their agent to notice the signs, slow down, and show compassion. You’d want that agent to protect their interests, respect their dignity, and make sure they weren’t just another transaction.

This is about being more than just a real estate professional — it’s about being a trusted guide during one of the most challenging transitions of someone’s life. If you approach every client interaction with this level of care, not only will you make a difference, but you’ll also elevate yourself as a professional in ways that go far beyond the deal.

Nikki Buckelew, Ph.D., is the author of “Senior-Centered Real Estate: My Path to Purpose” and founder and CEO of Seniors Real Estate Institute. Contact her at SeniorsRealEstateInstitute.com