In December 2025, Gregory Johnson visited a local bank branch in New Brunswick, N.J. Everything was going fine until he was ready to leave. He became agitated and confused. The bank contacted his daughter, Shakira, telling her he had no way of getting home.
“My dad was worked up. He says he called an Uber, it hasn’t come, and he’s cold,” said Johnson. She discovered that her father’s cellphone was dead, and asked the bank employee to charge her dad’s phone.
That’s when things went wrong.
“First they say we don’t have a charger,” Johnson explained, “Then he’s like, ‘Our manager said we can’t help him. If he wants his phone charged, he has to ask a customer.’” The situation escalated from there with the bank employee eventually hanging up on Johnson, and her father leaving the bank premises in a confused and agitated state.
What the bank staff didn’t immediately recognize was that Johnson, 70, had dementia and was experiencing an episode.
Incidents like this are becoming more common in the United States, with six in 10 people living with dementia wandering at least once, becoming lost or confused about their location. With the population aging rapidly and cognitive decline increasingly intersecting with everyday institutions, workers are encountering situations that they were never trained or meant to manage. Among the most unexpected places this crisis is playing out is the local bank branch. Across the country, tellers and branch managers are finding themselves on the front lines of a public health issue they were never trained to handle.
Aging population meets the banking system
More than 7 million Americans live with Alzheimer’s disease or related dementias, according to estimates from the Alzheimer’s Association. As the population ages, that number is expected to rise to nearly 13 million by 2050.
For many people experiencing cognitive decline, the bank remains one of the few institutions where they still conduct important business in person. Paying bills, withdrawing cash, and questioning unfamiliar charges are routine interactions, but dementia can turn them into confusing and sometimes volatile encounters. This can happen when clients have mirror illusion (they fail to recognize themselves in a reflection), severe agitation, paranoia, increased fatigue, disorientation, and even hallucinations.
Customers may forget recent transactions, repeatedly withdraw money, accuse staff of theft, or become distressed when security procedures slow them down. Financial confusion is often one of the earliest signs of cognitive impairment, but bank employees are rarely trained to interpret those signs.
The hidden role of bank employees
Traditionally, bank tellers are trained to detect fraud and verify identity. Increasingly, they are also being asked to identify warning signs of elder financial exploitation, a growing concern among regulators and consumer advocates. The Consumer Financial Protection Bureau has encouraged financial institutions to watch for suspicious behavior that might indicate a customer is being targeted by scammers or manipulated by caregivers. Between 2020 to 2024, fraud loss for seniors 60 years and older increased four-fold, skyrocketing from about $600 million in 2020 to $2.4 billion in 2024.
However, there’s a critical distinction. Suspicious online activity caused by fraud looks very similar to confusion caused by cognitive decline. The major difference is evaluating the intent and awareness of the client. Without training, staff can misinterpret the situation. A confused customer might be treated as disruptive. A frightened person might be seen as aggressive. In some cases, police are called when the real issue is a medical condition. The result can be humiliating for families and frightening — or even dangerous — for the customer.
“It’s really important to recognize that even if there’s suspected cognitive impairment, that does not mean that someone automatically does not have financial capacity to make their own decisions,” said J. Audie Black, Ph.D, ABN, founder and chief neuropsychologist at Idaho Neuropsychology. “When we talk about financial capacity, we’re talking about the thinking and judgment ability to execute their own transactions. Many individuals with mild cognitive impairment, for instance, can still make their own financial decisions, but they are more vulnerable to undue influence.”
A training gap
Some organizations are trying to fill the gap. The AARP, which advocates for seniors, has developed training programs designed to help frontline employees, including bank staff, recognize signs of cognitive decline and respond more appropriately. A popular program they use is called BankSafe. “The objective is a couple of different things,” said Jilenne Gunther, director of BankSafe. ”It’s really looking at how we can empower the financial industry to better protect older adults from exploitation, but also how to better interact with those that they may suspect have had dementia.”
AARP also provides the Dementia Hub, which was launched in June 2025. It was built on BankSafe’s existing model, brings together resources from across the world that financial institutions can use to treat clients who are facing cognitive decline, and is a direct response to a need in the industry.
These resources are key because bank employees cannot diagnose cognitive decline. “It’s looking for the signs that someone may be experiencing cognitive decline. How do I interact with that person so that you can have a better path to communication?” said Gunther.
BankSafe training and tools in the Dementia Hub equips employees with evidence-based tools to help them detect and respond to red flags. It encourages employees to slow down conversations, ask simpler questions, and recognize when confusion might be driving a customer’s behavior. It also helps workers understand when it may be appropriate to contact a trusted family member or escalate concerns through internal channels.
Adoption of this training,though, varies widely across the financial industry.
Large banks often focus heavily on fraud detection technology and cybersecurity. Smaller branches may have limited resources for specialized training. Unlike healthcare providers, financial institutions operate in a regulatory environment where privacy rules and liability concerns make intervention complicated.
When reached for comment about Gregory Johnson’s incident at the New Brunswick bank branch, TD Bank responded in a statement that ”our employees are trained to support clients of all ages, including those with disabilities, ensuring that everyone receives the assistance and service they require. Should our service standards fall short on any occasion, we conduct a thorough review to identify any missed opportunities to better support our clients in the future.”
TD Bank is not listed as one of AARP 2026 BankSafe verified organizations.
A delicate balance
Banks face a difficult balancing act: They must protect vulnerable customers from financial exploitation while respecting their independence and privacy. If employees intervene too aggressively, they risk violating a customer’s rights. If they fail to act, a customer may lose life savings to scams or manipulation.
In 2018, the Economic Growth, Regulatory Relief, and Consumer Protection Act was signed into law. It includes a statute that provides immunity from suit for disclosure of financial exploitation of senior citizens. This provision offers a possible safe harbor for banks that report suspected elder financial exploitation to law enforcement or adult protective services, as long as they follow certain steps.
Dementia-related incidents, though, fall into a gray area. A customer may appear vulnerable without being exploited. They may insist on transactions that seem irrational but are still legally permitted. For bank employees standing at the counter, those distinctions are rarely clear. Black advises looking out for a couple of things.
“Some of the things that you can observe are if your client has difficulty understanding or retaining basic information,” Black said. “This could show up as the person repeatedly asking the same question, or they might express confusion about a routine transaction, and in some cases, they may not even fully recall why they came to the bank and be uncertain about that. You can also see difficulty with trouble following multi-step explanations that you may be giving, feeling like they’re getting overwhelmed by even relatively simple choices you’re presenting, or they can appear unusually hesitant or dependent on others to speak for them.”
Preparing for the future
The financial industry is likely to face growing pressure to adapt in the coming years as the number of retirement-age Americans increases. That could mean expanded training programs, clearer protocols for handling confused customers, and closer coordination with families and caregivers. Some banks are also experimenting with trusted contact systems, allowing customers to designate someone the bank can call if unusual activity occurs.
These steps may become increasingly necessary as demographic trends reshape everyday interactions. For now, though, the responsibility often falls to frontline employees — people hired to handle deposits and withdrawals who now find themselves navigating the complexities of cognitive decline.
“I am grateful that I found my dad relatively quickly,” said Shakira. “He was huddled up in the train station, not hurt but cold, hungry, and thirsty. The episode could have ended much worse.”
This article was written with the support of a journalism fellowship from the Gerontological Society of America, the Journalists Network on Generations, and the Silver Century Foundation.
