CRITICAL DECISIONS
There are 10 critical inflection points where expert guidance means the difference between crisis and clarity.
A 6-month foundation typically covers the first 2–3 inflection points and sets the protective framework. Over a 12–24-month horizon, avoiding even one misstep can save between $10,000-$200,000+ in downstream costs (medical, legal, and financial).
What is the value of each inflection point to you?
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THE MOMENT
Something feels "off." Memory lapses. Subtle changes in judgment. Your doctor says "let's monitor it" or "that's normal aging." But your gut says something more is happening.
WHY THIS MATTERS
Early detection creates the longest intervention window. Biomarkers can detect Alzheimer's pathology 10-20 years before symptoms. But accessing proper testing is nearly impossible without expert navigation.
HOW STEWARDSHIP HELPS
✓ Navigate testing barriers and access blood-based biomarkers
✓ Expert interpretation of what results actually mean
✓ Right-sized response—neither dismiss nor catastrophize
✓ Clear roadmap for exactly what to do next
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THE MOMENT
You have test results or a diagnosis. Now what? What does this mean for the next 1, 5, 10 years? What can you change? What can't you? How fast will this progress?
WHY THIS MATTERS
Understanding your specific risk profile and likely trajectory determines everything that comes next. What are YOUR modifiable risk factors? This shapes every decision to come.
HOW STEWARDSHIP HELPS
✓ Personalized risk assessment based on your specific factors
✓ Realistic trajectory mapping for your situation
✓ Evidence-based prioritization of what matters most
✓ Family education so everyone understands what to expect
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THE MOMENT
You want to DO something. But what actually works? The internet offers a thousand solutions. Your doctor says "there's nothing we can do." What has real evidence?
WHY THIS MATTERS
You need a personalized, evidence-based plan you can actually follow.
HOW STEWARDSHIP HELPS
✓ Evidence-based intervention plan—only strategies with research support
✓ Personalized to your specific situation and preferences
✓ Implementation support—not just "what" but "how" to make it sustainable
✓ Ongoing optimization as needs change
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THE MOMENT
You still have cognitive capacity. You can still make complex decisions and express your values. But for how much longer? When do you have the conversations about future medical and financial decisions, end-of-life wishes, and legacy?
WHY THIS MATTERS
THIS IS THE MOST CRITICAL INFLECTION POINT. Once capacity is significantly impaired, legal documents may not be valid. Wishes can't be clearly expressed. Families must guess. Court involvement becomes necessary.
HOW STEWARDSHIP HELPS
✓ Facilitated conversations through difficult discussions
✓ Consultation throughout planning
✓ Family alignment—everyone understands and agrees
⚠️ Most families wait too long. Don't be one of them.
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THE MOMENT
Is driving and the home still safe? Can aging in place work with modifications? When is it time to consider assisted living or memory care? How do you balance safety with independence and dignity?
WHY THIS MATTERS
Driving and living arrangement decisions profoundly impact quality of life, family dynamics, and costs. The right choice at the right time preserves independence safely. Crisis-driven placement can cause extreme distress and higher costs.
HOW STEWARDSHIP HELPS
✓ Facilitated conversations through difficult discussions
✓ Consultation throughout planning
✓ Family alignment—everyone understands and agrees
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THE MOMENT
You're now seeing multiple specialists: primary care, neurologist, sleep doctor, cardiologist. Each focuses on their piece. No one coordinates. Medications conflict. Tests get repeated. Critical issues fall through cracks.
WHY THIS MATTERS
Fragmented care leads to medication errors, duplicated testing, and preventable hospitalizations. Older adults on 5+ medications have 50% chance of adverse drug event annually. Someone needs to be the quarterback.
HOW STEWARDSHIP HELPS
✓ Care coordination—single point of contact across all providers
✓ Medication management—review for interactions and cognitive risks
✓ Appointment facilitation—prepare questions, attend key visits
✓ Medical records organization—all providers have complete picture
✓ Advocacy to ensure concerns are heard and addressed
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THE MOMENT
Cognitive changes affect judgment and decision-making. When should financial safeguards be implemented? How do you protect assets from exploitation? When should Power of Attorney be activated?
WHY THIS MATTERS
Financial exploitation of older adults averages $120,000 per incident. Impaired judgment leads to poor financial decisions. But removing control too early robs dignity. This is a delicate, high-stakes balance.
HOW STEWARDSHIP HELPS
✓ Consult with estate planning financial advisors
✓ Family communication facilitation about difficult money topics
✓ Fraud prevention strategies to reduce vulnerability
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THE MOMENT
Who will be the primary caregiver? How are responsibilities divided among siblings? What happens when family members disagree? How do caregivers avoid burnout?
WHY THIS MATTERS
Family caregivers provide $470 billion in unpaid care annually—and often suffer health consequences, job loss, and relationship strain. Without clear roles and support, caregiver burnout leads to poor outcomes for everyone.
HOW STEWARDSHIP HELPS
✓ Facilitated family meetings to align on approach
✓ Clear role clarification to reduce conflict
✓ Caregiver education on disease progression and behavior management
✓ Respite planning to prevent burnout before it happens
✓ Professional resource connection when family care isn't enough
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THE MOMENT
A fall. Getting lost. A medication error. Aggressive behavior. When do you call 911? When do you manage at home? How do you prevent crises before they happen?
WHY THIS MATTERS
Each hospitalization accelerates cognitive decline. Hospital-acquired delirium affects 50% of older adults with dementia and often leads to permanent worsening. Yet some situations require emergency care. Knowing the difference is critical.
HOW STEWARDSHIP HELPS
✓ Crisis prevention planning—identify and address risks proactively
✓ Decision protocols—when to call doctor vs. when to call 911
✓ Environmental safety assessment and home modifications
✓ Behavior management using non-pharmacological approaches
✓ Expert guidance available when crisis happens
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THE MOMENT
Serious infection. Feeding tube decision. Hospice consideration. How aggressive should treatment be? What does comfort care mean? How do you honor wishes when the person can no longer participate?
WHY THIS MATTERS
These are the most emotionally fraught decisions families face. Without clear advance planning and expert guidance, families often choose aggressive interventions the person wouldn't have wanted—or feel guilty about comfort-focused care.
HOW STEWARDSHIP HELPS
✓ Advance planning completed early while capacity intact
✓ Ongoing values discussions as understanding evolves
✓ Decision support through specific choices as they arise
✓ Family facilitation to unite around person's wishes