Q: How do I know if this is right for us?

A: Cognitive Stewardship works best during what I call the "early window"— when changes are noticeable but capacity remains largely intact. This is typically Stage 1-2 of cognitive decline: subtle memory changes, mild confusion, family members starting to notice or compensate. Our initial consultation determines if you're in this window.

We're not sure if this is serious enough yet.

A: That's exactly what the consultation is for. I'll help you determine if a full evaluation is appropriate or if it's too early. Either answer has value.

Q: What happens if I develop concerning symptoms or cognitive changes?

A: This is exactly when Cognitive Stewardship proves most valuable. You receive immediate evaluation, priority access to Cognitive Stewardship services, specialist coordination, treatment eligibility assessment, and ongoing navigation—precisely when you need it most. Unlike traditional care where families wait weeks or months for responses, founding families receive same-week consultation and coordinated action within days.

Q: Why only 5 families?

A: Each family requires significant time, attention, and coordination. As a solo practice launching this model, I'm intentionally limiting initial capacity to ensure exceptional outcomes. This is a service that requires deep relationships. Once established, we plan to offer services to a limited number of additional families.

Q: What happens after 6 months?

A: Families can continue with ongoing stewardship as new inflection points emerge over the course of the journey. The foundational engagement establishes whether ongoing support is appropriate and valuable for your situation. There's no obligation to continue.

Q: I'm only in my 40s or 50s. Am I too young for this?

A: No. Midlife is an ideal time for lifestyle modification for cognitive health. Many modifiable risk factors begin affecting brain health in your 40s and 50s. Cardiovascular health, diet, physical activity, hearing preservation, and sleep quality all have cumulative effects over decades. Early optimization has the greatest long-term impact. Additionally, blood biomarkers can detect pathology 10+ years before symptoms—starting in midlife means catching changes at the earliest possible stage when intervention works best.

Q: I spend winters in Florida. Can I participate?

A: Yes. Founding families can be snowbirds or part-time Florida residents. We can accommodate flexible scheduling with in-person visits during your time in Florida and virtual check-ins when you're away. Quarterly monitoring can be done via telemedicine, with annual comprehensive evaluations scheduled during your Florida residence.

Q: Can I include my spouse and adult children?

A: Absolutely. Founding families include multiple generations—both for individual cognitive health optimization and to facilitate family planning conversations.

Q: What if testing shows I'm at high risk or have early biomarker changes?

A: Most people will receive reassurance that dementia risk is normal. If testing suggests elevated risk or early pathology, we discuss results in your specific context, provide support, explore or intensify early intervention, and create a proactive monitoring and planning strategy. Early knowledge enables early action—which is exactly when interventions work best.

Q: Is this just for people with family history of Alzheimer's?

A: No. While family history is one risk factor, Cognitive Stewardship benefits anyone who values proactive brain health optimization. Many founding families will have no family history but understand that dementia is potentially preventable—and want expert guidance for evidence-aligned prevention. Others have watched friends or colleagues decline and don't want to wait for symptoms themselves.

Q: What makes this different from concierge medicine?

A: Concierge medicine provides enhanced primary care access but remains reactive—waiting for symptoms before intervening. Cognitive Stewardship is proactive and specialized: we use tools and data (biomarkers, detailed cognitive testing, functional assessment) that primary care doesn't typically provide, implement evidence-aligned multidomain interventions, facilitate advance planning conversations, and coordinate specialty care specifically for cognitive health. Think of it as preventive neurology + concierge access + family legacy planning—integrated around preserving cognitive function before decline.

Q: Do you prescribe medications?

A: Dr. Stoeckel is not a prescribing physician. For medication management, we coordinate directly with your primary care physician and specialists. However, we provide evidence-based guidance on medical options, facilitate access to FDA-approved disease-modifying treatments when indicated, and coordinate care.

Q: What if I already see a neurologist?

A: Excellent. Cognitive Stewardship complements rather than replaces specialist care. We provide proactive monitoring, lifestyle optimization, and care navigation that traditional neurology doesn't offer. If you develop concerning changes, we coordinate directly with your neurologist—or help you find one if you don't have established care. Many founding families have existing relationships with neurologists for other conditions and Cognitive Stewardship integrates seamlessly.

Q: Do you accept insurance?

A: Cognitive Stewardship is not covered by insurance at this time. However, specific components (such as specialist visits, certain lab tests, or imaging studies) may be billable to your insurance if they become medically necessary.