STEWARDSHIP ROADMAP
Cognitive Stewardship isn't medical care. It's not financial planning. It's not concierge medicine. It's all three, integrated around a single mission: preserving what matters most before decline begins.
The Stewardship Roadmap is a comprehensive framework that protects cognitive continuity across five essential domains. Unlike episodic testing or reactive care, stewardship is continuous, coordinated, and designed to preserve capacity before decline begins.
The Pillars of Cognitive Stewardship
Cognitive stewardship isn't a single intervention — it's a system of management strategies in response to early cognitive changes, including medical, financial, family, and cognitive continuity. Each pillar addresses a critical vulnerability that, if left unprotected, can cascade into crisis.
Longitudinal Monitoring – Regular cognitive assessment using validated instruments to detect subtle changes years before conventional medical attention
Personalized Intervention – Evidence-aligned protocols for proactive brain health care
Treatment Navigation – Immediate coordination with specialists for time-sensitive access to validated biomarker tests and FDA-approved therapies or clinical trials when needed
Advance Planning – Structured conversations during periods of preserved capacity about values, preferences, and future care wishes
How the Roadmap Works
Month 1: Baseline Assessment
We begin with a 90-minute comprehensive assessment where we establish your baseline, including cognitive, functional, and decision-making (health, financial) assessment; cognitive coordination audit (who's involved, what's missing) • Goals for personalized health plan • Family system evaluation (caregiver burden, communication patterns)
Months 2-12: Ongoing Stewardship
Stewardship is continuous, not episodic. You'll receive: • Quarterly cognitive assessments (tracking function over time) • Monthly check-ins • Ongoing cognitive coordination • Updates on cognitive status and change scores • Evidence-based recommendations for personalized preventive cognitive care • Crisis prevention planning and early intervention when needed
Annual Review
At 12 months, we review your entire trajectory: • How has your cognition changed from baseline? • Do we need to adjust the stewardship plan? • What's working? What needs attention?
This becomes the foundation for Year 2 and beyond.
What Makes This Different
Traditional neuropsychology: You get tested once, receive a report, and go back to your doctor. If things get worse, you get tested again. Reactive.
Cognitive stewardship: You receive continuous monitoring, coordinated care, upstream protection, and measurable outcomes. We track your Cognitive Stewardship Index quarterly and adjust the plan as needed. Proactive care.
Traditional care waits for decline. Stewardship protects before it begins.