The Gift of Early Action

This week, I received an email that told the story of why Treasure Coast Cognition has a role in the community.

Note: Names and identifying details have been changed to protect family privacy.

A local husband wrote to share his wife's Alzheimer's journey. The email came through a chain of community connections. Before I'd even met them, I knew their story because it happened in our community.

There was a diagnosis of Alzheimer's disease (the most common form of dementia). By any measure, they're beyond the Cognitive Stewardship window. The family knew that. But as I heard their story, I was struck by something powerful: the choices they made years before diagnosis have shaped everything that came after.

The Window That Changes Everything

Here's what they shared about their timeline:

• 4-7 years before diagnosis: Small signs missed at the time (typical)

• 2 years later: Acknowledgement of what was happening - and immediate action

• 3 years later: Found community living where they could secure future memory care

• 6 months later: Official diagnosis

That period - roughly 18 months of knowing something was wrong but before formal diagnosis - that's the window. That's when decisions were made that have preserved dignity, peace of mind, and quality of life together.

They chose their living situation. They built their support system. They established their care team. They had conversations while everyone could still fully participate in them.

These weren't medical decisions. They were life decisions. And they made them while they still had the cognitive capacity and emotional bandwidth to make them well.

The Cost of Waiting

The husband wrote something haunting: "In looking back I realized that I should have recognized the signs much earlier." He's kept a diary, reconstructing the timeline. He now sees signs going back earlier, maybe even much earlier. So do others.

This is the pattern I see repeatedly in research and clinical practice: By the time families get a formal diagnosis, they've already lost 5-10 years of the window when proactive planning could have made the biggest difference.

Those aren't just lost years for intervention. They're lost years for choice.

The husband shared another story: Last January, they noticed a longtime friend repeating stories. He talked with the friend's wife, shared what they'd learned. The friend acted early and has started a new disease-modifying therapy. He "recognizes that they are now on a similar journey."

That conversation - one friend helping another recognize what's happening early enough to act - that's the intervention that matters most. Not a medication. Not a test. Human connection in the service of preserving choice.

Preserve Choice

When I first started thinking about Treasure Coast Cognition's messaging, a friend mentioned Volvo. Not because I wanted to sell safety features. But because Volvo understood something fundamental: people don't buy safety - they buy the future they want to preserve.

Volvo didn't say "three-point seatbelts and crumple zones." They said "they lived." They showed families intact and futures and choices preserved.

That's what Cognitive Stewardship is really about.

This family made choices early that are still paying dividends today:

• They still live in their condo, not institutional memory care

• They travel internationally with friends (who understand and support them)

• They participate in community activities and engage socially

• They spend nights in their community living environment by choice, not necessity

• Everyone was able to participate in planning this future

These choices exist because they acted early. The wife driving to the appointment where they made the community living deposit. The wife participating in care decisions. While "reluctant" was still possible - before cognitive decline made even reluctance impossible.

We Need Each Other

Here's what moved me most about the husband’s email. After explaining why they're beyond my Founding Families program window, he wrote:

"It may be that the greatest value in any relationship might be in my/our ability to share with others in your program who may be just beginning their journey."

This is what community means in the context of cognitive aging. We need families who are further along to light the path for families just starting out. We need the courage of people who've navigated these transitions well to give permission to people who are afraid to begin.

Clinical expertise matters. Neuropsychological testing matters. Evidence-based interventions matter.

But so does this: A husband who's kept a diary so he can answer doctors' questions accurately. A wife who voluntarily stopped driving and sold her car - no dramatic intervention needed - because the relationship and trust were strong enough. A friend who noticed repeating stories and cared enough to have a hard conversation.

The dementia journey isn't something we do to people or for people. It's something we walk alongside people through. And we walk it together, as a community.

The Holiday Gift We Can All Give

As we move into the new year, here's what’s on my wish list:

If you're noticing changes in yourself or someone you love - memory slips that seem different than normal aging, difficulty with tasks that used to be automatic, subtle shifts in judgment or personality - don't wait for a crisis to force action.

You have a window. It's open right now. The choices you make in this window will shape everything that comes after.

If you've walked this journey and navigated it well - like this family - your wisdom matters. The families just starting out need to know it's possible to do this with grace, with dignity, with continued joy. They need your permission to act early, to have hard conversations, to prioritize choice while choice is still possible.

If you're connected to families in either situation - make the introduction. Build the bridge. We find our way through this together or not at all.

Looking Ahead

I'm planning to meet with the family in January. Not as a clinical evaluation - they have excellent care already. But as a conversation about how families who've done this well might support families just beginning.

I am thankful for the email that landed in my inbox this week, sent by a husband I've never met, forwarded through a chain of community connections, written with candor and courage about the hardest journey a family can walk - that email is exactly why this work matters.

We preserve choice by acting early. We act early by supporting each other. We support each other by building community that doesn't look away from hard things.

That's the gift we can give each other this holiday season and into the new year.

We're all in this together. And we all need each other. 🎁