As someone living with Alzheimer’s, and lucky enough to have been diagnosed early, I’m fully aware of the challenges of the disease and growing old, as well as the challenges we inflict on those who love us. To assist myself in my journey and also provide assistance to others, I’ve published a book of hope, scientific information and practical choices to delay Alzheimer’s and improve brain health titled Use Your Brain to Fight Alzheimer’s.  I’d like to share a glimpse of some positive ways we can plan for our future.  

There’s a great deal that often goes unsaid when a neurologist first tells you that you have Alzheimer’s. The focus tends to be on medication, names like Leqembi or Kisunla, but rarely on what comes next. Perhaps it isn’t the doctor’s role to discuss how life will change, or how many decisions you’ll soon face about your future. Yet, this is exactly the time to start thinking about those choices. These new drugs can delay the progression of Alzheimer’s, but they are not a cure.

 We all know the painful truth about this disease, the gradual loss of mental clarity while the body remains largely intact. But being diagnosed, difficult as it is, also offers a rare opportunity: a glimpse into what may lie ahead, and a chance to prepare for it. It’s not a pleasant picture, but there are steps we can take now to make things easier for ourselves and for those who will one day care for us. In fact, many of these same steps are valuable for anyone over seventy who has begun to shift their gaze from building a future to managing how that future unfolds.

When I began the diagnostic process, an experience that can vary widely from person to person, I was fortunate. My primary care doctor referred me to a Neuro-Rehabilitation Psychologist. After a series of in-depth tests assessing my mental agility, she identified weaknesses in executive function and processing speed. Alzheimer’s was not yet confirmed, only suspected. But what stood out from that evaluation was its focus on rehabilitation; practical ways to improve and support brain health.

 By contrast, my neurologist’s questions are more routine: Are you exercising? Are you getting enough sleep? Have you had any falls lately? However, this is a long way from explaining exactly why he is asking and what to do about it. Understanding “why” is critical, because these simple actions are far more than medical checkboxes; they are part of a broader strategy to protect and preserve what we can of our brain function for as long as possible.

 In the sections that follow, the focus shifts to exactly that—what you can do now and why it matters. Understanding the reasons behind each recommendation is just as important as the actions themselves. This next part will also include practical steps you can take to make things easier for your future caregivers and loved ones. Knowing why certain choices support your brain and overall well-being gives you a sense of control and purpose, helping you prepare not only for your own journey but also for those who will walk it with you.

Not one of the many medical professionals I’ve seen has ever asked one of the most important questions: Is your house in order?

 It’s a question that deserves attention, one that anyone approaching the later years of life should face honestly, especially if they care about the people they’ll one day leave behind. Putting your house in order is not just about possessions or paperwork; it’s about easing the burden on those who will step in when you can no longer manage the details of daily life.

 Let’s begin with one of the simplest, but most overlooked, issues: Who will pay your bills? Whether death comes suddenly or after years of decline, this is a question that needs an answer NOW. In the past, it was straightforward, bills arrived in the mail, and you wrote a check. Today, most of us manage our finances online. That convenience comes with a hidden complication: passwords.

For many of us, passwords have become a tangle of letters, numbers, and symbols, different for every account, often stored in a password manager that itself requires a password to open. Without clear  records of how your bills are handled, what needs to be paid, when payments are due, which credit cards or accounts are used, and how the bills arrive, your loved ones will be left confused, frustrated, and overwhelmed at a time when they’re already under stress.

Don’t forget about the less frequent expenses either, those once or twice-a-year payments like property taxes, insurance premiums, or professional fees. A simple list noting what to expect and when it comes due can make an enormous difference. Taking the time now to organize these details is one of the most thoughtful gifts you can leave behind: the peace of knowing that those who care for you will not have to untangle what could have been clearly explained.

When it comes to banking, your caregivers or loved ones will need full access to the information they’ll require to manage your accounts. This includes knowing your account details and understanding exactly what is needed for banks to recognize a power of attorney or other permission to act on your behalf.

With Alzheimer’s, now is the time to designate a trusted person to gradually become familiar with your financial routines. The disease slowly erodes the ability to make sound financial decisions, and eventually even simple calculations can become challenging. By starting early, you can create a partnership with the person who will handle your bills. Together, you can map out a plan to recognize the point at which you may no longer be able to manage your finances independently, ensuring a smoother transition and reducing stress for both you and those who will care for you.

There are several legal matters that need attention NOW while you still have the clarity and capacity to make decisions.

Anyone who will take over your finances cannot do so legally without a Power of Attorney. Banks and financial institutions are slow to act without this document, so getting it in place early is critical.

Equally important is the Health Care Power of Attorney. Except in life-saving emergencies, no one can make medical decisions for you without your explicit permission. Now is the time to designate that trusted person. Remember, you can change this designation at any time; up until the point where you no longer have the capacity to understand or make decisions. After that, it’s too late.

It’s also time to think about the end of your life. Decisions such as a Do Not Resuscitate (DNR) Order should be made now, documented in your Health Care Power of Attorney, shared with your doctor, discussed with family, and copies provided to the hospital. Clear communication ensures your wishes are honored and prevents confusion during stressful moments.

A Will is another essential step. It allows you to clearly outline your wishes, avoid surprises, and reduce potential conflicts among heirs. Wills can always be updated later, but having one in place now provides peace of mind. For further protection, consider a Living Trust, which consolidates your assets, designates an executor, and can help your loved ones avoid the costly and time-consuming probate process.

Finally, it’s time to discuss your final wishes regarding burial or cremation. Designating a funeral home and making arrangements in advance, including the possibility of burial insurance, spares your loved ones from having to make difficult decisions in the midst of grief. Planning ahead ensures your wishes are respected and relieves your family of unnecessary stress during an already emotional time.

While putting your house in order there are other actions that can improve your well-being and independence for as long as possible.  You’ve heard many of these choices before, but I can tell you they are based on scientific studies that have been proved to be valid.

As we grow older, the body’s internal engine, the metabolism, gradually begins to slow down. This decline doesn’t happen overnight but is the result of several interconnected changes that come with age.

One of the most significant factors is the loss of muscle mass. Muscle is a metabolically active tissue, meaning it burns more calories even at rest than fat does. As the years pass, we naturally lose some of this muscle, which in turn lowers the body’s calorie-burning capacity. Adding to this is a general decline in physical activity. Many older adults move less than they once did, leading to further muscle loss and an even slower metabolism.

Hormones also play a crucial role. Levels of testosterone, estrogen, and other hormones that help regulate metabolism tend to decrease with age, subtly shifting how the body manages energy. Meanwhile, changes occur deep within our cells, the energy factories of the body, making them less efficient at producing the fuel we need.

Over time, these changes alter body composition. Fat gradually replaces some of the lost muscle, further tipping the balance toward a slower metabolic rate.

Still, not everyone experiences these shifts in the same way. Genetics, lifestyle choices, and overall health all shape how dramatically, or gently, our metabolism declines with age. With regular activity, strength training, and healthy habits, many of these changes can be slowed, helping the body stay more energetic and resilient through the years.

Yes, EXERCISE is very important.  Retired people tend to sit more often than move around.  This requires a concerted effort to exercise daily.  Current science suggests a target of 150 minutes a week minimum.  The types of exercise are up to you and there are a wide variety to choose from.  One goal of exercise for those of us with Alzheimer’s is to increase blood flow to the brain.  This increased blood flow brings more nourishment and aids the brain’s waste disposal system.

DIET, meaning what we eat, can help or hinder our bodies natural processes.  We live in the age of processed foods which mother nature never intended as a food source for humans.  If you recognize the danger of processed foods, and correct your eating habits by using the MIND diet your body will thank you in physical ways.

SLEEP is essential for brain health.  While we sleep, the brain is far from idle, it’s at work repairing, restoring, and organizing itself. Each night, as we move through deep and dream-filled stages of sleep, the brain consolidates memories, strengthens learning, and clears away the toxic waste that builds up during the day. This cleansing process, carried out by the brain’s glymphatic system, helps remove harmful proteins linked to Alzheimer’s disease and keeps the mind functioning smoothly.

Sleep also restores the brain’s energy, sharpens focus, and stabilizes mood. It regulates the balance of hormones and neurotransmitters that affect how we think and feel, helping us stay calm, alert, and emotionally resilient. Over time, regular, high-quality sleep protects against cognitive decline and supports long-term brain health.

In essence, sleep is not a luxury, it’s a vital form of nightly maintenance that allows the brain to renew itself, preparing us to think clearly, remember well, and face each day with mental strength.

ACTIVATE YOUR BRAIN.  Keeping the brain active is one of the most powerful ways to delay the onset of Alzheimer’s disease. Just like muscles grow stronger with use, the brain thrives on challenge and stimulation. When we learn new things, solve problems, read, play instruments, or even engage in meaningful conversation, we create new neural connections and strengthen existing ones. This process builds what scientists call cognitive reserve, the brain’s ability to adapt and find new pathways when others are damaged.

An active brain also supports healthy blood flow, promotes the growth of new neurons, and encourages communication between brain cells. These effects help protect against the buildup of harmful proteins, such as beta-amyloid and tau, that are linked to Alzheimer’s.

In simple terms, keeping your mind engaged, through curiosity, creativity, and lifelong learning, acts like daily exercise for the brain. It doesn’t just sharpen thinking today; it helps build resilience for the years ahead, slowing the changes that lead to memory loss and cognitive decline.

One final thing to think about.  Memory loss is not sudden, it is a slow progression of killing memory neurons in various parts of our brains.  Which neurons are killed first varies widely among individuals so the symptoms of Alzheimer’s also vary.  With early diagnosis we have the advantage of recognizing what types of memory are fading.  Others can point out to us our losses which we need to consider, but we are the only ones who recognize what we used to be able to think.  That said, now is the time to start planning ways to mitigate these losses.  For example, getting lost.  If you have a cell phone you probably have GPS mapping.  Starting to map all your trips before you leave the house can help.  Setting up routines now for ensuring all things are shut down safely before going to bed can avoid problems in the future.  There are strategies to learn for memory loss, abstract thinking and finance.  There are strategies for compensating for slow processing speed and poor executive function.

NOW is the time to plan your future and make the choices that will help you prolong your independence.  Now is the time to identify and give the necessary power to your future care givers.  Now is the time to create those documents that will enable them to help you.  Now is the time to make your final wishes known.  These decisions can always be changed in the near term.

If you are interested in an in-depth descriptions of all of the above, as well as, the mental processes behind those recommendations read Use Your Brain to Fight Alzheimer’s, available on Amazon.com.