Optum Memory
Health Support
Empowering patients and families. Improving outcomes.
Get answers without seeing a specialist
The Everett Clinic and Polyclinic primary care physicians are trained to diagnose cognitive issues, so you can get answers without waiting to see a specialist.
Our unique memory loss and caregiver support program is designed to streamline the path to care for your loved ones. We’re making memory health support more accessible by training our physicians to diagnose and develop an appropriate care plan — and pairing them with Medical Social Workers to implement it.
How we support patients & caregivers
What to expect as a caregiver
Pat’s story
Don’s story
The importance of early diagnosis
Understanding what’s happening
Get the support you need based on where you are in the journey.
Schedule a professional cognitive assessment
Understanding what’s happening, what to expect, and how to help starts by scheduling a primary care appointment for a professional cognitive assessment. Whether they are an existing patient or someone new to our clinics, you can find a doctor that’s right for your loved one’s needs.
Common caregiver concerns
Click on any question for helpful answers, information, and resources
Are there different stages of Alzheimer’s and what can I expect?
There are 3 stages to Alzheimer’s: early-, mid- and late-stage dementia. Below is a summary of what you can expect and what to consider. For more details, steps to take, and tips on your caregiver journey, download this helpful guide by the Dementia Action Collaborative.
Mild or early-stage dementia
With early-stage dementia, your loved one has difficulty accomplishing some activities. Signs can include:
However, they may remember stories from long ago or to do familiar things.
During the early stage, you should be an advocate for the correct diagnosis. Learn all you can about the disease and actions you can take, including:
Moderate or mid-stage dementia
In this middle stage, confusion becomes more evident. They may:
However, they may become increasingly present and “in the moment”.
At the mid-stage, you should develop your network of support, establish routines, and take safety precautions. To start:
Severe or late-stage dementia
In this stage, your loved one is entirely dependent on personal care. They may:
At the same time, they may still be attuned to the emotions of others and enjoy companionship.
At the late stage, you should:
Mild or early-stage dementia
With early-stage dementia, your loved one has difficulty accomplishing some activities. Signs can include:
- Having trouble with time or sequence of events
- Writing reminders and losing them
- Demonstrating mood or personality changes
- Expressing sorrow, suspicion, anger, or frustration
During the early stage, you should be an advocate for the correct diagnosis. Learn all you can about the disease and actions you can take, including:
- Attend medical appointments
- Ensure medications are taken properly
- Review tips for communicating effectively
- Look into Advance Directives if one doesn’t currently exist
- Consider ways to protect their financials from missteps
- Create and stick to simple routines
- Resist the urge to do things for them
- Keep up your own health
In this middle stage, confusion becomes more evident. They may:
- Have trouble recalling their address or personal history
- Not recognize familiar people
- Lack judgment and become more irritable, repeat questions, or wander
- Have delusions or hallucinations
At the mid-stage, you should develop your network of support, establish routines, and take safety precautions. To start:
- Practice not taking behaviors personally
- Look into options to maintain their current living situation
In this stage, your loved one is entirely dependent on personal care. They may:
- Not recognize you or others by name, but it doesn’t mean they don’t know or feel who you are
- Have difficulty communicating
- Experience changes in physical ability to walk, talk, sit, and eventually swallow
- Be vulnerable to infections
At the late stage, you should:
- Be gentle with yourself and your loved one
- Allow plenty of time for tasks
- Be together in ways that don’t require words
- Actively seek palliative care or hospice care
- Consider other emotional support for yourself
- Consider discussing end-of-life preferences with family and friends
Is it safe for my loved one to drive?
Patients with dementia are at greater risk of motor vehicle accidents. If your loved one is diagnosed with dementia, consistent with state law, they should not drive a motor vehicle.
New troubles with driving can be a sign of dementia that requires evaluation. Signs of difficulty may include:
New troubles with driving can be a sign of dementia that requires evaluation. Signs of difficulty may include:
- Forgetting how to locate familiar places
- Failure to observe traffic signs
- Driving at inappropriate speeds, hitting curbs, or using poor lane control
- Confusion between the brake and gas pedals
- Becoming angry or confused while driving
- Returning from a routine drive later than usual
How do I tell my loved one they need to stop driving?
For people in the early stages of dementia, you should start planning and have conversations about how they will get around once they can no longer drive. Preparing them will ease the transition.
Important tip: As things become critical, approach the conversation from an emotional standpoint — not a logical one. Dementia mainly impacts the top portion of the brain that involves logic and reasoning. The emotional brain is still normal so emotional appeals are more likely to be effective. Sit down next to them (not facing them), touch them (hand on knee or back), and start a conversation with something like, “I am worried about you and would like it if you would stop driving. Will you do this for me?” Explore more tips from the Alzheimer's Association, including how to start the conversation, what to do if doesn’t go well, how to find available transportation options and key warning signs. A variety of public transportation options may be available to patients with dementia, and a social worker can help your family consider your options.
Important tip: As things become critical, approach the conversation from an emotional standpoint — not a logical one. Dementia mainly impacts the top portion of the brain that involves logic and reasoning. The emotional brain is still normal so emotional appeals are more likely to be effective. Sit down next to them (not facing them), touch them (hand on knee or back), and start a conversation with something like, “I am worried about you and would like it if you would stop driving. Will you do this for me?” Explore more tips from the Alzheimer's Association, including how to start the conversation, what to do if doesn’t go well, how to find available transportation options and key warning signs. A variety of public transportation options may be available to patients with dementia, and a social worker can help your family consider your options.
Is it safe to leave my loved one alone?
This question requires careful evaluation. Someone in the early stages may be ok to be left alone and you can take steps to create a safe home for them. Read these helpful tips on home safety from the National Institute on Aging.
Their ability to recognize a dangerous situation, like fire, is what’s important to consider. Do they know how to use a phone in an emergency? Are they able to get help? You may want to seek professional guidance if they:
Their ability to recognize a dangerous situation, like fire, is what’s important to consider. Do they know how to use a phone in an emergency? Are they able to get help? You may want to seek professional guidance if they:
- Attempt to pursue interests that might warrant supervision, like cooking or woodworking
- Wander and become disoriented
- Show signs of depression or withdrawal when left alone
- Become confused in stressful situations
I’m worried my loved one will fall when no one is around
There are steps you can take to minimize the possibility of this happening:
- Remove furniture or clutter so they can move more freely
- Make sure they have steady handrails and install rails in showers and bathtubs
- Remove small rugs and put carpet on stairs — mark edges with brightly colored tape or add lighting
- Put a gate across stairs if they have balance problems and make floors less slippery
Do people with dementia end up in nursing homes?
Most people with dementia live in their own homes but need extra help with things like managing finances, cleaning, and errands. Although some people with dementia end up in nursing homes, most do not.
Are there medicines one can take for dementia?
There are some medications available that may help. They don’t work for everyone and not everyone is a candidate. It’s important to understand that while medications may delay memory decline, they’re not a cure. They cannot stop the disease from worsening over time.
There are new medications coming available for Alzheimer’s and mild cognitive impairment. You can ask your doctor whether your loved one may or may not be a good candidate for one of these newer medications.
There are new medications coming available for Alzheimer’s and mild cognitive impairment. You can ask your doctor whether your loved one may or may not be a good candidate for one of these newer medications.
What are my options for care assistance?
- Adult day services that focus on activity, exercise, and socialization
- In-home care to assist with bathing, dressing, getting ready, or other personal care needs and routines
- Respite care is a short-term option that gives caregivers a break in-home or out-of-the-home
Respite care facilities can care for adults during the day or overnight and handle short- and long-term stays. This is a good option if your loved one requires multiple people for care. These facilities can also be a good trial for those considering a move to a higher level of care.
You may also want to consider Palliative care to treat symptoms of Alzheimer’s Disease, such as depression, anxiety, and difficulty sleeping. The care team can teach your family what might trigger behavioral symptoms and how to avoid them.
Explore more resources in Washington State from Community Living Connections.
Where can we get help coping with difficult behaviors?
Contact the Alzheimer’s Association to learn how to manage them or call 1-800-272-3900.
You should also take time to identify what may be triggering challenging behaviors, including:
Important tip: Don’t rely solely on logic when communicating with a loved one. An emotion-based approach is more likely to get results. They can sense your emotions and may emulate what you feel. “You’d better put a coat on because it’s cold” may not be as effective as something like, “I’m worried we might get sick. Will you put a coat on for me?”
You should also take time to identify what may be triggering challenging behaviors, including:
- Medical-related triggers like excessive medication side effects, untreated hearing or vision loss, acute infections like urinary tract infection, angina, constipation, pain, etc.
- Physical triggers include the space being too large, cluttered, or stimulating. There are no orientation cues, a poor sensory environment, or an unstructured routine.
- Tasks and responsibilities that overwhelm the patient with their complexity.
- Quality of communication of caregivers towards the patient. Dementia is a disorder that impairs a patient’s rational, logical abilities but leaves emotional abilities intact.
What does insurance cover?
It depends on what type of insurance your loved one has. You should check their policy. While private insurance and government resources may help cover some expenses, it’s common for individuals and families to have to pay out of pocket for some services. This can include respite, home health, and nursing home care.
You should find out if your loved one has a long-term insurance plan. Carefully review the policy to determine if Alzheimer's is covered, what’s covered, and for how long. The plan may cover skilled nursing homes, assisted living, and licensed home care. Your medical social worker can help advise you based on your insurance coverage. You can also visit the Alzheimer’s Association to learn more.
You should find out if your loved one has a long-term insurance plan. Carefully review the policy to determine if Alzheimer's is covered, what’s covered, and for how long. The plan may cover skilled nursing homes, assisted living, and licensed home care. Your medical social worker can help advise you based on your insurance coverage. You can also visit the Alzheimer’s Association to learn more.
What legal steps should I take?
There are multiple things to consider, including the steps that follow. When a loved one is diagnosed with mild cognitive impairment or dementia, preparing and signing legal forms as soon as possible is important. Dementia will affect the ability to sign legal documents in the future.
Legal planning
You’ll need to address financial and healthcare decisions. Here are some important forms you’ll want to have completed as soon as possible:
You can hire a lawyer or attend a free legal clinic by End of Life Washington to prepare these documents for you or do them yourself. You should also download this Dementia Legal Planning Toolkit from the Dementia Action Collaborative. The above planning documents should be completed as soon as possible, updated regularly, and shared with loved ones, doctors, and hospitals.
Durable Power of Attorney
At a minimum, you should complete a Durable Power of Attorney for Healthcare and a Healthcare Directive. This provides a clear opportunity to support the care directions, even when the patient cannot.
Advanced care planning
Making healthcare decisions for yourself or a loved one is complicated. That’s why it’s important to have clear arrangements and preferences. You can change them as needed, but getting plans in place and creating structure now will help you down the road. Here’s a checklist of key actions and considerations*:
*Adapted from The National Institute on Aging
Protecting end-of-life choices
This is a challenging topic for everyone, but learning what legal options are available in Washington State will allow for end-of-life planning on the individual’s terms. Here are some important tips:
Legal planning
You’ll need to address financial and healthcare decisions. Here are some important forms you’ll want to have completed as soon as possible:
- Durable Power of Attorney for Finances and one for Health Care: This lets the patient choose a trusted friend or relative to help with finances or health care decisions when they cannot
- Healthcare Directive: A living will or advance directive allows the patient to choose what kind of medical treatment they want to have if they’re terminally ill or permanently unconscious
- Dementia Directive: This allows the patient to make choices about dementia care and other issues that are likely to arise
Durable Power of Attorney
At a minimum, you should complete a Durable Power of Attorney for Healthcare and a Healthcare Directive. This provides a clear opportunity to support the care directions, even when the patient cannot.
Advanced care planning
Making healthcare decisions for yourself or a loved one is complicated. That’s why it’s important to have clear arrangements and preferences. You can change them as needed, but getting plans in place and creating structure now will help you down the road. Here’s a checklist of key actions and considerations*:
- Start discussions early to ensure their wishes are central to ongoing decisions
- Create documents that communicate the patient’s needs for healthcare, financial management, and end-of-life wishes
- Choose one place for important papers so a trusted family member or friend knows where to find documents and instructions
- Make copies of Healthcare Directives and place them in all medical files — and with every doctor the patient sees
- Secure permission in advance for a doctor or lawyer to speak directly with a caregiver as needed
- Reduce anxiety about funeral and burial arrangements by planning ahead
Protecting end-of-life choices
This is a challenging topic for everyone, but learning what legal options are available in Washington State will allow for end-of-life planning on the individual’s terms. Here are some important tips:
- Visit End of Life Washington
- Discuss specific wishes with the doctor to ensure they can and will support them
- Create a living will or advance directive to help protect your loved one’s rights
- Register for a free 60-minute presentation on advance planning
Caregiver resources
Helpful information, resources, and organizations to support you and your loved one.
Community Living Connections
Home and community-based support services
Alzheimer’s Association
Care, support, and research for those affected
Community Living Connections
Home and community-based support services
Dementia Road Map
Helpful tools for patients and caregivers from the Dementia Action Collaborative
Dementia Legal Planning Toolkit
Important do-it-yourself documents and forms from the Dementia Action Collaborative
Advance Care Planning
Free one-hour online workshop for caregivers
Get answers from a specially trained doctor
Use open scheduling to make an in-person appointment with select care providers. If you’re new to our clinics, it’s a great way to experience being well cared for. If you’re a current patient, you can schedule an appointment by phone or in MyChart. Request a “cognitive assessment” when you schedule an appointment. If you have Medicare, the annual “wellness test” includes a cognitive test.
Schedule Online
Or call 1-425-259-0966 TTY 711
Schedule Online
Or call 1-206-329-1777 TTY 711
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