Screenings, primary care, and specialty memory clinics do different jobs - here is the order San Diego families should work through, and who to call first.
By Marcus Reyes, LSW · September 20, 2026
Most families arrive at a doctor's office with a feeling rather than a record, and that is the single biggest reason a first appointment goes nowhere. A physician has fifteen minutes and a patient who is, in that moment, alert, dressed, and answering questions politely.
Spend a week keeping a plain list. Note the date, what happened, and what it interrupted. Repeating the same question within an hour is different from forgetting a name. Missing a bill payment for the first time in fifty years is different from misplacing keys. Getting turned around on a route they have driven for decades belongs on the list, and so does a personality change - new suspiciousness, withdrawal from a church or club they never missed, a short fuse where there never was one.
Also list every medication, including over-the-counter sleep aids and supplements. Several conditions that look exactly like dementia are not dementia at all: thyroid disease, B12 deficiency, depression, an untreated urinary tract infection, sleep apnea, and drug interactions all produce confusion in older adults, and all of them are treatable. A good evaluation rules these out before it rules anything in.
San Diego County has an unusual asset here. The UC San Diego Shiley-Marcos Alzheimer's Disease Research Center offers community memory screenings at no cost, with no obligation to join a research study. A screening runs roughly twenty minutes and produces a simple signal: results in the expected range, or results that warrant a full workup by a physician.
The center can be reached at (858) 822-4800, and it operates from UC San Diego Health's East Campus Office Building in La Jolla as well as a South Bay location in Chula Vista. Screenings are also offered periodically at senior centers around the county.
Be clear with your family about what this is. A screening cannot diagnose Alzheimer's disease or any other dementia, and a clean result does not close the question if you are still seeing changes at home. What it does well is break a stalemate. For a parent who has refused to see a doctor about memory for two years, a free twenty-minute appointment is a far easier yes than a neurology referral, and a flagged result gives the family something objective to bring to the physician.
The next stop is the primary care physician, and there is a specific appointment worth asking for by name. Medicare covers an Annual Wellness Visit, and detection of cognitive impairment is a required element of it. It is a separate appointment from a problem-focused visit and from the one-time Welcome to Medicare visit, and many older adults have never used it.
Call ahead and ask the scheduler for an Annual Wellness Visit with time set aside for a cognitive assessment, and send your written list to the office in advance through the patient portal. Then go to the appointment. An adult child in the room who can describe what has changed over eight months is the most useful diagnostic instrument available, and it is the thing most commonly missing.
Expect the physician to order bloodwork and review medications first, and to ask your parent to complete a brief cognitive test. If the picture is unclear or the findings are significant, the primary care doctor is who refers onward - to neurology, geriatrics, geriatric psychiatry, or a dedicated memory disorders program. Within a Medicare Advantage plan that referral pathway matters, because the specialist has to be in network. HICAP provides free, unbiased Medicare counseling in San Diego County and does not sell insurance.
A full workup typically involves neuropsychological testing that runs a few hours, brain imaging, and a clinical interview. San Diego families generally reach this through one of the major health systems - UC San Diego Health, Scripps, Sharp, or Kaiser Permanente - or through the VA San Diego Healthcare System in La Jolla for veterans enrolled in VA care. Which door you use depends far less on reputation than on your parent's insurance and who is accepting new patients, so ask both questions on the first phone call.
Waits for neurology and neuropsychology are real and can stretch for months. Ask to be placed on a cancellation list, and ask whether a geriatrician can see your parent sooner, since geriatric medicine handles a great deal of cognitive assessment. Do not stop the practical work while you wait: legal and financial planning is easiest to complete early, when your parent can still participate meaningfully in decisions about their own money and care.
For veterans, the VA pathway is worth pursuing directly rather than in parallel, because VA enrollment can also open caregiver support and respite services private insurance does not cover.
Families routinely put off calling anyone until they have a name for what is happening. That is backwards. Support organizations in San Diego work with families who are still in the suspicion stage, and their help is most valuable then.
Alzheimer's San Diego is an independent local nonprofit offering education, support groups, and family consultations. The Alzheimer's Association operates a free 24/7 Helpline at (800) 272-3900 staffed by people who can talk through what you are seeing at two in the morning, in more than 200 languages. The County of San Diego's Aging & Independence Services is reachable at (800) 339-4661 and connects families to caregiver support, adult day programs, and in-home services - the same number handles Adult Protective Services reports if safety becomes urgent.
If the evaluation eventually points toward residential care, that is a separate research project with its own timeline. California licenses assisted living and memory care through Community Care Licensing, and every facility's inspection and complaint history is public at ccld.dss.ca.gov. But none of that is today's task. Today's task is a written list and one phone call.
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