How to get mom diagnosed for dementia when her primary won't help?

Unfortunately you may have to wait until there is some event that "forces" action.
That probably will be a trip to the ER.
Does your sister have POA? Or do you? Anyone?
If no one this should be taken care of BEFORE she is formally diagnosed. (If a lawyer thinks she is competent to appoint someone. If not you may have to go the route of you or sister obtaining Guardianship)
Your sister should NOT be spending her money on mom's personal expenses.
She should budget a set amount and when that money runs out that month then no more purchases.
Mom should not be driving. Sister should have the car disabled. And if mom is living alone, she should not be. A call to local Senior Services might provide some guidance. Your sister should tell them that she can no longer safely care for mom. (safety is not just mom's safety but your sister's safety, if she is experiencing seizures she should not be the sole caregiver)
When/If you go help your sister she should leave and let you help mom so there is no 3 party dynamics that your mom can pick fights with pitting you all against each other.

The driving issue is very hard. My father’s license was revoked in CA after his ALZ dx. He kept driving anyway. I am 3000 miles away and we tried everything we could think of. Disabled the car, let the air out of the tires, syphoned the gas, hid the keys, etc. He is like the terminator. He just won’t stop. He found a way around every problem and even went out and bought a new car when we had the truck towed away because it was “broken”. After that I froze his credit so he can’t finance anything again. But it took a year for us to finally get the cars removed for good. He had a fender bender in front of his house. Hit the gas instead of the break and hit his friend’s parked truck. Luckily he did no damage to the truck but he really crushed in the front of his car. Perfect. Opportunity came knocking. We had the car towed away and told him the mechanic said the car is totaled. If they can fix it, I will have it taken to a relatives house where he will sell it for me. Then the next week my dad’s girlfriend took him away for the day and I arranged to have his other car “stolen”. He came home to find the car gone and all hell broke lose. My dad’s girlfriend pretended to call the police and file a report. When he starts getting upset we now have a family member who he doesn’t know on the phone call him and say, “this is officer x, we are still looking for the car so give us some time on this”. That seems to work.

Then he demanded to be taken down to buy another car. His girlfriend managed to let the three different dealers know what was going on and they all just said, “you can’t buy a car today because you don’t have any credit”, or you are unable to buy a car anymore because you don’t have a driver’s license.

This is going to be an ongoing struggle with him I know, but if he manages to get his hands on another car, it will be time to get the actual police involved.

Neurologist, not geriatric psychiatrist.

Simply refuse to ride with your mom behind the wheel, and when she gets mad, tell her why.

I remembered being scared when driving with Mom. Then, being terrified when both our teenaged children were in her car and almost t-boned. My son yelled ‘Grandmom, what are you doing?’.

I recognized Mom was beginning to slip and began keeping notes of the things I was seeing that were different in her. Eventually, she didn’t take her meds and ended up in the ER. I was able to insist on a bedside psych eval after attending neuro read my notes.

Good Morning,

First and foremost--take the keys away. Mom shouldn't be driving. I had to do the same thing and Mom is on a blood thinner. You cannot be polite about this. You have to think of Mom's and other's safety on the road. They can't see what is happening.

Lots of water and a shot of cranberry juice. A UTI can also mimic Dementia or sometimes they have both at the same time. The railings around the toilet are better than the booster seat. Along with white "cotton briefs". No step-in/no back shoes or area throw rugs.

I had a Nurse Practitioner come to our place and assess my mother. Should you find another PCP with a better rapport? A lot of PCP are not taking new patients, let alone once you hit 80. If you can find a NP and a MD who can oversee, that can be done too. A family medicine practice will suffice and they go on the portal and keep the PCP abreast of mother's specialists.

The portal is the way to go. You can do everything online especially if you are out-of-state.

The first signs of my mother's decline was her peripheral vision. I couldn't understand why my mother would walk behind a car backing of out supermarket parking space. After all, she had new hearings aids and cataract surgery. Well, with Lewy Body Dementia your peripheral goes first so it's like putting snorkeling goggles on a person and they only see a small circumference in front.

The executive functioning skills and any type of instructions my mother could not follow just as you mentioned. Now I am not a medical professional but I am just telling you our situation.

You could get a Neurologist and/or Geriatrician Neuro-Psychologist. My mother has both. The PCP is/was wonderful. Everyone's situation is different.

This is important--check out on your State Board's Medical website ALL of your mother's doctors. I had a bad feeling about one and my "little voice inside" was right on target.

I have my mother check in with a Geriatric Neuro-Psych every 6 months. I accompany her. It's not in my mother's best interest to have an MRI every 6 months since my mother has a bad heart. We know she has Lewy Body Dementia. I don't want her tortured. I switched her from Warfarin/Coumadin to Eliquis. The blood draws and INR were all over all the place and her arms were black and blue. There are no blood draws with Eliquis but it is more expensive.

Dementia patients are afraid of the water but they still have to be groomed. I have a shower chair, nozzle, handicapped bars and a beauty box and spa bathrobe for my mother. Every so often I take Mom across the way and also have my mother's hair washed and styled. A cut every 6 weeks, Podiatrist every 9 weeks, dentist cleaning/check up every 6 months.

Maybe you could get her in the shower and the next day bring her to the hairdressers. Make gradual changes. Once you get a PCP some will can work with some doctors will let you have an online appointment. It depends. They have to see you first and then examine you but as time goes on and these are progressive diseases as one ages, this can be done. In the mean time if you can control some of the symptoms, if it's possible, you need a diagnosis first.

The test at the Neuro-Psy doc will be, they ask the patient, what is 7 from 100...what is 7 from 93...what is 7 from 86, etc. Then the 3 word test--remember these 3 words.

I hope I was of some help...

See if there is a Neurologist in the area.

If or when you can get Mom to the doctor for evaluation , don’t shower her , let them see what is her true self .

What is the goal here? Is it just to have her stop driving ? Or are you looking for a diagnosis in order to get her into assisted living ?

My mother’s PCP was no help either , all he did was suggest assisted living after I gave a note I had written to the nurse to give to the doctor . ( Later the nurse told me the doctor asked her opinion about my mother before seeing Mom that day , and the nurse told the doctor that she “ was seeing cracks for years”) . My mother said absolutely not leaving her home .
Doc didn’t offer any testing or referral to any other doctor, just told her she should think about assisted living to give me a break . That didn’t help because my mother felt it was my duty to take care of her . He did have the nurse give me a brochure about getting home care, which mom refused strangers in the house .

But Mom could not be home alone at night anymore. She was sundowning , calling up saying my (teenage) sister stayed out all night with her boyfriend . My sister did not live with Mom , nor was she a teenager . She was a married mom in her 40’s .
My other sister called our local County Dept of Aging , they sent out a social worker who interviewed Mom and said she wasn’t safe alone and needed 24/7 supervision ( not to mention bathing ). The social worker was scheduled to come back with someone else to remove my mother from her home and physically bring her to an assisted living facility that we picked out . ( mom would not look at any ) . One of my other sisters told my aunt who called up and tipped off my mother. My mother then said she was having chest pain , I think to avoid being taken from her home . We called ambulance to take her to the hospital.

At the hospital she finally had an evaluation ( at my asking when I explained the situation ) got the social worker at the hospital involved. Mom was diagnosed with dementia deemed it was not safe to live alone and she went to assisted living from the hospital .

Fortunately POA papers were done years previously when my father was alive .
If you don’t have POA that can be problematic , if Mom is not willing to sign , or if she’s not competent or willing enough. If no POA assigned by your mother she will be a ward of the county or you could seek guardianship through an elder care lawyer ( which is expensive) .

If you are looking to get Mom out of the house try to get her to sign POA first for medical and financials . Then call dept of aging to help if your mother is unwilling to go look at assisted living places . Have one or two picked out ahead of time .

If Mom ends up in the ER asked them to have her tested for dementia , say you don’t think she can live alone anymore . Say it’s an unsafe discharged and don’t take her home . Get the social worker involved to help facilitate placement at a faculty . Tour and have a few in mind . My suggestion is placement since your mother sounds very uncooperative .

Disconnect the car battery so she can’t drive . If your sister or anyone else lives or stays with your Mom , don’t leave car keys where your mother can find them .

You and sister need a united front ( covertly ) to get Mom placed in assisted living possibly memory care . Without money will need to start Medicaid process and find a facility that takes Medicaid . Does she own her home , sell that and use the money from sale to pay the facility . A elder care lawyer can help with this process or sometimes a social worker . Good luck .

Think about me and my family.Don't let her drive one more minute.She should not be alone-get her help.You are endangering her to falls, etc.

Look for a Neuropsychologist. Extensive testing can be done and discern between various types of dementia to be sure she receives the correct treatment and therapy. A friend learned her husband had Vascular dementia instead of Parkinson's related dementia which should be dealt with in very different ways. Use the patient portal and maybe an appointment can be made sooner. If you don't have access be sure you get it when you are there. I have found this is the best way to be sure the doctor receives and hopefully understand a message as you intend it rather than messages not communicated properly by well meaning staff member. Some dementia patients are misdiagnosed and the wrong medications can make it worse.

Get a referral for a neurologist. Tell her it is recommended evaluation that her doctor is unable to do in his/her practice. Call/write the doctor in advance and outline all the problem behaviors that you have noticed.