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We have been trying to talk to the in laws regarding MIL memory issues and progression. As soon as it's discussed they forget or cancel appt. with PCP. Her PCP did adjust the blood pressure medicine but that has not helped with memory or dementia. Who can test her? They are enrolled in Federal Retiree coverage and don't know if a referral is needed for specialist. Worried since our visit we noted the issue is taboo with her but FIL agrees that she is worse but just lost where to turn. Any ideas? Wyoming area agency on aging or where to look for guidance?

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Yes she needs a neuro psych assessment. Here PCP could offer a referral. Also an Aging Life Care professional can be a bridge to get her to see neuro psych. You will have to pay out of pocket for an Aging Life Care professional. As an Aging Life Care professional I work with a Nurse who comes in and does an assessment at her home on her medical, cognitive, routine living and care related needs. The assessment process often pushes people who are struggling out of their denial because the recognize what they can no longer remember or do for themselves. The Aging Life Care Professional walks you and them through the process.
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This is common, denial. The more you hound them the longer is will take for the assessment to get done. Back off, call her doctor, PCP's can do an initial assessment, tell doc what is occurring, ask doc to get her into the office to check on something else. Doc will not give you any information but you can talk to them and tell them anything you care to. Maybe doc will be successful.
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We are also in the federal health system. While it is true you don't need a referral ,unless your doctor is in "network" you may have have a large co pay for going out of network. I would first either call member service or the nurse on the insurance card and describe the the situation and ask for recommendations. Or if your in laws are fortunate enough to live near a major hospital, I would call their nureo dept and ask who they think would be the best person for her to see. You could take the in laws out for lunch, and depending on the time of the appointment, either you or hubby could say he has a medical apt and stop there.
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pnutbutmchoc: I strongly suggest that your MIL seek out a geriatric doctor. That doctor should be able to administer the needed and VERY SIMPLE memory test, e.g. where are you?, who is the President currently?, etc. Bear in mind, though, that this is just the tip of the iceberg, so to speak, and will only be able to tell you "yes, she has dementia." Go from there to seek out medication that will help her.
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pnutbutmchoc: I love your site name. I can just picture if McDonald's sold peanut butter sandwiches, you'd go for one!
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Who has POA or Medical proxy? Can you and FIL call pcp's office together to discuss what sort of specialist would be best for her to see?
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FIL has authority and I know would not hesitate if not for her maybe hypersensitive state that she may very well have been combative with him re the family concerns. I'm thinking if hubby can get insurance referral info and proceed with a local neuro appt. that might be more encouraging than leaving it to them to do and follow through. Allot weighing on FIL, but it's negligent of all of us to do nothing and she clearly cannot live without him and that's got to be horrible for him. I assume a neuro would be best?
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Opps, sorry I forgot to add that some of the federal health plans are HMO plans which requires referrals, this may also apply to some PPO plans it all depends on the plan they are in. That is why my first suggestion is to call the insurance co. BTW your father in law has to make that call, not yoy
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I also have medical coverage as a retired federal employee. It is likely that the family has a brochure from the specific insurer which explains coverage. I don't think you would need anyone's ok to talk to the insurance company about coverage and the process/need for a referral, and providers. There's nothing confidential about that. The relatives also may have Medicare which is likely to be the primary insurer if there are just the two insurances for the retiree.
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You will not be able to get info concerning your in-laws coverage unless you hold a medical POA and that may have to be sent to them. If FIL is OK, call from his home and have him tell the rep that its OK to talk to you. You can then ask the rep about referrels and what doctors are in ur area. At that time, ask if they will allow ur FIL to give permission verbally for you to ask questions in the future without going thru him.
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