Someone shows deficits apparent to those close, but denies problem. Primary care won't evaluate until patient requests. How can we get eval?

You need a new primary care doctor. It is pretty insane for her doctor to say he won't do eval until SHE asks for it. I doubt many people would ever ask because they have no idea what you are forgetting.....because the nature of the disease is forgetting. If you continue to use the doctor, then you need to ask him: How do you get an evaluation for a person who does not realize they have a problem and then give a list of examples of some of the changes in her behavior.

You might check the insurance plan to find out what they will pay if you see a neurologist without a referral. Very possible some/most of the visit would be paid - maybe just lower payment.

I'll have to remember your dr's response on my list of craziest things I've heard from an educated medical provider.

Take him to a different physician. It's part of a general practioners responsibility to evaluate mental status and cognition EVERY VISIT especially if you are there and voice concerns. If the Dr. makes recommendations and he refuses to follow them that's different-pts have rights- but for MD not to even evaluate him is unacceptable.

GPs are supposed to have a 'wellness' visit with all medicare patients annually. This includes the most basic cognitive testing but at least it's something. If your GP doesn't do this, there is something seriously wrong and it's not (only) with your parent .

Who is not ready to declare him incompetent? You or the doctor? I agree with the other posters. You need to change doctors. A doctor sees a patient for 10 minutes. They should rely on family members for their insight and feedback about what is really going on. My FIL was still driving at 92 and going to various doctors with my MIL. He told everyone all sorts of nonsense about how he was cooking meals, keeping up the house and just generally doing well. The doctors wanted to believe it and no way to know until I started going with them. I am a nurse and got neurology eval referral and then neuropsych testing to confirm what we knew. But PCP believed whatever he said until I helped her understand it was wishful thinking on his part.

What kind of deficits are you seeing? I took my MIL to a doc appointment to check her for a UTI. I was not her medical PoA. I discretely passed the doc/staff a note requesting that they perform a cognitive evaluation because we were worried about her and they were happy to oblige. She did poorly on the test. It was very helpful to move forward in helping her knowing what her actual abilities were.

I am part of the Medicare Wellness Program - it's free - and I get evaluated annually.

If his primary physician refuses to evaluate, inquire about the medicare wellness program. A nurse called my DH monthly and now it's me getting the calls, lol. But it's nice to know that someone has my back! Anyone on Medicare is eligible for this program.

I would request eval. If doctor won’t do it find a better doctor. We had to do that. It has helped some. He has referred her to doctors she needed to see and it took a bit to get in to see neurologist. Now next step neuropsychologist. The new doc takes his time to talk to my mom and check with me to see if she’s actually telling him everything. She still has problems but we are starting to learn more about them now. So I’m wishing you luck on doctor front.

Definitely get your LO's POA docs in order, but also see if you can find a geriatric physician. (I'm assuming your LO is elderly?) No referral necessary, and a geriatric physician will be specifically trained in testing for and diagnosing dementia. A neurologist referral may still be necessary to get a more detailed diagnosis: MCI vs LBD vs ALZ, etc.

If you feel he is unsafe and incompetent in his own care you can call APS to check on his situation. If they agree they will report back to you on ways to proceed for guardianship. Without that you do not have rights.

I have a few thoughts.
1) If you don't have power of attorney, you need to pursue it.
Legally the Dr can't discuss your father's medical care with you due to HIPPA.
2)Orher than treatment, what are you hoping to gain from an evaluation? Sounds like a serious discussion with Pop about a retirement village is in order.
3) An evaluation may not show anything. I just went through this with my Aunt. During a mini mental evaluation she got 29 out of 30 questions correct! This is the same gal that forgets everything 5 minutes later. Tries to answer the TV remote when the phone rings and almost burned down the house with the microwave.

At the very least, POA would at least give you a leg to stand on with the Dr.
Hang in there!