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An important question to ask you is whether she has an assigned PoA? If so, this person needs to be notified of the concerns and then read their PoA document to see what activates the authority (usually it is an official diagnosis by a doctor).

How old is your MIL?

What symptoms does she have that leads you think she's having a cognitive issue? FYI there are some illnesses that can also create dementia-like symptoms. One is a UTI. This is what she should be tested for first and foremost. The way you get an uncooperative person in for treatment is to call 911 and tell them she is not behaving like herself and you suspect a UTI. They will test her for this in the ER and prescribe antibiotics if she has an infection.

But if she doesn't, they will not do a cognitive test in the ER. This could be done most easily through an exam with her primary doctor. You may need to tell her a "therapeutic fib"... that an annual (free) wellness exam is required for her benefits to continue -- or whatever narrative you think will motivate her to go. Before the appointment you go into her medical portal (if she has one set up) or have a pre-written note that you discretely hand to the nurses explaning who you are and what your concerns are. Then you need to stay in the room during the entire exam (sit behind her if possible) so that when the doc asks her questions you can confirm or correct her answers. This is exactly what I did with my MIL and I was shocked at how poorly she did. She couldn't draw a clock face nor remember the 3 words (and this is the simpler cog test).

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