We're not sure how much awareness my mom has of the situation, but she has enough awareness that she stopped driving and cooking saying she doesn't seem safe performing those activities. In the last week, she's forgotten how to use a remote key and left cold cuts in a kitchen drawer instead of the fridge. We recently discovered several unused bottles of her medication which tells us she is not taking it daily. When asked about it, she says she takes it, but sometimes forgets. How do we approach her to ask her to discuss this with her physician and to allow my dad to manage her prescription? We along with my dad are wondering how best to address the situation.
Get a geriatrician, not a family doc, dad should have a discussion with doc before the appointment. Get all of mom's documents in order now!
From that point we discovered that she could absolutely not live on her own anymore because she 1) didn't take her meds correctly no matter what and 2) wasn't remembering to eat or how to work her appliances. We chose AL for her and not a minute too soon.
We only lived 6 miles from her and even though I had been calling her daily to "walk her through" taking her meds and eating, she was still NOT doing it even though she was telling me she was. So, from now on you cannot assume anything your mom tells you is accurate (and she's not doing it on purpose).
As gladimhere emphasized you must protect all her sensitive information immediately so she doesn't fall prey to scammers and abusers, or just lose things. Whoever is her PoA needs to check the document's language to see when the authority is activated. She needs full-time help now. You can ask your mom if she'd like help with things (I showed my mom how I managed my banking with online access and then offered to set that up for her. This way I had her login and info so I could manage things.) I wish you all the best -- you will be very busy until she is settled into a care arrangement that works for her and her caregivers.
I always recommend going here as well:
https://www.alzconnected.org/discussion.aspx
If your mom can't recollect something it is a kindness to agree with her and live in her reality--this is a good place to start :http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf
You are lucky that your mom recognizes that there are issues and that she has altered her behavior so that she's safe! That's great. That said, if she has a formal diagnosis it may be terrifying. We couch everything as 'memory issues' for my mom.
Your mom should have a physical soon so that other possible causes of her confusion can be ruled out (thyroid imbalance, vitamin deficiency, UTI, etc). I would contact the physician's office and explain your concerns, so that if they can't work her in soon, at least the lab work can get done now, so that something simple like a UTI could be treated quickly, then see where she is cognitively. Now is the time to make a little 'introduction' letter where you share what cognitive issues you're seeing. This is useful to hand off to the physicians prior to any office visit.
Since your Mom's aware that there has been a cognitive decline you could tell her that the doctor's visit is because of her concerns. If other causes are ruled out your physician should then refer you to (usually) a neuropsychologist or neurologist for further testing. Within a diagnosis of 'dementia' there are many sub-types, and the progression of the memory loss, and meds, are different for each.
For now: What can your dad handle? Do you have any concerns about his memory as well?
Now is the time to plan for a worst case scenario of your dad being suddenly incapacitated while caring for your mom:
Have BOTH mom and dad assign a power of attorney for EACH of them and clarify what their wishes are regarding advance directives. Many states offer POA and advanced directive paperwork online--you might want to see what those look like. Many people use an elder care lawyer to set up the POA.
https://www.elderlawanswers.com/kinds-of-trusts-12007
https://www.nia.nih.gov/health/advance-care-planning-health-care-directives
Hospital and physician online portals have a way to scan in your paperwork, and most hospital systems offer their version of advanced directives as well, but do get copies of the POA, advanced directives, and contact numbers into their medical records. POA should be filed with the bank (this is key), insurance co, Medicare, etc.
Now is also the time to make sure that there is a plan for the POA be a backup contact on as much as possible and to have access to all the financial info--bank accounts, taxes, utilities, etc. If online banking or bill paying hasn't been set up, then that should be done. Medicare has an online portal too that it might be worth getting set up.
Her changes may have been slow enough that they have crept up on your dad and he doesn't see as much of a change as you do. Usually there's a desire (of course) to stay as independent as possible and the changes are often rationalized as normal age related forgetfulness.
MEDS: Can your dad manage your mom's meds?
Mom's Housework: Who can do? Will she need help? The goal is to take as much of the day-to-day intensive memory tasks away from your mom, but not put them on your dad. Is your dad able to come to grips with the changes? How's he doing? Would they benefit from a homecare aid coming by to make sure meds are taken and who can do light meal prep or cleaning?
Do they want to stay in their home or are they open to downsizing, perhaps to a nice AL with memory care available for later? Look at CCRC's. Lay the groundwork for a move. You will get a lot of helpful advice here. I wish your family well.
I think that since she is already aware, that you as a family should sit down with her and have a calm discussion about what now needs to take place for her wellbeing and safety.
You may want also see a neurologist as they are typically the ones to diagnose any kind of mental decline.
I wish you and your family the best.