A dementia diagnosis feels like it demands instant decisions, but most can wait. Here is a calm, day-by-day plan for the first week for Houston families, with the few things that truly should not.
The appointment where a doctor says the word "dementia" tends to end the same way for Houston families: everyone nods, someone takes a pamphlet, and the parking garage at the medical center is the first place anyone says anything out loud. What follows is rarely a crisis. It is a long stretch of decisions, and the first week is not the time to make most of them. It is the time to do a small number of things that protect your parent's safety and keep their legal options open.
Day one and two: get the facts in writing
Diagnoses are often delivered quickly, and families remember very little of the conversation afterward. Ask the clinic for the visit summary and the exact diagnosis wording, because "mild cognitive impairment," "Alzheimer's disease," "vascular dementia" and "Lewy body dementia" lead to different expectations. Ask what stage the doctor believes your parent is in, whether any reversible contributors were ruled out (medications, thyroid, B12, depression, hearing loss), and what the next appointment is for.
Also ask the physician for a signed, dated letter on letterhead stating the diagnosis. That sounds bureaucratic, but the Texas Department of Public Safety's Silver Alert guidance asks families to have exactly this kind of documentation ready, because law enforcement may request it if a person with dementia goes missing.
Questions worth asking at the follow-up
- Which of my parent's current medications could be affecting memory or balance, and should any be reviewed?
- Is it safe for them to keep driving, cook alone, or manage their own medications?
- What changes should make us call you right away rather than waiting for the next visit?
- Is a referral to a neurologist or geriatrician appropriate?
Day two and three: call for a human guide
The Alzheimer's Association Houston and Southeast Texas Chapter runs a 24-hour, seven-days-a-week Helpline at 1-800-272-3900. The chapter describes support groups, educational programs, early-stage programs, individualized planning with licensed professionals, and safety services for people at risk of wandering. The Association's care consultation page describes help identifying current needs, building a plan and finding services. It does not state a price or say who delivers each consultation, so ask when you call.
For Harris County specifically, the City of Houston's Care Connection Aging and Disability Resource Center offers free, confidential information and referral, including help finding providers and with applications. You can reach it at 1-855-937-2372 or 832-393-5500. It serves older adults, veterans, people with disabilities and their families throughout Harris County. If you live in Fort Bend, Montgomery, Brazoria or another surrounding county, the same toll-free number is a reasonable first call to ask what your county's local resources are, and dialing 2-1-1 is another statewide starting point.
Day three to five: the legal documents that cannot wait
This is the part of the first week with a real clock on it. Signing legal documents generally requires that the person understand what they are signing. Dementia does not remove that ability overnight, and many people in the early stages can still sign. But the window closes gradually and you cannot know exactly when. Once it closes, the alternative is usually guardianship, which is a court process. We cover that tradeoff in our post on guardianship vs power of attorney in Texas.
The documents elder law attorneys most commonly discuss for this situation are:
- A durable power of attorney for finances, so a trusted person can pay bills, deal with banks and handle taxes if your parent no longer can.
- A medical power of attorney, so someone can make health care decisions when your parent cannot. The Texas Health and Human Services Commission publishes advance directive forms on its website. The statutory form has its own signing requirements, so confirm the witnessing or notary rules before anyone signs.
- A HIPAA release, so doctors can talk to you about your parent's care.
- A directive to physicians and any end-of-life wishes your parent wants recorded, discussed with them while they can still express their preferences.
We are not attorneys and this is not legal advice. If your parent has real estate, retirement accounts or a trust, a consultation with a Texas elder law attorney this week is money well spent. Ask the attorney whether they feel your parent currently has the capacity to sign, and whether they recommend a physician's note documenting it.
Day four and five: safety at home and on the road
Make a quick, honest walk-through of the home. You are looking for the risks that matter most early on: stove and oven use, medication management, stairs and loose rugs, unlocked exterior doors, and firearms. A weekly pill organizer that a family member fills, automatic stove shut-off devices and motion-sensor lights are inexpensive and unobtrusive first steps.
Wandering and the Silver Alert
Even in early stages, create a one-page profile now: full name, date of birth, a current photo, physical and clothing descriptions, diagnosis, vehicle and license plate, previous addresses and favorite places. The state's Silver Alert program has specific criteria: the person must be 65 or older, live in Texas, have a diagnosed impaired mental condition, and the request must be made within 72 hours of the disappearance, among other requirements. It is not a registration program, so there is nothing to sign up for in advance. Preparing the documents is what helps.
Driving
Driving is usually the hardest conversation. A diagnosis alone does not automatically mean someone must stop driving that day, but it should start a clear plan. Ask the physician for their opinion on driving safety, as the Medicare assessment described below specifically includes a driving safety review. Watch for new dents, getting lost on familiar routes and near misses, and keep a short log of what you see. If your parent resists, a recommendation from the doctor often lands better than one from a child.
Day five and six: book the Medicare care planning visit
Medicare covers a cognitive assessment and care planning visit (billed as CPT code 99483) for people with cognitive impairment. According to CMS, it includes a cognition-focused history and exam, an assessment of daily living skills and decision-making capacity, staging with standardized tools, a medication review, screening for behavioral symptoms, an evaluation of home and driving safety, and a written care plan. A family member or guardian must be present as an independent historian, and the care plan includes education and support for the caregiver. CMS notes that Medicare Part B deductible and coinsurance apply, so ask your parent's plan what your share will be. Not every practice offers this visit, so call and ask for it by name.
Day seven: take a breath and decide what not to decide
By the end of the week you should have a diagnosis in writing, a call made to a dementia specialist or helpline, the legal conversation started, and the biggest home hazards addressed. You do not need to decide on moving your parent. Families who rush into a move in the first week often choose a community they later regret, or move a parent who could have stayed safely at home for years with some help.
When you are ready to look at options, memory care, in-home care and assisted living all serve different stages. Costs vary widely: assisted living in the Houston area commonly runs roughly $3,200 to $7,800 a month depending on the community and level of care, and memory care is typically higher. Treat these as ranges, not quotes, and verify details directly with any community you consider. You can also check any Texas licensed facility's inspection history on the HHSC provider search, and our walkthrough on how to look up violation history shows how.
Take care of the caregiver too
The person who made the phone calls this week is often the same person who will carry the next several years. Support groups through the Alzheimer's Association chapter, adult day programs and respite care exist for that reason. Our post on adult day programs and respite care across Greater Houston is a good next read.
If you would like to talk through where your family stands, call Houston Senior Advisor at (346) 385-3815. Our advisors can help you understand options across Harris, Fort Bend, Montgomery, Brazoria, Galveston, Liberty, Waller and Chambers counties, with no pressure to decide this week.
Last updated October 17, 2026. This guide is general information for Greater Houston families, not medical, legal, or financial advice.
