@wctdoc1943 Actually the OT department did very thorough sets of testing for her cognitive abilities. It was explained to me that their clinical diagnosis can determine that there is an impairment, however her doctor needs to make a medical diagnosis to discover WHY there is an impairment.
All three of us siblings live nearby, and my sister is actually with her the most. She is the oldest, and first up to make decisions for her. She will be her health POA whenever she decides to take that over.
As a teacher, I am very much aware of executive functioning and impairments, and am reading reports often enough to understand the contents at a deeper level than my siblings. Having my own disabled child, I am also literate in specialist jargon! They are stating that I am exaggerating, and the OT's tests were not accurate. They have convinced her primary care doctor that she is better functioning than she is, and talked the primary care doctor into signing off on her retaining her driver's license (that the OT recommended pulling). Scary.