How do I sit down with my Mother and tell her that I see that something is going on with her brain?

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She gets very violent with us when questioning her actions. She is a closet alcoholic also, she takes Lyrica and pain meds, then drinks every night about 5-6 very strong drinks. Some night she falls and just passes out sitting in her chair, head in her lap, she does not tell her doctor at all. I shared with her breast cancer surgeon 6 months ago, and now mom will not go back to the cancer doctor ever again, because she is embarrassed.

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This lady has refused to see her breast cancer surgeon in six months. There may be dementia and there may be alcohol-related problems, and there may be a combo of two or more factors, but I have to say that my immediate concern would be to get her to go and see *somebody* about her cancer (including, I'm sorry to say, the risk of brain metastases). Embarrassment just can't be allowed to be an issue.
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A recipe for disaster-
Dementia
Alcohol
Anti-seizure med
Pain pills (narcotic?)

From Drugs.com;
What should I avoid while taking Lyrica?
Avoid drinking alcohol. It may increase certain side effects of Lyrica. This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

(Me) Lyrica is an anti-seizure drug. When mixed with booze it's a recipe for disaster.

Pain medication (narcotics) depress the central nervous system, so does alcohol. She could easily overdose and die when taking all 3!

Since she suffers from dementia also, she no longer can responsibly take her meds.

Immediately call her primary doctor and tell him/her everything. Does s(he) know that mom's got dementia? Your mother can NOT just stop taking Lyrica due to bad side effects. But the doctor should be aware of what's going on.
She should be evaluated by a geriatric neurologist.

Also, consult an elder law attorney as to your part/responsibility in her care. Of course you can't make your mother stop drinking (I tried that through the years and it backfired horribly) but somethings got to change. She's in danger if she keeps up her routine.

You've got a time bomb here so I'd suggest you call right away. Also call Adult Protective Services for a wellness check.
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Just some background:

1) How old is your mother? Does she live alone?
2) How long has she been drinking this heavily? Did it start before the dementia, or is it fairly recent? If long-standing, what did you do about it before the dementia?
3) What is the status of her cancer? (in remission, stage x, what?)
4) As far as you can tell, is your mother in denial (There is nothing wrong with me!) or simply refusing help (I'll live my life any way I want to!)

This information might help focus our answers.
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I agree. People who have dementia, as indicated in your profile, don't really process information the way they used to. Asking them to understand, process, and use proper judgment, isn't really reasonable. Eventually, they cannot drive the train and be in charge. Sometimes, they need protection from themselves. That's why I'd discuss things with her doctor and an attorney.
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Doesn't sound promising to try to sit mom down and talk.

Better to go through her dr. She needs more than a good talking-to. If she's been violent in the past, telling her that her brain isn't working well--it's not going to go well.
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Your profile says that your mom has dementia. I'd discuss your concerns with her doctor as well as an attorney. I'd explore your responsibility to protect her safety while in your care. Her dementia may render her incapable of using proper judgment in drinking, taking meds, etc. It's not a good situation to be in, since, it's difficult to control a person who is intent on drinking, but, if she's incompetent, it could be problematic if bad things happen. I'd get professional advice to protect myself.
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Her breast cancer surgeon?

Oo.

Does your mother still have a reasonably good relationship with her primary care doctor?
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