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Her sister has been gone since December 2022, so just 6 months. We took our aunt to visit her sister in hospice once. When she died, we told her and watched her fall apart. My aunt accompanied us to the funeral/burial but doesn't remember doing so. She asked about her sister the following weeks and every time, she was devastated as if hearing it for the first time. She asked again a few days ago. I am of the opinion we do not keep telling her, but just say she's doing well. My husband (her nephew) disagrees.

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"How is my sister?"

"The last time I talked to her, she was doing fine. Would you like to look at some pictures of the children/have another cup of coffee/watch TV?"

Note the deflection and changing the subject. You DO NOT keep telling her her sister is dead, because keep in mind (and tell your husband), not only would you upset her terribly, but she may also be thinking of her sisterly relationship when they were children. To her, you may be telling her not that an elderly sister has died, but rather that a CHILD has died.

My mother's reality eventually settled somewhere in her high school years. She had an imaginary husband who had in reality been her high school boyfriend, and as a couple in her mind they went from being two elderly people who'd rediscovered each other after 70 years to two 16-year-olds. If my mother had asked about her sister and I'd told her she'd died, she had thought I was telling her that her 20-year-old sister was dead. That would have devastated her even more than her sister's actual death at age 90.

DO NOT continue telling her. To do otherwise is cruel and heartless, and you can tell your husband I said so.
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You are right! You’re giving peace of mind and at this time that’s all she really wants. Keep it up and don’t let others tell you you’re wrong.
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Tell your husband-
to think for a minute how he has felt whenever he first heard the news of the death of someone with whom he was close (if he has ever lost anyone). That initial shock is so incredibly painful, and then your heart and mind slowly adjusts to the new reality of the loss. That adjustment of heart and mind is NOT happening for your aunt - she is suffering the initial pain every single time she hears the news! It is like a punch in the gut. Only a cruel person would keep telling her this and watching her get upset.

It would not be a lie to say "She's not sick or hurting any more."
Then redirect the conversation.
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"...she was devastated as if hearing it for the first time..."

Yes, tell the truth. Keep stabbing her in the heart over and over again.

Doesn't your husband see how the truth hurts his aunt? Why does he want to do that? Why? Honesty is the best policy? Blind honesty is stupid. If a dangerous guy/murderer comes looking for you, is he going to be honest and tell that creep where to find you?
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Don't say she's doing well. There's no need for outright lies which mislead your aunt into pursuing the delusion.

Instead, you can ask questions to encourage her to talk about what she does remember. That might be as recent as the visit to hospice, or it might go back earlier. You confirm the accurate recollections and steer her away from the mistaken ones.

Was she especially close to this sister?
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Like Isthisreallyreal suggested, I would try to tread that way - not the whole truth but not lying (unless I had to).

Be aware of her words, sometimes she may remember her sister was ill.. if so, another answer could include "Well she had been ill but has good Doctors & Nurses & is getting the treatment she needs".

I think *how* it's said matters too eg: a worried sounding reply vs a cheerful, confident "oh she was fine when I talked to her a while back".

Then pivot into fond or fun memories she has of them as girls.
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Why would you keep beating a dead horse? She’ll keep asking about her sister and you’ll keep repeating the same answer. It’ll drive you nuts!! It’s time to learn “therapeutic fibbing”. It’s controversial technique but it’s effective. Some believe it’s lying; it’s not. Lying is meant to deceive, therapeutic fibbing is meant to validate a LO’s reality. Honesty isn’t always the best policy when communicating with a person with a dementia related disease. I think telling the truth repeatedly, as in your aunt’s case, is actually cruel. Why put her thru the angst and trauma of hearing her sister died every time she asks? Answer her questions as though her sister was still alive. Get out of your reality and into hers.
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I wouldn't keep putting her through the grief. That seems awfully cruel in my opinion.

I would say you don't know. Not a lie, you don't.

Haven't seen her for awhile. Not a lie, you haven't.

Last I heard she was fine. Not a lie, her struggles are over.

See how easy it is to not devastate her repeatedly without an actual lie?
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Beatty Jun 2022
Yes, great answer.
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My God why would you want to upset this poor woman over and over again when you know it’ll never sink in? Just say she’s doing fine.
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lealonnie1 Jun 2022
No kidding and Amen
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I agree with you - there's no reason to continue devastating her each time she has to hear that her sister has passed. It doesn't serve a purpose - and it's not like she'll retain it and never ask again. Much easier for her to hear better news about her sister.

If your husband and nephew disagrees, it may be helpful for them to learn more about dementia to fully understand.
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There is no point in upsetting your aunt with the truth. Applying rules of normalcy and morality to dementia is senseless, and if you follow the experts advice, its suggested to avoid telling a dementia sufferer their loved one is dead. What we "believe in" is irrelevant. If I told my mother with dementia every time she asked me that her parents, siblings and husband were dead, she'd have been crying and inconsolable for a solid year! Instead, I used what's known as therapeutic fibs and told her the family was living in Florida, where it was warm. Or on vacation. Or in New York. Or their phone wasn't working. Or or or. Whatever it takes to keep your aunt happy and not upset or agitated is what you do. It's the same thing as not having her watch the news or telling her about the Texas school shooting. Just because it's "the truth" doesn't mean it's healthy for her to hear! That's why in Memory Care Assisted Living facilities they play child like games instead of turning on news shows or watching horror movies......the goal is to keep dementia patients calm and relaxed. WE enter THEIR reality now, which is quite a bit different than our own. That's if we want to best help them.

Put opinions aside now and rely on what the dementia experts advise in this situation. Here is an article on the subject with links to other topics about AD and dementia and how to handle certain situations:

https://www.helpforalzheimersfamilies.com/learn/quick-tips/confusion-and-memory-loss/what-to-do-when-a-loved-one-with-alzheimers-forgets-that-someone-is-dead/

A good book to pick up is The 36 Hour Day which is full of useful information for both you and your husband to learn as you try to help your aunt with her condition.

Good luck to you
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I don't believe lies help anything. I would tell the truth.
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TChamp Jun 2022
Agree, even if the patient doesn't understand, there is no excuse for distorting the reality. Once you start lying, an infinite chain of lies follows, because more lies are needed to support the previous lies.
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Tell her that she is fine, the truth will not accomplish anything but to upset her, then she will forget and ask again and again.
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