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Mom is in mid to late stages of dementia, she does not remember that her siblings have passed, or that the one that is still alive didn't pass. Her short term memory is very bad, but she does obsess over negative things. I am also pretty sure she is depressed, and the news of losing her son will not help. He lived in another state, and was disabled due to a stroke many years ago. We have not seen him in the past two years because his physical ability to travel declined at about the same rate as my mothers mental ability to travel. Some folks say don't tell her, other's say tell her once, then just go with it if the question comes up, meaning don't make them grieve all over again time after time. My main concern is her quality of life, and I don't want to cause her any heartache if I can avoid it. What I fear is that once word gets out, well meaning family and friend might send sympathy cards to her, and that would also add to her confusion. I have sent an email seeking advice from the director of her facility, perhaps they will have some insights or suggestions.

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This is always a very difficult decision. I would say she should be told if she was used to seeing him one a regular basis. As he lives far away and she never mentions him I don't think i would mention it can you intercept any cards or letters that may arrive. As he is far away there won't be any question of attending the funeral or anything.
if you can remain calm if you tell her and she does not seem visibly upset she may not realize that this is bad news she won't become obsessed with the news.
As I said before it is not an easy decision so follow your heart on this one.
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My condolences for the loss of your brother. A similar scenario happened when my grandmother was 97. Her son died, and we decided not to tell her as he had lived on the other side of the country, and wasn't part of her daily life. We thought we'd spare her the grief. She died 3 weeks later. At her funeral, one of her nurses showed up, desperate to tell me that my grandmother had been crying uncontrollably and mentioning her son, my uncle. Although no one had told my grandmother of her sons death, she somehow knew. I'll never forget the look on the nurses face. She was shocked, and had driven a long way to make sure that I knew what had happened. It was remarkable. This is a true story. I can't explain what happened with my grandmother and uncle, but if I had to do it again, I wouldn't tell her. I would, however, stay by her side as much as possible to comfort her. God bless.
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Condolences on the loss of your brother.

My Mom's only surviving sister died when Mom was in nursing care. I remember coming home one day and there were all these messages from my Mom on my answering machine. I phoned her up and asked her what was wrong. She said "is it true?" I said is what true? She said "I had a dream, and in it, my sister Eve came to tell me that she was gone but to assure me that she was alright" So I told her I hadn't heard anything. But that week I received a notification in the mail that my Mom's sister had died. She had died on the night that my Mom had that dream. So, weird huh?

I would have probably chosen not to tell my Mom but turns out her sister came to her and told her herself.

Maybe, your brother will do the same with your Mom. I would tell her just in case she finds out from another source but then I would leave it and if she forgets and asks about it in the future I would say he's fine and leave it at that. No point making her fret over and over about something.
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I have the same problem with my aunt. I think the cards and phone calls will be shocks whether she has heard the news once before or not. I’ve considered letting family in mass know that news of this sort is painful and their condolences can cause more pain for her and might be awkward for them when they realize they just delivered the news to someone who doesnt remember that they already knew.
It’s a hard problem.
I’m sorry for the loss of your brother.
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I believe you already know what you want to do. If it was me I’d ask myself what is the benefit of telling her? So she can grieve her son? So she can attend the funeral? So she doesn’t get the shock of getting condolences cards? (By the way, where is she that you cannot control the mail that gets to her?)

The answers to the first questions, so she can grieve? Why?
Attend the funeral? Why?
At a certain point in life, when our minds cannot process loss and suffering as they used to, certain things don’t make any sense, certain things can only add to the confusion and to depression.
I don’t know your family’s religion but I believe she will find out one day, hopefully very far away, when they find each other in heaven and that will be quite a nice surprise :)

So I’d say, if there is no good purpose to do something, there’s no good reason.

God bless you and I’ll say a prayer for you, your brother and your mom :)
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Thanks so much for your kind and thoughtful answers. I met with the staff today (director and nurses) to discuss and get their thoughts and the first question was "how important is it to you to tell your mom". I told them what was important to me was to eliminate stress and anxiety wherever possible, and to do my best to insure that she has a high quality of life.
So we decided to not tell her, and they will hold her mail for me to review and intercept any cards or letters.
There is not going to be a funeral, just a simple cremation and scattering of his ashes in his favorite fishing spot in the mountains.
My mother did say she had nightmares the night before, and we don't know the exact time of death yet, she said she could not remember what the dreams were about but that they were awful. So perhaps there was some sense of his passing on her part.
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