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He doesn't understand why some of the things he thinks happened didn't happen, or why he forgets or gets confused. He's 94 and lives in a nursing home. He asks questions about his health.

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For 94 he's doing great just being alive. Hell, at 62 I can't remember stuff. I'll go out to the kitchen and forget why I went. Telling a dementia patient he has dementia is like telling a drunk they are drunk. The information is neither processed nor retained. The only thing I still retain is water.
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As the brain succumbs to dementia, the ability to understand its own functioning goes away. Don't bother to tell him that something he "remembers" never really happened. He doesn't need to understand, and furthermore, he can't understand. Tell him "white lies" that agree with his memory. "Yes, that happened, but then this other thing happened...."

As much as possible, go along with what he says. I call my husband's ALZ "memory problems." I never discuss his thinking problems because that would make him very unhappy. I'm afraid I still correct him when he says "You never told me that!" I feel attacked and blamed, so I get defensive. He is in a much earlier stage of dementia than your father, though. I'm practicing biting my tongue for the future.
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I agree with the above he is in a safe place and does not need the added burden of such a diagnosis. What good is it going to do if you tell him. If he asks a direct question just give him the memory loss explanation and re assure him he is not going crazy.
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I don't think it is important to use the D word. It can be upsetting to have a label on something. The same idea can be gotten across by using words that can be less upsetting. My mother won't tolerate the D word, but she is okay if I mention that sometimes she forgets things. I have a more difficult time dealing with the confusion. Usually I don't try to deal with it. She may make up things that never happened, but I let it go because it doesn't really matter anyway. No harm done.

It seems that many or most older people start showing some signs of dementia when they get to a certain age. What we can hope is that their minds will hold out as long as their bodies do. If forgetfulness and confusion are problems that your father has, pointing them out to him will probably only make him anxious. It may be better to use kinder but truthful explanations that have to do with forgetfulness. No one wants to feel like they are going crazy.
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i think its all in the timing. when the elder has a moment where they are lamenting their loss of control and confusion they are at this point rather receptive to ( and deserving of ) a genuine answer. one of my nieces told mom as soon as she was home from the hospital that she was " crazy " . didnt go over well. mom told the remainder of the people in the room to drag this tugboat out into the front yard. lol . tina IS kinda lumpy
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