My 3 brothers have passed away and I'm the only one left to take care of my mom. She has vascular dementia. I want to look at photo albums with her but my brothers are in most of the pictures. What do I tell her when she asks where they are?

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My cousin, who has Vascular Dementia, hardly ever asks where people are, but, we enjoy looking at photos of deceased family members just the same. One day, she asked where her parents are (They have been dead for many years.) . I hesitated for a second, (I was not going to tell her the truth) and she said, I'm not sure if they are living. Then, I said, they are living in our hearts forever and she looked so relieved. She said yes, that's right and we moved on.
You could just say that brother couldn't be there that day, but, you would let him know about the visit.

I wouldn't avoid the family photos. I talk and share things with my cousin, even though, I'm not sure if she really remembers the stories that I tell. I talk about our fun road trips, where we lost our reservation and ended up at some swanky hotel. Or how we got front row seats at a concert, picked flowers at my grandmother's house, got hot
dogs at my aunt's store, etc. She loves those stories, but, I have no idea if she really recalls them or not. It's just the sharing and warm feelings that count.
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freqflyer is right. You don't have to tell your mom your brothers have died if you think she'll accept another explanation (they're away on business, they moved away, etc).

You can also pull out pictures from the album that don't have your brothers in them and look through them with your mom thus avoiding the conversation about where your brothers are.

Do whatever you think will cause less stress for your mom.
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Sagebrush, one can use what is called "therapeutic lies" when taking care of an person who has dementia. Thus, if your Mom ask there are her sons, just make up some excuse that you think she would understand.... like they are busy at home, or on a trip, etc.

I know one shouldn't tell someone with dementia that a loved one had passed otherwise that person would grieve all over again.... and again each time they are told as in their mind they are hearing this for the first time.

Oh how I wished I would have gone through photo albums with my parents to find how "who are these people?". But, of course, so many times old photos had been boxed away not to be found until one's parents had passed.
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