My Mom (91) with dementia begs me to let her go see her parents. How do we tell her that her family is no longer alive?

Imho, though some health sites state that the responder should go along with/agree with confabulation of the elder, that may not be advisable. Perhaps redirection is the best approach.

Instead of repeating that they are dead or having to come up with creative excuses, you might say, "Wouldn't it be wonderful to see them? What do you remember most about your mother? What are the best things you learned from your father! . . " prompts like that.
you could both "spend time" with her mom and dad through memories and conversation.

Have you thought about taking her to where she used to live when she was young and where they used to live and then their grave sites? I don't know if it would be too much to take her to the grave sites, but for her to visit the places she used to live when she was younger could bring back some fond memories for her.

Did you ever consider that your mother is asking for permission to move on? As people age they mentally prepare for the next stage and often give signs to their loved ones that they are ready. She could be asking you for permission to go and be with them. Until you give your mother the final ok for her to be with her parents, she may linger in her confusion. We never want to say goodbye to our loved ones but giving them permission gives them peace to move on when they are ready.

Please read “Final Gifts” by Maggie Callahan and Patricia Kelley. It explains the signs that our loved ones give us before they pass on. I read this after I lost my father but it would have been helpful before he passed. It would have help him have the confidence that we will all be ok once he is gone. It would have helped me understand some of the signs he was giving me.

You maybe able to tell your mother that her parents are waiting for her when she is ready. When she decides to visit them, you all will be ok. Tell her that you love her and want what is best for her.

I do not have much experience with dementia but it seems we all need some confirmation of what will happen when we pass both in the afterlife and here on earth.

How to tell her? You don’t.

She is not going to remember your telling her. My friend had a MIL with dementia who kept asking about her dead husband. They’d tell her he was in Heaven and she’d immediately cry. It was like hearing it for the first time over and over.

So after a few weeks of this, it was time for a different approach. Now the husband is just “out”.

”He’s at work.”
”He had to go to the store.”
”He’s busy.”

It didn’t stop MIL from asking 20 times a day, but it stopped the crying and upset. They did feel bad lying to her, but having her break down in tears was much worse.

If she has dementia she's not going to remember what you say or rather she visited them or not.
So just tell her ok and keep making excuses about when you can go.
Benter than telling her they're dead and she'll ask again and again and have to be sad again and again.

You might start on an album of her parents, sister, ect and let her help put in pictures and talk about them

If your mother thinks that her parents are living, she no longer has the mental equipment to distinguish objective reality from what her damaged mind is telling her.

Describing kindness as a “lie” is a lie in itself. When my LO entered a comfortable local MC, she’d make poignant calls home, leaving messages on the answering machine for her mother and sisters, who had been gone for many years before.

The messages to the answering machine grew fewer and fewer, and as they ended we knew she’d moved to another part of her life with dementia.

If not traveling because of Covid was comfortable for her, follow HER cues with offering her open ended responses that allow her hope and comfort.

“They’re having the Living Room painted and they want us to wait until it’s finished”

”There’s a storm expected so we’ll wait until the weather gets better”.

”Can’t plan to go until allergy season is over (….the kids are out of school)- whatever is logical and comforting.

I have instructed my younger family members to LIE humanely to me if I ever become cognitively disabled, and they know that they darned well better do so!

Loving kindness and her comfort are all that matter.

I remember when I was around 12 my grandmother spent a couple of days with us. She was around 85 at the time and after lunch she wanted to go and visit her grandmother... Mum used to convince her it was not the right moment saying for instance : it is better if we go later, you know she is old and take a nap after lunch. Granny would agree and then forget about it.

Don't tell her. If using Covid travel restrictions doesn't work anymore, then try something else.
Go along with her and say that you'll have to make plans to go. That they moved to Florida or something and it's a long way. Tell her anything. Just don't tell her they're dead. All that will do is upset her and she won't remember why she's upset. It will make her regress and really set her back too. Caregiving will become much harder for you both. Don't tell her.

Whatever you answer, don’t tell her that they’re deceased..that will upset her. My 94 year old mother goes through a phase where she’s climbing out of bed to look for my father..& wants to call my grandmother. …Hugs 🤗

Personally, I'd tell her we went to see her, and have an entire conversation about what we saw, who we talked to, and how much fun it was. Use details you know about her parents, their house, and their activities, their friends, other family members that might have been there, pets -- whatever you can come up with.

"Mom, wasn't it fun to see your parents again? When we drove up to the house, there they were sitting on the porch just like they always do!"

"It was fun to see Cousin Bob again, too, wasn't it?"

"Your mom's garden was so beautiful with those roses. What type does she grow -- do you know?"

My mother has conjured up her first high school boyfriend and is now "married" to him. We've had extensive conversations about him even though I never met the guy. He and his parents moved from her hometown in 1944 and she never saw him again, and he's been dead since 2009, but he's as real to her as anyone standing in front of her. I think that me "seeing" him as well brings her a lot of comfort, and she's only caught me faking it once when I told her he was on the phone and she said, "NO, HE ISN'T!"

Help her conjure up happy memories even if they're with people who are no longer around. There's no reason to tell her over and over that they're gone, because that only breaks her heart over and over, too.

You answer the dementia family as you do all other people, with gentle honesty. Unfortunately, if the person cannot hold on to the information, you have to be repetitive. As long as this is the case you will have to repeat it. What is your other option? Lies? And then refusal to take her to see these imaginary people? That really isn't an option at all. There is so sadly no way to sideline this grief I believe. Lies always complicate life. In an attempt to avoid grief we can just sometimes cause more of it. I am so sorry for this pain for her.

I went through the exact same phase with my mother who has moderately advanced dementia & lives in Memory Care Assisted Living; she'd insist on 'riding the bus' to go see her deceased parents in NYC (we live in Colorado). At first I'd try to distract her or say that the bus wasn't running that day, but she'd stay stuck on the subject for days on end without letting up. She'd actually get dressed & ready to leave, it was that bad. So I decided to let her know both of her parents were deceased, but they were in heaven and doing fine, laughing, playing cards & drinking wine with the rest of the family members who'd passed on. She would cry a little every time we had this discussion, but in the end, it gave her closure to realize she couldn't ride the bus to go see them; they weren't there anymore. Plus, I believe the picture I drew for her of them having a good time in heaven w/o pain & anguish also alleviated her anxiety about what state they were in now that they were deceased.

She sometimes brings the subject up nowadays, but not often. She went through a phase but it did end and I think I sped up the phase by putting a period at the end of the sentence for her, you know? I don't know what will work for your mom, and sometimes you have to try different things to find out what WON'T work! I hate dementia, I really do. I went to see my mother today & was again sad to see what a dramatic decline she's taken lately. The whole thing just stinks.

Wishing you the best of luck finding a solution that works for your mother and gives her some level of peace & closure.

daybyday- this phase will pass. My mother used to ask the same questions over and over, and now she's got aphasia and rarely talks.

It can be very frustrating and wears on your patience. With my mom, my first method was to avoid her questions, second method was to give short answers that didn't require much effort to repeat. Oh yes, having to repeat answers really drove me mad. My usual replies were "Uh Huh, OK, Sure, Yes" or just grunts.

In your case, perhaps you can try "Sure, we'll go later." Hopefully, it will appease at the moment until next time.

Try different answers. The one she accepts the easiest is the one I would use over and over. When she accepted no travel allowed as a reason, you saw how she could accept a distraction. Keep using that if it works for her.
Look up Teepa Snow. She is brilliant with how to distract without upsetting.