Mom is 91 and in a SNF for 3 years. She dreams of going home and living the active, creative and beautiful life she had. But a stroke robbed her of this option and she is bed-bound now. She is frail but not dying. There is no hope of further physical improvement. She believes otherwise. She conquered many difficulties in life through sheer force of will but that will not work this time. She tells me of her future plans and I just say “uh-huh” and grey rock. But really, what do you say when there is no hope of improvement and a long, unhappy life is the most likely future? Mom is not a person of faith and finds no comfort in such conversations.
You can fix this for her. You can't change this for her, and you can't change her own dreaming and thinking about it. You are simply there to listen and to comfort. You aren't responsible. There is no fix here, and nothing for you to "do". Simply listen and empathize with her pain, and her wish to escape it with dreams.
You can always redirect the conversation or distract her. My husband took out his phone or laptop and showed his Mom funny animal videos on YouTube. Worked every time to get her to laugh and have a conversation about what she saw. Or travel videos with beautiful scenery.
You need to go to visits prepared. We also used to take her old photo albums and pretend like we needed her to identify the people and places in them. Since they were old photos, most was still in her long-term memory.
We also brought her the letters her son wrote to her (and she kept) when he was in the Marines and read them to her, or played music on her Bose player, or got her in a wheelchair and tooled around the facility and grounds.
The creativity for conversation needs to come from your end. She can't do it anymore.
I wouldn't totally dismiss faith. As her life becomes more and more devoid of worldly pleasures and things, that void will be an open invitation for something. Many people replace those things with very negative things because they have little to nothing positive to have faith in.
With my mother I just did chitchat. Superficial stuff about what's going on with the grandkids, the weather, the news, had lots of pictures to show her. I didn't talk about grim issues unless my mother brought it up. And I would engage in an honest conversation about her situation. That didn't happen too often.
We all know acceptance of decline and death is the elephant in the room. that few people wish to acknowledge.