Dear Family Advisor

Nobody wants to tell Mom that our sister is dying.

Last updated: Jun 22, 2010

My siblings don't think we should tell Mom that our sister is dying of cancer. (She's in hospice.) Mom has early-stage dementia and lives in an assisted-living home. She gets confused but for the most part still knows we're her children and asks about us often.

My siblings argue that the news would upset and confuse her, but I feel that my sister and my mom need to say goodbye and be together. I'm very close to my sister and I think she really wants and needs this.

I've thought of just going to pick Mom up, taking her to my sister's hospice room, and dealing with the fallout later, but I'm afraid it will really get ugly and taint my sister's funeral. What should I do?

Sometimes you have to do what you believe in your heart is the right thing to do and not worry about what other people think about it. Do make sure your sister wants what you think she wants. If she's asked you specifically to help her see her mother, then I would honor that. She needs this closure and time together.

Even if your mom comprehends that her daughter is leaving this earth, there's no guarantee that she'll be able to feel it or understand it in the same way she would have before. Most people with dementia have an inability to connect all the pieces of the past and really engage in what's happening now.

Prepare your sister for the ways your mom might react. She might be upset and aggrieved, or she may act as if she didn't hear or understand. She might "get it" -- then forget. Help your sister realize that the time might not go as she envisioned and that all she can do is follow the moment. Gently suggest that perhaps she'll get the most out of it by simply being together again. She might not want (or need) to focus on cancer or the fact that she may die soon, but view this visit as a sweet and tender time to cherish.

Ideally, you'll allow your sister and mother to have this precious time to themselves. But stand by; sometimes when an elder with dementia doesn't see a loved one for a long time or senses that there's some sort of tension or anxiety, she can act out or get upset, and your sister may be too weak to deal with it. If that happens, you can help by stepping in to calm your mother. Ask her care supporters ahead of time what works best for her; perhaps you could offer her favorite food or a walk.

I wouldn't mention this visit to your siblings, before or after. This is between your sister and her mother. They don't get to vote on whether it happens. Simply take your mom quietly, and when you get back, keep mum. If they find out and start to get worked up, assure them that all went well and that your sister was glad. Stand your ground and refuse to get sucked into a battle.

Later, it may be wise to let your mom skip the funeral services. Someone with dementia can find it challenging to move mentally between the past and present. Your mother might not be able to grasp the finality of death. The day after the service her daughter might be alive -- to her. If she's had that wonderful visit with her daughter, that may be all she needs.

If your siblings get upset that your mom knows about your sister's passing, at least your sister won't have to listen to it! It will be a time to honor her life, and you can tell them it's pointless to let a family squabble taint such an important day. Stay the loving family member you are today, tune out any negative feedback, and know that giving your sister connections with her mother gave her a welcome sense of peace and closure.