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With prompting, she remembers he had an illness that prevented him from traveling (they lived about 1200 miles apart). The ill son, let's call him Joe, died last week and there will be no funeral, per his wishes. His illness, ALS, was not diagnosed until after he'd stopped visiting her and he never told her on the phone that he had a fatal disease, he just stopped calling when speech became too difficult. He didn't want her to know his illness would be fatal. But when her other son (the one I'm married to) and I visit, she repeatedly asks how Joe is and says she's worried about him. My father-in-law is still alive and lives with my mother-in-law in a nursing home. He also has some dementia but I'm not sure whether he would remember being told about Joe's death or not. My mother-in-law gets anxious and worried nearly to tears if I don't show up for a visit on time (so, I know she can remember some short-term things). I'm afraid she'll spend the end of her life in terrible grief if we tell her about Joe's death. On the other hand, it just feels wrong to keep lying to her about her own son.

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Can you and your husband decide on a place where Joe has gone that fits with something you don't feel is a lie? If he has indeed gone to a better place (at least with no pain or distress), you can work on a story about it. Think it through and digest the story for several days so that you are comfortable with it. Neither she nor you need the grief - it will achieve nothing.
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Ask one of the nurses if there is grief counseling there. You need someone who understands Dementia. I would only tell her once and Dad too. They need to grieve. Its not fair to Mom to think her son no longer wants to see or talk to her. Dad too. And say, the reason Joe hasn't called is because his sickness made it impossible for him to talk. Then say because of his sickness, he has passed. Keep it short and no big explanations. If they happen to ask, just say ALS. They will know it as Lou Gericks desease. Tell the staff what ur doing so if MIL gets too upset they can give her something to calm her.
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Joe is too far away to visit (true)and Joe's illness isn't bothering him any more (also true). It's too bad you can't see him again,
what would you tell him if you could?
would you like to look at the family album with me?
(or if she is religious)I know you'll meet in heaven one day.
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Honestly it’s not wrong in my opinion to not tell her, you are protecting her. She doesn’t need that grief at this stage of her life. Sparing her is a gift of kindness.
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Don’t tell her. I’m 48 and I have a son that died 4 years ago. I’ve told my other kids that when I get dementia and ask where their brother is, to lie to me and tell me anything other than he died. Tell her he moved to Hawaii for his job, that long distance calls and plane tickets are unaffordable. Let her live out the rest of her days in peace. This is a grief that goes down to your soul and it doesn’t go away.
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oh my goodness, no don't tell her.  That is grief she doesn't need.  We have to tell fibs to keep them emotionally okay.  It's just the way it is.   I think 
It's best if she's told he moved far away for his job and he just can't come visit because of distance and money.  You'll think of something.  Best of luck.
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When/if I am past rational thought, I will want my caregivers and loved ones to feel totally comfortable telling me a brief, humane, fictional account of what has happened to those who are or were part of my life.
The sweet and loving relative for whom I am responsible, moves almost seamlessly between reality and the softer world of those whom she has lost, and I offer short, supportive comments that make her comfortable.
Kindness, compassion, and love are much more important to her where she is, than meaningless facts.
I’ve discussed this with several religious leaders, and they uniformly agree.
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Thanks for all the advice. We also talked with the social worker at the nursing home and the physician's assistant who cares for my in-laws and decided to tell them about Joe's death. They should know that he hasn't just forgotten about them. They'll grieve, but that's part of life. Maybe they'll stop worrying about him. Maybe they won't remember what we told them. But if they're present enough to ask about him so much, they should respectfully be told the truth.
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I am glad that you are telling your mother-in-law and father-in-law that their son has died.  They have the right to know what has happened to cause their son not to call them.  They will grieve, they will get upset, and that is okay. 

{{Hugs}} and Prayers 🙏 during this time of sadness at the loss of your brother-in-law.
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