AndreaP, I agree: I wish someone would hand me the guidebook/rule book/operations manual for dementia!
I'm not going to tell you what to do or what not to do. You have to do what works for you and your mother. Certainly nobody wants to be a liar.
I was at a dementia lecture a couple of weeks ago, given by a neurologist, and he talked about some of things you mentioned in your post. In case it's helpful, I'll look in my notes and see what he said.
The thing about "going home" seems to be common to many people with dementia. In some cases, people do seem to be remembering a specific place they lived, but in other cases, it seems to be less about a real place (such as a former home) and more about wanting to be somewhere they feel safe and comforted. I don't think it literally means that the care home is a bad, terrible, awful place, at least not usually for most people. Others here might have more insight about that. My mother wanted to go "home" from the hospital and then there was a lot of wanting to go "home" when she first moved into the care home, but that has stopped now (she's been there for about six months). In her case, she was saying she wanted to go to her home where she actually had been living, but of course she thought it was safe and clean and okay for her live alone, because there was "nothing wrong" with her. All true in her dementia mind. In reality, of course, it wasn't safe, it was filthy and she could not live alone. I'm sure this sounds familiar to many of you.
So, my notes from the lecture the other week say that a lot of dementia patients who talk about going home are saying this because they have an instinctive feeling of uncertainty or not knowing what to do, and this presents as "I want to go home," where "home" represents a place where they felt safe and had a routine and a job (they were a child/student/parent/accountant/whatever). The doctor says this can be triggered by a person and/or the environment, and the feeling comes from a neural network in the limbic system, which is not something under conscious control--it just happens.
This can happen with other things besides "going home," but that seems relevant to what Andrea is talking about.
Then the doctor talked a bit about delusions. A delusion is a false, fixed belief imbued with a lot of emotion. This happens often with dementia.
Sometimes a person with dementia will respond to a situation or a person with a delusion, or tell a particular person the same delusion repeatedly. Although the person with dementia won't remember the conversation, they may retain a emotional memory associated with the person they talked to. So a person may (inadvertently) become a "trigger" for a particular conversation/delusion. They may also now associate that feeling (often negative) with you, when they see you.
He recommended trying distraction/redirection by someone who isn't the trigger if possible (especially in a situation where the person is very upset), but that's not always possible, of course.
The doctor said that you don't necessarily have to lie, but what you say/how you respond should not challenge their reality. It is very important NOT to confront a delusion. Do respond, do be vague and redirect/distract, and do reassure them you are taking it seriously.
He gave an example about talking to a patient with a delusion that the staff were stealing her socks; I'll type that up if anyone would find that helpful.
As concerns the repetition: they do not remember they asked you five times already, or that you just had this conversation, but they can have a feeling about it. That feeling comes from the limbic system, not the cortex, and again, is not something they are aware of/have control over. They are not making a conscious decision to ask you again.
There was a lot of very technical neurology stuff I didn't take notes on as I didn't understand it terribly well, but I hope some of that is helpful.
To be more specific with Andrea: my mother was VERY upset (especially with me but not with my husband) about going into the hospital and moving to the care home, and got very angry and nasty and loud about it. Of course she could not remember/understand why she was in hospital (she was found wandering in the cold with no coat and had clearly fallen and hurt herself, was taken to the ER/A&E department, and then sectioned/admitted to Geriatric Psych) and in her head she was fine, so why was she there? Oh, it went on and on and over and over and it was awful. Then, when she went to the care home, it was the same thing, there's nothing wrong with me, I can look after myself, I want to go home, why have you done this to me, and on and on and on.
Andrea, my mother was also miserable at home. She was alone and lonely, she was anxious all the time, she wasn't eating or sleeping or washing, she lost a lot of weight, it was horrible, just horrible. Like you, I think a care home sounds great. It's like the dormitory at university, without exams! Someone to shop and cook for me, and clean my bathroom, and do my laundry, sounds just fine. Not to mention the excursions and activities and all the ice cream I can eat and people to talk to 24/7.
My mother is somewhere in the middle-ish range of Alzheimer's type dementia, and has no short term memory. None. She can still carry on a reasonably normal sounding conversation, as long as you don't mind talking about the same things over and over. The neurologist explained to me that with some types of memory impairment, there are memories that are properly coded and stored but they can't be properly retrieved, so they come out scrambled or mixed up with other memories (like a damaged computer file shows garbled text). In other cases, things that happen don't get put into storage at all, and so there literally is no memory to retrieve. You cannot access, what isn't there (if the computer did a search, there would be nothing to find).
I'm sorry as this seems to be all over the place.
Like Canary, I mostly don't lie to my mother, but am selective about the truth I tell. My mother left her condo in January and of course my husband and I immediately began to clean it out, knowing she would not return and we would need to sell it eventually, as she needs the money.
When my mother says, accusingly or otherwise, "what have you done with the condo?" I say, well, Brian and I cleaned out the fridge so the food wouldn't spoil. She always says that's a good idea and sometimes the conversation stops there.
When she says, have you sold it and taken all my money? I say, calmly, of course not. (Once I do sell it, I will lie to her because there is no other option for me.) But I always say, we are keeping an eye on things and it's fine. And that's as far as she has ever gone with the conversation, even when she is at her worst.
When she asked me, why am I here (in the hospital or care home) I learned to answer, because the doctors said you needed to stay until they got your medicines sorted out. For whatever reason, this was the answer she accepted. When she would ask, how long do I have to be here? I would say, I don't know how long you will have to be here. I hope it won't be long. Then she would say, well, I don't want to be here, I want to go home now! My response was: I know you want to go home as soon as you can. Of course you want to go home. Who wouldn't? I don't know when you can go home, but we will ask the doctor/nurse/staff when you can go home. And then I'd offer her coffee or food or a snack or just change the subject. Repeated as necessary.
So this was using the combination of things that I found worked for my mother:
-calm demeanor and tone of voice
-respond to what she says
-don't contradict, argue, or correct
-offer reassurance (I'll take care of that, I'll look into that for you)
-use humour where possible (works with my mother; might not work for you; don't ever use humour with someone who is paranoid)
-shift any perceived blame to someone else, like a doctor
-distract or change the subject
I have no idea if any of that will work or not, or help or not, but thought it couldn't hurt to put it out there.
I hate dementia.