Hi Judy, Welcome to the forum. You are in a really difficult situation to be dealing with the mental confusion issue along with the physical deterioration. Yes, dementia is a factor in some cases of ALS, though I don't know the statistics. I think it makes it much harder on many fronts to have that complication, and I deeply feel for you. I hope you have family and community support for both your husband and yourself. As for the dilemma of telling him about the fatality of the illness, that is a tough one with different ways to look at it, so no wonder you are pondering this. I'm not sure what I would do in your situation. On the one hand, if he has hope and it is helping his general mental state to think there may be a cure possible, maybe that is ok...so long as he isn't spending lots of money looking for impossibilities or not taking care of business that needs to be attended to. On the other hand, I think people need to know the truth of the eventual outcome to make decisions about what they want to do with the time they may have left.. the things they want to say to their loved ones before they are gone, and to be involved in realistic decision making regarding end of life decisions or life extending options. However, the dementia factor changes this if he is unable to comprehend the progression of the illness. Yet, he also may just be in the denial phase, and need a little time to accept what is happening, or possibly he is trying to spare you the pain. It is really hard to talk about, I know. One more thought though....I don't think you would want him to hear the bad news from someone else in passing. I don't know if I have been much help with this ramble. You've probably been tossing around many of your own thoughts. Just take your time and be good to yourself.