Background: Open, person-centred conversations about dementia are essential for supporting autonomy, dignity, and adaptation following diagnosis. However, such dialogue is often avoided in everyday practice. This study explores home care nurses’ experiences of engaging in conversations with people living with dementia about their condition. Methods: An empirical, qualitative study was conducted in two Norwegian municipalities. Five home care nurses participated in semi-structured interviews analysed inductively using qualitative content analysis. The study followed the COREQ guidelines and received ethical approval from the Norwegian Centre for Research Data. Findings: Three main categories were identified: (1) Hesitation despite recognised importance, (2) Barriers to initiating dementia dialogue, and (3) Avoidance driven by euphemisms and fear. While nurses acknowledged the importance of enabling people living with dementia to talk about their diagnosis, they rarely initiated such conversations. Structural factors, including time pressure, task-oriented routines, and unclear role boundaries, reinforced avoidance. Personal uncertainty and fear of causing emotional distress led nurses to use euphemistic language such as “memory problems” rather than explicitly naming dementia. The findings reveal a “silent dialogue” in which both nurses and patients share awareness of the diagnosis but refrain from addressing it openly. Discussion and implications: The study highlights the ethical tension between protecting patients from distress and promoting autonomy through open dialogue. Strengthening organisational and professional support for person-centred communication, including time allocation, training, and reflection, may empower nurses to engage more confidently in meaningful conversations about dementia. Conclusion: Person-centred communication in dementia care requires not only individual competence but also organisational conditions that legitimise and enable such dialogue. Addressing the silence surrounding dementia can enhance relational care and uphold the personhood of those living with the condition.