Expert: Mary Gordon - 3/18/2008

Question
How long does a patient in late stage 6 Alzheimer's usually live?  My grandfather exhibits all the symptoms of stage 6 that I have been able to find on any website.  My grandmother was extremely unhelpful with any questions I asked, so I am going about finding information another way.  I don't think she wants to know how much time he has left, but I do.  Somehow more information helps me cope.

Answer
Hi Melinda.

Its tough to guess how long he will live. There are so many factors involved.

You don't say if he developed Alzheimer's at a relatively young age or at a relatively old age? Has his disease overall progressed rapidly or slowly? How is his overall health? Is he frail with many chronic health issues, or is he robustly healthy?

Not only is Alzheimer's considered a fatal illness, but as you can imagine, having Alzheimer's can complicate the diagnosis and treatment of other health problems that may arise - making it much more likely that those other health problems may contribute to an earlier death.

After all, if a person can't tell you about they feel, and can't answer questions - there is no often no chance a caregiver will know something is brewing until the person have symptoms that you can see externally, or by their behavior.

Even if a family knows about a health issue,  they may decide it's not worth putting the person through scary or painful diagnostic tests. A family may also feel the same about treatments and therapies that may cause discomfort or worse (like surgeries or chemotherapy).

The person with dementia can't understand the purpose, they can't cooperate - and many families decide it is better just to keep the person comfortable and happy, and leave the rest to nature. They decide that since the person's life span is already limited, the best option is to stop the poking and prodding and try to give them the best possible quality of life.

Another factor is what your grandfather may have wanted. For example if he had a heart attack or choked due to swallowing problems common in later Alzheimer's, would he have wanted to be rescusitated. Would he want to be taken to hospital and be treated aggressively for pneumonia with tubes and a respirator? Many people tell their loved ones they don't want any of that to happen - and many families decide they prefer palliative care only, such as is provided by hospice programs. They want the person loved and respected, kept out of pain and discomfort, but they don't want extraordinary measures, trips to the emergency ward, etc. Your grandmother will know what her husband wanted, and is likely to try to respect his wishes.

My mother in law progressed into Stage 7 a full two years before she died - so she spent the last two years of her life unable to talk, walk, or do anything for herself. She was incontinent, she had to be spoon fed soft food, she didn't know anyone, and she spent her days sleeping in a wheel chair (where she had to be propped up) or in bed. However, she was 78 when she hit stage 7, so she was relatively young, and she was very healthy - she had no major health problems to shorten her life.  

We also had a neighbour who lived 7 or 8 years in the end stage. She was unusual, but again, very healthy and robust, and she got very good care, so she lived on, like a shell of who she had been.

I'm sure this is a very upsetting topic for your grandmother. After a lifetime together, this must be very hard on her -  she is probably dreading what lies ahead - not just his eventual death, but the terrible days she may be facing as he gets worse and worse. I'm not surprised she has trouble talking about it. She may be very scared about whether she can handle this - and after all, she is probably worried about her own health, their finances, being alone, and all the things that go with her situation.

If there is anything I can help you with, feel free to ask. I wish I could give you a more definitive answer. On average, people with Alzheimer's survive between 6 and 8 years following diagnosis, but having said that doesn't mean he won't survive another several years, or die sooner than expected  from some other complication.

Your grandmother is lucky to have her family around her. She needs your love and understanding, perhaps even more than your grandfather.

Mary G.