Expert: Mary Gordon - 11/10/2009

Question
My mother has had AD for 9+ years.  She has been in a nursing home for the last 5 and prior lived with us.  She is at end of her life.  She can not hold her head up.  It has been a long haul for her (and me).  How long can she live without food?  She is at 10% of her food intake and maybe less.  Her coloring is changing.  No rattling in her breathing yet.

Answer
Hi Mica,

My heart goes out to you. This part is so hard for those she will leave behind.

My guess would be that she will pass within the next two months - but they can surprise you. My mother in law survived right to the natural end of her dementia as well. What happened with her is that she took in less and less, no matter how she was coaxed or how many times a day anyone tried. Finally she stopped eating and drinking entirely, lapsed into a coma and passed away. The very last phase took about 6 weeks in total - and she basically took in nothing at all the last four or five days. It was so gradual - and she survived longer than anyone expected given how very little she ate and drank during those final weeks. Ultimately, it's really the lack of fluids that make the end come - although it doesn't appear to bother the person at all - they don't seem to feel hunger or thirst. Their kidneys shut down and they fly away.  

When the end came, there was no drama, no rattle or gasp. She just faded away to a whisper, and then she was gone, like what held her to her body was the most slender of threads. It was gentle, peaceful and quiet - and she didn't seem to be suffering at all. It was as though she was completely ready to go, and there was no resistance left. The staff kept her very comfortable, and moistened her lips with glycerine wipes, although to tell you the truth, I'm not sure how much awareness she had remaining of her physical condition or her surroundings.

It won't be long now. Try to be completely still and present in the moment. Sit by her, hold her hand, and say your goodbyes. Whisper whatever you need to tell her in her ear.  It's been a long hard road, hasn't it - and she deserves the rest that is coming. Take care of yourself. Where ever she is, she knows you did your best.

Below my signature I've pasted one of my favorite quotes - it comforted us through the process.

Mary

A Parable of Immortality, by Henry Van Dyke
I am standing upon the seashore. A ship at my side spreads her white sails to the morning breeze and starts for the blue ocean. She is an object of beauty and strength, and I stand and watch until at last she hangs like a speck of white cloud just where the sea and sky come down to mingle with each other. Then someone at my side says, "There she goes!"

Gone where? Gone from my sight ... that is all. She is just as large in mast and hull and spar as she was when she left my side and just as able to bear her load of living freight to the place of destination. Her diminished size is in me, not in her. And just at the moment when someone at my side says, "There she goes! there are other eyes watching her coming and other voices ready to take up the glad shout, "Here she comes!"