Expert: Michalene Peticca - 2/9/2010

Question
Hi, my father has had Alzheimers for some years now. He is being cared for at home by my siblings and is in the final stages of the disease. He is completely sedentary (immobile) and incontinent. For the past few months, he has only been getting about 350 calories a day, sometimes less. He usually just won't eat, despite trying all the recommended tips and tricks, and everyone has decided not to force him to do so. There is also a no resuscitate order and no plans to put him in hospice as he does better with family than with healthcare workers (we tried that in the past - not a good scene). He also doesn't drink much - probably less than a glass of water a day and maybe 1/2 cup coffee and some Ensure. He sleeps about 15-16 hours per day now and now rarely urinates while he is awake and just a little when he is asleep. And for the past couple weeks it has been brown in color. I have been told that means the kidneys are starting to shut down. My question is - how long can he last in this situation - with 350 or less calories and kidneys starting to shut down? I must travel to visit with him and I am just trying to get a gauge on what kind of time frame I have here... want to spend as much of the last moments with him that I can, but have limited leave time available to do so, unfortunately. Would you be able to give me any sort of gauge on what is going on right now with him and what time frame we are looking at? Thanks so much for any insight you can provide. -Iris

Answer
Hello Iris,

I am so sorry about your father and i fully understand your family care and your wanting to be with your father.   He sounds very lucky to have you all.

While i am not a physician, it has been my experience that an individual can sustain over 2 weeks, sometimes longer!,  just on small amounts of fluid.

With your father's situation, i would suggest you wait one week and then start traveling to be with him.   Although you may not be with him at the very end....i do believe you will have that closure you need and that will benefit you so much more.

My prayers for your family,
Best Regards,
Michalene Peticca, MA