First post and question on impact of other health issues

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Michael Ellenbogen

Sadly no one can answer that question based on what we know today. Odd ar she wil die from somthing else based on what you shared and not dementai. 

LaurenB

Hoping4Endurance wrote:

I've read the forum for hours and appreciate all of the wise counsel and understanding.

Welcome to the group!

Please don't judge my question as I'm taking very good care of my MIL. We never had an affectionate relationship so there are no bonds of love. But I believe in duty. I'm also fortunate in being in a career that allows early retirement.

So, I will be able to retire this summer and none too soon as it's becoming increasingly difficult to care for her while working.

MIL was recently diagnosed as moderate mixed dementia. I was surprised at how badly she did on her neuropsychology exam. But, now I understand how well she's been able to compensate and cover up. 

My question is: is it reasonable to assume her dementia outlook will be much shorter than 8-10 years? She is 90 and has other serious health issues, including lung cancer (diagnosed 8 years ago but dormant for 5 years after immunotherapy), stage 3 kidney disease, minor stroke 3 years ago and high blood pressure.

The life span listed are just averages.  Given that she’s 90 years old already and has serious health issues, it could be possible that the other diseases take their toll on her before the dementia.  There is no way to accurately predict her outcome.  I’ve seen many of my patients live into their hundreds.  Some are very ill while others are rather healthy and are 107 and 103 years old.  

I know the question comes across as harsh but if I'm looking at an 8-10 year decline into stage 7, I'll need to take a much deeper breath. 

I  don’t see your question as harsh.  We all like to plan and would love to know how long this journey will be.

Thank you in advance for your responses.

M1

Welcome to the forum.  Agree with Lauren that no one can answer your question for sure, but:  a quick google shows that 6-7% of 90 yo women make to to 100 (about half that for men).  So the chances are better than not that her lifespan will not be that long, even if she didn't have other problems.

harshedbuzz

Hoping4Endurance wrote:

My question is: is it reasonable to assume her dementia outlook will be much shorter than 8-10 years? She is 90 and has other serious health issues, including lung cancer (diagnosed 8 years ago but dormant for 5 years after immunotherapy), stage 3 kidney disease, minor stroke 3 years ago and high blood pressure.

I know the question comes across as harsh but if I'm looking at an 8-10 year decline into stage 7, I'll need to take a much deeper breath. 

Alas, no one has the crystal ball needed to answer your question. One of the many awful aspects of this disease is that there is no way to plan for the allocation of resources-- whether financial or emotional-- in dementia. 

When my dad (another difficult person, btw) was diagnosed, my DH forwarded me an article that said at the time of an Alzheimer's diagnosis the life expectancy of a person with late onset is typically halved. That turned out to be true for dad, one of my aunts and the mother of a dear friend whose mom was about your mom's age.

In retrospect, I did see subtle changes in dad's personality more than a decade before he was diagnosed when he was well into the mid-stages. He was still able to hide this around most other people for a time. And my other aunt probably had early symptoms by 2003 when she was widowed and lived with mixed dementia (vascular followed by Alzheimer's a few years later) until early 2018. She was in a MCF for over 8 years which is quite unusual. Those with vascular dementia tend to progress a bit more quickly than those with Alzheimer's I'm told.

It's possible that she has already lived quite a bit of the expected 8-10 years of an average disease progression already. This is especially likely if her personality had become more challenging in the last several years because of the loss of a social filter. 

A question you and your spouse need to discuss are preventative care and testing and if you would opt to treat cancer or kidney failure going forward or make a decision to call in hospice. 

Wishing you all the luck in taking on this task. You are a very kind person to take on the care of a woman who was not what you deserved in a MIL. I will say that my dad was also tough. Towards the end of his life, his mood and behavior changed and he became nice which is pretty unheard of. In the last couple weeks there was a sweetness that allowed us to mend our relationship which was very healing for both of us. My SIL had similar with my MIL who initially loathed her. I hope you are able to experience something like that. 

HB

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BassetHoundAnn

Hello, Hoping4Endurance (what an appropriate name!), and welcome to the forum. 

Your question is not harsh. Alzheimer's is a war, one that is fought long and hard, and as in every war the combatants yearn to know when it will end, when they can go home and return to normal life, return to the old ways of joy and happiness. They are fighting daily exhaustion, trauma, and are emotionally ragged. But as with any other war Alzheimer's drags on and on with no relief in sight for anyone. 

So there is no way to know how long it will go on. There are a few online calculators but they are awful. 

My mom is going to be 97. She first started showing signs a little over five years ago when she started going to her bank with crazy questions, and the manager called me in alarm. A few months later paranoia set in because her home of 50 years no longer looked familiar. 

She has suffered a heart attack, minor stroke, edema probably caused by pulmonary failure, what looks like undiagnosed diabetes. Just in the last few months she's fought off pneumonia, covid, RSV, UTIs, and klebsiella. Last spring she survived noravirus. In a little over a year she's been to the ER 8 times for head wounds that required stitches and staples due to falls. 

To say that she keeps trucking in spite of it all would be an understatement. She seems to be thriving at her memory care. Two years ago when I found her mostly unresponsive on the floor of her assisted-living apartment I never would have guessed she would endure so long or so passionately.

But she is in her 90s and life can turn on a dime for those in their 90s. I have friends with parents in their 90s who had been seemingly healthy but died quite suddenly from infections, or pneumonia or sudden organ failure. Often within days. Life can go in a flash for someone in their 90s. 

I will say this, that the stages of Alzheimer's appear to be speeded up a bit for my mom. Two years ago according to the gerontologist who examined her she was in late Stage 5 with elements of Stage 6. Since then she's leapfrogged into late Stage 7. Her decline in the last few months with all the infections she's fought has been rapid. 

But overall there's no way to chart a map through Alzheimer's, or know in advance how long the suffering will last. It's truly a war of misery and exhaustion for all involved. 

Mckangel

Hoping4Endurance I have asked myself the very same question about the probability of how long my almost 92 year old mother will live. She is a heart patient although stable in that regard but she is declining mentally pretty rapidly, especially since my father’s death a little over a year ago. The question does not come across as harsh at all to me; it is a practical issue of trying to figure out and prepare for the unknown. in my mother’s case, I am trying to make decisions based not only on her current health needs but how long I can make her finances last without sacrificing any needed care. I just wanted you to know you are not alone in dealing with these questions.