I just took my dad (age 84) with Alzheimers and vascular dementia to his cognitive appointment with the geriatrician (his PCP). he scored a 1 on his cognitive test, where last year he scored a 6. he was asked things like day, date, year, draw a box, clock, identify animals none of which he knew or could do. I reported that he has seemed to be having a hard time swallowing, coughing after water a bit, getting a bit "frozen" with water in mouth. Doctor said, this is the first thing they have trouble swallowing and might need to start thickening water. Will start to have a speech therapist to help with strengthening vocal cords - he speaks quietly at times. and a new PT and OT regimen. what shocked me at the appointment was that she said he probably has 1-2 years left. Now, I know it's coming, but to hear it from her was shocking. He was diagnosed around 6-7 years ago, but had signs about 8 years ago. She said he'd probably stop talking soon (already only uses a few words, 1-2 word answers) I've heard of people living a long time without talking, hardly eating, etc. Can she really be right about his time left?
Please allow him to rest and be comfortable with help from hospice now. By the time swallowing becomes an issue with AD and dementia, it's time for hospice to step in. They will provide some help for mom also in the way of bathing and providing a hospital bed and free supplies, but not too much else. The chaplain is good to talk to about fear and distress.
I'msorry you're going through this and wish you good luck and Godspeed with a difficult situation.
Seeing the therapist gives them more social interaction as well.
I think you probably have a good feel for the stamina of your father, how feeble he is but people don’t always die from their major malady. At 84 in the US he has already outlived most men.
He would have a life expectancy of about 6.44 more years with all cause mortality.
But in end stage or nearing end stage Alzheimers, I would expect the doctor to know her patient’s prognosis.
How fit he was in his middle years makes a difference as well as it acts as foundational strength.
The speech therapy is really important for all the reasons mentioned.
Additionally all the therapies are beneficial for the caregiver. You aren’t looking to cure him or restore him but to keep him comfortable, stretched and able to transition. The therapist can teach you how to better manage him w/o hurting yourself or hurting him. Their evaluation when they see him can help you decide.
The average life expectancy for a male born today is 76.5.
Sometimes it helps to put it all in perspective.
He had a few swallowing problems earlier on but they didn’t get bad until his last few weeks. Same thing with speech.
He was also resistant and combative and would not cooperate with PT or OT or even drinking water or anything else or eating anything except small amounts of ice cream his last 6 months. We tried Thick-It and many other things and he flat out refused all of it. I think malnutrition and chronic dehydration contributed to his other physical issues (most likely multiple forms of cancer). So, I would say dementia was not the primary cause of his death but it certainly contributed. He was in home hospice the last 4 months. His immediate cause of death was aspiration pneumonia as is very common with dementia.
His geriatrician pointed to poor bloodwork values and also chronic wasting and weight loss as major reasons for concern with increasing urgency his last 12 months. I believe problems swallowing led to dehydration which in turn led to increased falls, along with muscle wastage from not eating.
All this to say— it really depends a lot on all the factors going on with your dad. No one knows for sure, but geriatricians do treat people at the end of their lives, so have way more experience than most of us.
It sounds like you are doing everything you can so he can be as comfortable and engaged as he reasonably can at this time in his life. He is lucky to have you. Don’t burn yourself out!
Only God knows that day and time that He'll take your dad Home, but from what you've written it sure doesn't sound like it will be long at all, so just enjoy whatever time you may have left with him.
And quite honestly I don't think that I would put your dad through anymore therapies at all as his brain is so severely broken that he's not going to retain anything at this point anyway. Just let him enjoy whatever time he may have left with out putting him through things that won't help anyway.
However, I have found that the Hospice nurses are pretty spot on.
So, depending upon how quickly your loved one is going down, if it starts progressing more quickly, then the doctor may re-evaluate him. Otherwise, I think it's 50/50. That's just my opinion.