Can Alzheimer’s stage 5 patient go from being able to dress and toilet themselves to needing extensive care in a very short time?

My brother’s wife is in about stage 5. He does all of the shopping, cooking, cleaning etc. while working at his business from home. Two adult daughters will step in for a week “here and there” when he has to go out of town for work. They complain about this in spite of living only 35 minutes away. He lives in denial and has made no plans for any escalation of the disease.

They have a nice home and he has done little, if anything, about the 5 year look back. He has a comfortable income but not nearly enough for a memory care facility (when and if needed). I worry that her condition will escalate faster than he anticipates and things will fall apart quickly. The marriage was not a good one. She stayed in it for financial reasons and he stayed because of responsibility. She is 69, was formally diagnosed about 4 years ago but showed symptoms as far back as 10 years ago. This is why he put off separation. He did not want to burden his rather spoiled daughters (ages 37 and 41). Both have long term relationships and no children.

He has his own medical problems and the stress levels are causing health issues for him. His wife is very good at making doctors and friends think she is doing much better than she really is. They’ll go out to dinner with friends and she will remain quiet or say something like “what do you think of what the president is doing? She can’t take it any further so he has to jump in. She sleeps a great deal during the day. When she is awake, she asks him the same questions over and over. I believe he thinks this will be the worst of it.

He and I are very close and always have been. He’s helped me more than once and would never leave me in a bad situation he didn’t try to help make better. I want to do the same for him now. How can I make him realize that it will change and he won’t be able to do it all? What options are there for someone with too much money to qualify for help, but not enough for memory care or full time at home care. How quickly can stage 5 go to 6 and 7? I don’t know if the state you live in makes a difference as far as care cost and direction for caregiver. They live in north Florida. I might add that his wife has always been a bit selfish and has always, even in health, had a sense of entitlement. She was never concerned about who she burdened.

If it sounds like I don’t like her, I don’t. However, for his sake, no one would ever guess this to be the case. How can I help my kind, generous. good hearted brother. I live 2000 plus miles from him and still work. I have 4 more years to retirement of any kind. Thank you in advance for any ideas you may put forth. I’m so very grateful for this community.