An elderly Calgary man accused of killing his wife of 56 years suffers from severe dementia and is not medically fit to stand trial, a judge ruled Friday.

Fred van Zuiden, 85, was charged with second-degree murder after his wife, Audrey van Zuiden, 80, was found dead inside their home on Oct. 4, 2016.

Forensic psychiatrist Dr. Ken Hashman testified late last year that he believed van Zuiden was unfit to stand trial after evaluating him for two months.

He appeared in court again Friday, telling Judge Allan Fradsham that van Zuiden's condition has now worsened.

Van Zuiden and his wife, Audrey, pose in this undated photo. Family friends have described the pair as soulmates. (Vince Walker)

"He can still beat everyone on the forensic unit at chess, but he can't remember he just saw his lawyer," Hashman said.

Van Zuiden wrote a bestselling memoir about hiding from the Nazis for two years as a boy in occupied Holland during the Second World War.

Court heard that van Zuiden at times believed it was still the 1940s and he and Hashman were on the run from German soldiers.

That confusion also surfaced in earlier court proceedings. In November, van Zuiden seemed confused as he appeared before a judge, asking, "Am I in court?" as he was escorted to the prisoner's box and mumbling, "I have not committed a murder in all my life."

At the time, family friends said van Zuiden didn't understand his wife was dead.

Van Zuiden requires around-the-clock care, the forensic psychiatrist told court Friday.

The judge accepted the expert's findings and ruled that van Zuiden must go before a mental health review panel within 45 days for a determination on where he should receive care.

Defence lawyer Alain Hepner said said he will seek to have the criminal charge stayed after that.

He said his client, who was not required to attend Friday's hearing, is very confused and does not understand what is happening around him.

"He doesn't understand. He doesn't recognize Dr. Hashman, who's really the head caregiver for him," he said.

"I can't explain it to him. He doesn't even know why I'm there on behalf of the family."

Van Zuiden has been held in custody at the Southern Alberta Forensic Psychiatric Centre, where he will remain for the time being.

Grandfather figure

Vince Walker, left, and Gordon van Gunst, friends of van Zuiden, say the elderly man is being well cared for at the Southern Alberta Forensic Psychiatric Centre. (Colleen Underwood/CBC)

Family friend Gordon van Gunst said staff there are taking good care of him and have come to like him.

"Fred is now a grandfather to them type figure. And they appreciate him like that," he said.

"It would be nice if he could stay where he's at. There are only a couple of facilities in our province that will allow for care of people with severe dementia."

Another friend, Vince Walker, said van Zuiden and his wife, Audrey, were an inspiring couple.

They're as close to being one person as you could ever get," he said. "They only had each other. They were a unit."