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You can use bots to keep him alive. You can also still rest in his bunker after he is gone.
Also if you say hello to him in BT form, he screams
I completed the game on PS4 never even knowing the Elder could pass. I didn't even spend a lot of time focusing on his missions, I was just lucky enough to be around whenever the pacemaker was needed.
When I played on PC, I didn't bother delivering the pacemaker at all, and he was lost a lot quicker.