Dementia in Films: Getting It Right

I loved the novel Still Alice because it was an accurate portrayal of Alzheimer’s disease. And the movie Still Alice got it right too.

I lead support groups for caregivers of people with Alzheimer’s so I was eager to find out what they thought of the movie.

“Has anyone seen Still Alice?” I asked at the next meeting.“Yes, but I didn’t like it,” said Phyllis.

“Really?” I was surprised.

Fran chimed in, “Me neither.”

“Why not?” I thought maybe it was too harsh a reminder of what they were living with—but not at all.

Fran explained, “It doesn’t begin to show how difficult and tedious the caregiver’s job can be.”

“Exactly!” agreed Phyllis. “Alice wet her pants once, not six times a day.”

The caregivers went to the movie looking for a realistic depiction of Alzheimer’s caregiving. I went looking for an accurate presentation of the disease. We all wanted the film to get it right.

Why did we care so much about its accuracy? What difference could it make?

If the movie is accurate, it can promote understanding of the disease and lessen fear and especially the stigma. This may be some viewers’ first look at Alzheimer’s.

If it’s honest, it can elicit compassion for the person with dementia and for their care partner. Certainly the caregivers I know looked for validation of their trials.

If a movie includes the context of the caregiver relationship, it can lessen a tendency to judge caregivers, as well as increase support for them.

The movie Still Alice focuses intensely on Alice and her experience—so much so that some critics faulted it for leaving the other characters undeveloped.

An honest and engaging portrayal of a disease as misunderstood as Alzheimer’s is no small accomplishment. Yet every case of Alzheimer’s—indeed, every life—takes place in a context. The most important component of context for people with Alzheimer’s disease and other dementias is their relationship with their caregiver. The relative absence of a focus on that relationship in Still Alice was noticed by caregivers and critics alike.

How have other films presented dementia? I was curious, so over a period of three weeks I watched seven more movies that purport to depict Alzheimer’s or other dementias in a leading character and also show caregiving in that situation. Two of the films got Alzheimer’s right and had much richer relationship contexts than does Still Alice, and one got dementia (caused by a stroke) and the grueling caregiving right, but it failed to move me.

Four other movies got either the dementia or the caretaking wrong, and I’ll write about them in my next blog.

In all four of the getting-it-right films, the caregiver is a husband. That’s probably just chance. Women are the care partners in Alzheimer’s in two-thirds of cases—daughters are as common as wives. In fact, in Still Alice her husband cares for her at the beginning, but when he moves away to take a new job, her younger daughter takes over.

Two of the films that got dementia right, Iris and Still Mine, are nonfiction. Iris is based on John Bayley’s memoir-biographies of his wife, Anglo-Irish novelist and philosopher Iris Murdoch.

The movie is rich in context and realistic caregiving. Iris alternates between the 1950s, Murdoch and Bayley’s early days in Oxford, and the 1990s, the years of her decline due to Alzheimer’s. The flashbacks allow us to grasp the intellect being destroyed, and—equally important—to understand the couple’s unconventional relationship: Bayley accepted Murdoch’s infidelities and unexplained absences.

There is obvious irony in her former brilliance, independence and flair for language—and her later confusion, dependence and loss of language.

The movie shows Alzheimer’s as it is. I was satisfied on that score.

Nor will caregivers be disappointed. Bayley is by turns loving, worried and impatient. When Murdoch huddles close to him in fright after the postman rings the bell, Bayley snaps, “Stop nudging up to me like a water buffalo! It’s only the postman.” More often he is affectionate and solicitous.

When he is driven by stress to explode in anger, we understand his exhaustion, and we have the context to know that years of hurt have played their part as well.

Still Mine is based on the true story of a Canadian farmer, Craig Morrison, and his wife, Irene, who is developing dementia.

Much of the movie concerns Craig’s building a new, more suitable house for them. In his run-in with authorities over building codes, we witness his unrelenting integrity and resolve.

Craig is initially impatient with his wife’s memory lapses, but like the best of caregivers, he quickly catches on that she can’t do better.

Their relationship of 61 years and seven children ripens and adapts with the changes that Irene’s illness brings.

Even this thoroughly decent and loving man eventually reaches a breaking point when he can’t get her cooperation in what’s needed for her safety. With honesty, the film shows the scene—and its aftermath: Craig, bowed with shame. Sometimes caregiving unveils a part of ourselves we’d rather not see.

The most moving moment in the film for me comes when Irene says to Craig, “Do you know what scares me? What if I forget everything?”

His reply, “You’ll still be my Irene.”

We never doubt Craig’s goodness or his devotion.

The last getting-it-right movie stands out from the other three. It is Amour, a French film about a couple in their 70s.

Calamity strikes early in the movie. The wife suffers a stroke. In an attempt to lessen the damage, she has surgery, which fails.

After a second stroke, she is cognitively impaired and bedridden. She has trouble talking and can no longer feed herself. Her condition and the burden of her care are not hidden from viewers. We get an accurate and harrowing picture of vascular dementia, which is similar to Alzheimer’s. And the film ends horrifically.

I came away from the movie shocked to realize that, in spite of watching all the piteous details of a stroke’s aftermath, I didn’t really care about the people involved.

How do the other movies that are accurate about the effects of dementia get us to care?

We know how Alice is experiencing her disease in Still Alice because she tells us. Furthermore, we see it on her face and in her actions. She wins our compassion. The movie ends with a beautiful scene in which it is clear Alice still knows what love is.

In Iris, Murdoch, the prize-winning writer, stirs empathy throughout, especially when she reflects on Alzheimer’s causing her to lose words. “Sometimes it frightens me and sometimes it doesn’t. And that frightens me because that’s it winning.” In addition, the movie exposes the deep connection between Murdoch and Bayley. Irisis about a marriage and its endurance even when impacted by Alzheimer’s. We care because they care.

We feel we know the Morrisons in Still Mine. We come to love Craig Morrison for his goodness and integrity, and we believe wholly in his love for Irene.

In contrast, Amour, following a style known as retentive realism, withholds from us almost everything the characters are thinking and feeling. We are kept at such a distance from them that they might as well be wooden dolls.

All too often, people keep themselves at a distance from dementia. I hear endless stories from care partners about friends and relatives who stay away.

A movie that honestly brings us into the lives of people with dementia and their caregivers and treats those people with full compassion allows us to see ourselves in them.

Then we care.

A movie that makes viewers care could bring friends and relatives back into the real lives of those living with Alzheimer’s or another dementia, who so need their support.

That’s a good reason for a film to get it right about dementia.