Emotional Health

Dr. Ford on Emotional Health: The Caregiver’s Dilemma in “Still Alice”

fordCecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for Women’s Voices in many articles over the years.


 5221859997_9c8cc5eb3f_zImage by Melvin E. via Flickr (Creative Commons License)

Julianne Moore won a much-deserved and overdue Oscar for her performance in Still Alice, a film that depicts the heartbreaking descent of a woman in her 50s into early-onset Alzheimer’s disease. Her plight is all the more poignant because, as a world-renowned scientist and professor at Columbia who has done seminal research on the acquisition of language, she is someone who has always relied especially on her intellect and her cognitive powers. We watch as she loses her faculties—slowly at first, and then with astonishing alacrity. Meanwhile, her family—her research/physician husband and their three adult children—are caught up in the vortex, both collective and individual, that this creates for them all.

The film shows the backstory of the family and its characters. Early on, there is a scene at a restaurant—a celebration of Alice’s birthday—and we learn that she is loved and appreciated by her husband and children. Does he seem a bit self-satisfied and cerebral? Is the older daughter contemptuous of her younger sister’s aspirations to be an actress? Does her brother seem overwhelmed and preoccupied by his life as a medical resident? Perhaps, but Alice herself seems oblivious and unfazed by all of this. Later we see Alice preparing an enormous Thanksgiving feast singlehandedly, without much help from them. Are they selfish and self-involved, or have they learned that Alice is self-sufficient and likes it that way?

Alice certainly seems happy with her life. The only exception is that she is worried about her younger daughter, Lydia, who has decided to skip college and become an actress—a plan that her mother thinks is shortsighted. Despite considerable pressure, Lydia sticks to her guns, and it is her ability to follow her own path and think independently that may allow her to be the family member who is best able to deal with Alice’s changing needs.

One of the many things the film illustrates well is that these tragedies impact each family, as well as each individual within a family, in its own particular way. The personalities and relationships that existed prior to the onset of the illness necessarily have an impact on how everyone behaves subsequently. Alice, who is portrayed as a loving, strong, and perhaps over-giving person, is devastated by her diagnosis, but especially by the fact that Alzheimer’s is a “familial” disease—that is, her children have a 50 percent chance of inheriting it. Her son, Tom, is negative; Lydia, the actress, declines testing. Anna, the eldest, who is pregnant with twins, is positive, but she is relieved that embryos can be tested. Her feelings are not explored much beyond that, except that she goes ahead with her pregnancy, so we assume that the results of the test were negative.

The most important person in Alice’s life—her husband, John—is shown in more detail. As a research physician, he ought to understand what is going on, but he reacts more as a husband, and, more important, as the kind of person he has always been. At first he is confused and in denial, which is both typical and understandable. But he doesn’t seem to realize the magnitude of Alice’s underlying illness, although in some ways that is the theme of the movie: An Alzheimer’s victim is both herself and yet profoundly different at the same time. Though he struggles to be empathic and sensitive, he has difficulty understanding the world from Alice’s new point of view.

This becomes especially apparent when he is offered a prestigious post at the Mayo Clinic. He reasons that their life in Minnesota won’t be all that different from their life New York. He’ll look after her and they will have a caregiver during the day, just as they do at home. Besides, it’s only for a year, and if she wants to see the kids, including the new grandchildren, it’s a quick plane ride.

His preoccupation with himself and his own needs prevents him from understanding that taking Alice away from everything she could still recognize would be devastating. The nature of the disease is that it progresses in an uneven way: On some days you are more “yourself ” than on others, and it’s hard to predict when that will be. But when you take someone away from everything she knows, you remove any chance that she can still have those better days.

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  • ellen sue jacobson March 20, 2015 at 6:28 pm

    Wonderful insight into the movie. You describe the husband perfectly; he’s not online denial, he is thinking only of his needs and does not truly understand the impact the illness has on Alice. Nothing tested seems like an ostrich-technique,keeping your head in the sand, but that is a choice. Thanx for the terrific review. Julianna Moore was terrific!