Dr. Vikas Bhalla is a Consultant Geriatrician at the West Suffolk NHS Foundation Trust and tweets as @drvkb
Still Alice is a film I have been looking forward to seeing for a long time, not only in my role as dementia lead for my hospital but also as a self-confessed film geek. There has also, of course, been huge hype surrounding Julianne Moore’s performance, for which she has won virtually every single “Best Actress” award this year, including an Academy Award, BAFTA, Golden Globe and Screen Actors Guild.
The film is based on Lisa Genova’s debut novel Still Alice (2007). Moore plays Alice Howland, a professor of linguistics at Colombia University in New York. She is happily married to a fellow academic John (played by Alec Baldwin) and she has three children. At the age of 50, Alice is diagnosed with familial Alzheimer’s dementia.
Unlike films that have dealt with a similar subject matter, such as Away from Her (2006) and Iris (2001), Still Alice is revelatory in that we are given Alice’s first person point of view, regarding the effects the disease has on her, rather than the subsequent consequences to the family. Early on, whilst Alice is jogging, we are shown her perspective of what it feels like to become suddenly lost, frightened and disorientated in an environment that should be familiar. Later in the film as the dementia progresses, she becomes lost in her own home whilst trying to find the toilet. This unfortunately leads to upsetting and undignified consequences.
I found the use of technology throughout the film of particular interest. At 8 o’clock every morning, Alice would use her phone as a memory crutch. She would regularly play the phone’s word game as a way of hopefully staving off the progression of the disease. Video-calling technology is also used to keep her in contact with her younger daughter (Lydia) who is living in California. Later on, when Alice’s dementia starts to reach the stage where she forgets her children’s names, there is an extremely poignant and upsetting set piece that raises the question of assisted dying.
The use of technology however was not just played out on film: its co-director, Richard Glatzer, suffered from motor neurone disease and as filming progressed, so did his condition. Sadly, he died on 10th March, having watched Moore win her Oscar from his hospital bed.
Glatzer relied on typed instructions in order to direct Moore and her fellow actors (due to his becoming virtually mute), a fact beautifully reflected in the film when Alice states “It’s amazing how much technology can help”. Both in its subject matter and the means of its creation, Still Alice shows us the importance of new developments in assistive technology for the elderly and those with disabilities.
The lack of awareness and potential help for people with dementia in comparison to cancer is played out on a number of occasions. In one scene Alice, having just being diagnosed with Alzheimer’s dementia, says “I wish I had cancer”. Whilst she remains lucid, she feels greatly stigmatized and helpless: that sense of unease and helplessness mirrors the feedback I’ve received from relatives who have had loved ones with dementia.
One relationship that isn’t fully developed is the one between Alice and her husband John. As an academic and an obviously intelligent man, at times, he doesn’t seem to fully comprehend her condition and its inevitable progress. He plans to move away from New York just as her dementia appears to be entering the “end stage”. He opts instead to arrange a live-in carer for her. Perhaps this is his way of dealing with the grief?
I found the film to be an extremely accurate portrayal of the journey from the early onset of mild cognitive impairment to just about the end stage of dementia. We are shown a fabulous pinhole view of a person’s journey through an inevitable, frustrating and frightening decline. Towards the end, her younger daughter Lydia (played magnificently by Kristen Stewart) asks Alice “What does it actually feel like?”. Her accurate and articulate response, some days “I almost pass for a normal person” while on other days “I feel like I can’t find myself”.