Some movies cause us to think about ourselves and society. An important issue for most of us is our health and our medical care. Each year there are a few movies that portray health issues important to each of us in our lives. Annually I name the best health-themed movie of the year, as I did with Dallas Buyer's Club in 2014. This year I have nominated 4 films for the award in 2015. Here is my choice for my Health-Oriented Motion picture Excellence (HOME) Academy Award: Still Alice.
One of the most challenging illnesses facing people is the development of dementia. Dementia occurs in 1 of 20 people between 65 and 74, but in 40% of people over 85. So this illness is faced by most families. Still Alice portrays many issues in one common form of dementia: early onset Alzheimer's disease.
Based on the novel by neuroscientist Lisa Genova and written by Richard Glatzer (who himself suffers from a degenerative neurological disease ALS) and Wash Westmoreland and Lisa Genova, Still Alice was produced by Lex Lutzus, James Brown and Pamela Koffler. But our impressions of the film are largely based on the excellent acting of its stars. Julianne Moore portrays the frustration, fears, depression and courage of the patient, a young 50-year-old linguistics professor at Columbia University who notices memory lapses, accepts the diagnosis, and struggles to be the matriarch of her family for as long as possible. Planning for her gradual deterioration is a goal she approaches in an original way. Her husband, played by Alec Baldwin, illustrates the constant fight to keep the marriage alive and still advance his career, but ultimately he has to decide what is most important to him, an issue faced by many families.
Another issue portrayed by the film is the reaction of the daughters and sons. Actors Kate Bosworth (the lawyer daughter), Kristen Stewart (the actress daughter) and Hunter Parish (the physician son) show the range of reactions faced by adult children of the patient in confronting their mother's diagnosis and what it means for them in their own lives. How do they provide support and still manage their own lives? See the film to see what you would do in their shoes.
As the genetic understanding of Alzheimer's disease advances, it is appropriate that this issue is addressed so well in the film. It is not the details of the mutations in chromosomes 1, 14, or 21 that are associated with familial early onset Alzheimer's disease or the APOE mutations in late onset Alzheimer's disease which are discussed, but rather whether individual children will want to have the testing and how they will adjust to the results. See the film to think about whether you would want to be tested.
Here are my tips, based on this outstanding movie:
• See Still Alice and think about how often your family and/or friends have been affected by cognitive decline, memory problems, dementia or Alzheimer's disease and how everyone has adjusted to the illness.
• If you have noticed decreased memory or confusion, get help and evaluation from your primary physician, If your physician does not comprehensively evaluate your problems, get a second opinion or ask for a neurology consultation.
• If Alzheimer's Disease is diagnosed, ask about gene testing and if it would be appropriate. For more information on gene testing, check the chapter on inherited illnesses in my book Surviving American Medicine.
• If a family member has Alzheimer's disease, get information on the illness from Internet sites and ask questions of the physician. Find out how you can give the patient more support. Realize all the emotional challenges you as a caregiver can face and how you can get support. Discuss this with your physician.
• Remember that facing serious illness can be frustrating and exhausting. Use all resources to find tips on adjustments you can make to help deal with problems.
• Research advances are happening constantly. Keep abreast of results that might help you or your families. Support research that affects you, your family or friends with charitable donations.
Still Alice is an excellent movie that will help families better understand issues of dementia, a common problem in America. Congratulations to the producers, writers, actors and crew. Well done!