Moviemakers know it is dramatic when a beautiful heroine tells her devoted husband she is losing her very self. As a result, Hollywood produces many movies about Alzheimer's. Iris (2001), The Notebook (2004), Away from Her (2006), and Still Alice (2014) are all recommended by the Alzheimer's Association in spite of some poetic license about the disease. Here's a look at what these movies showed.

Iris: Evocative and Accurate on Alzheimer's

Iris starred Judi Dench as Iris Murdoch, the noted British novelist. Based on the memoirs of John Bayley, Murdoch's husband, the film depicts the devastation of Alzheimer's. The dramatization is particularly poignant given Iris Murdoch's brilliance. Watching the foremost English novelist of her generation struggle to remember simple words like "puzzled" and "spoon" makes for good drama. It is especially affecting given Iris's words: "There is only one freedom of any importance whatsoever . . . that of the mind."

Kate Winslet's spirited invocation of Iris as a young woman and Judi Dench's portrayal of the older Iris with vacant eyes, agitation and growing dependency paint an unforgettable portrait. Hugh Bonneville plays Iris's clumsy, devoted young husband and Jim Broadbent gives an Oscar-winning portrayal of her husband as an older man.

The strain upon caregivers is shown realistically when John melts down in a climactic scene. He yells at Iris that everyone once wanted her, and now he alone has her. Yet he doesn't want her anymore as she belongs completely to the disease. Many caregivers of Alzheimer's patients can empathize because they are similarly overwhelmed spouses or family members. On the whole, the movie is accurate about Alzheimer's symptoms and effects.

The Notebook: Alzheimer's Inaccuracies

The Notebook stars Ryan Gosling and Rachel McAdams as a young couple, in flashback. James Garner and Gena Rowlands play the same couple in their elder years.

The movie is unrealistic about Alzheimer's. Allie, the Alzheimer's patient, wears makeup, heels, a smart suit, and nice jewelry. Although she no longer remembers her husband Noah, her children, or the woman she once was, she either grooms herself this way or nursing home staff does it for her. This is unlikely for an Alzheimer's patient or for burdened nursing home staff. An ABC news report on government findings stated that understaffing in nursing homes is widespread. It often leads to bedsores, infections, and weight loss, not Hollywood glamour.

The plot goes that Allie wrote the couple's love story in a notebook years ago. She told Noah that if he read it to her, she would always come back to him.

Reminiscence therapists often do use photos or scrapbooks to trigger memories in Alzheimer's patients. Yet Noah's attempts cause violent agitation in Allie. She is then sedated by staff. Given the dangerous antipsychotic drugs often used to calm dementia patients, Noah does Allie no favors by trying to force her recall through "the notebook."

Away from Her: Alzheimer's Effects on Love

In way from Her, Fiona (Julie Christie) shows signs of Alzheimer's. She puts cooking utensils in the refrigerator and can't remember words like "wine" or "yellow." Her sense of time is skewed: "When did we move to this cottage?" she asks. "Last year or the year before?" Her husband Grant (Gordon Pinsent) replies, "It's been twenty years."

When Fiona gets lost and must be found and brought home by Grant, she decides to enter an institution. A month later, she doesn't remember Grant. She is polite when he visits, but is far more enthralled with fellow institutional resident, Aubrey. Grant is reduced to trying to win her back.

Fiona is grief-stricken when she is separated from Aubrey, but after a little time, she forgets him, too. She comes to understand that Grant is a kind, consistent man and her love for him rekindles.

The stages of Alzheimer's seem stepped up in pace in this movie. Yet it is a powerful portrait of Alzheimer's patients and caregivers struggling to sort out memory loss and love.

Still Alice: Evocative and Accurate on Alzheimer's

The symptoms and progression of Alzheimer's are accurate in Still Alice. This is no surprise, since consultations with the Alzheimer's Association took place throughout the development of the story. The novel by Lisa Genova, a neuroscientist trained at Harvard, was also accurate at the time it was written. It was important to everyone involved that the film was true-to-life and up-to-date in knowledge about Alzheimer's.

In an Oscar-winning performance, Julianne Moore plays Alice, who has early onset of Alzheimer's. Although Alice is a linguistics professor at Columbia, she has trouble remembering words. While lecturing one day she goes blank, but covers gracefully, humorously mentioning that she shouldn't have had champagne over lunch.

A Graceful and Poignant Depiction

Authors Mace and Rabins say that with Alzheimer's, "Old social skills and the ability to make customary social remarks are often retained longer than insight and judgment." Alice masks her condition with grace, but in time she can no longer do so. At the family beach house, she forgets where the bathroom is and wets herself. She fails to recognize her daughter, Lydia (played by Kristen Stewart).

A pivotal moment comes when Alice gives a speech to the Alzheimer's Association. She notes how difficult it is for a once competent person to become incapable, even a figure for ridicule. Yet, she asserts, her mistakes do not reflect who she is, they are just the disease.

Mace and Rabins would concur. They say, "The person who has dementia probably feels lost, worried, anxious, vulnerable, and helpless much of the time. He may also be aware that he fails at tasks and feels that he is making a fool of himself."

The family ultimately decides that daughter Lydia must become Alice's full-time caregiver. The husband (Alec Baldwin) must work, and other siblings' lives are full. Caregiver Lydia reads a complex passage to Alice and asks her what the passage was about. Alice looks blank, as if she has already forgotten it. Yet in her new, slow, slurred way of speaking, she says the reading was about love. Her caregiver affirms this and, in doing so, affirms Alice. Alice is still who she always was. She is still a thinking, feeling human being worthy of love.

The Take Away

Movies that accurately depict the symptoms of Alzheimer's may notify relatives that a loved one's memory lapses may be serious. Hopefully, too, these poignant and dramatic stories arouse greater compassion for dementia sufferers and their caregivers. The more accurate films prove that a movie can be evocative without sacrificing the truth about Alzheimer's.

Sources

ABC News (2012). Report: Understaffed Nursing Homes Endanger Patients. Available at http://abcnews.go.com/US/story?id=96416&page=1. Retrieved 1/27/2016.

Alzheimer's Association. Recommended List of Videos. Available at https://www.alz.org/library/downloads/resources_librarycore_videos.pdf. Retrieved August 1, 2016.

Alzheimer's Association. 10 Early Signs and Symptoms of Alzheimer's. Alz.org. Available at http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp. Retrieved March 31, 2016.

Klever, Sandy. Reminiscence therapy: Finding meaning in memories. Nursing, April 2013, 43(4): 36-37. Doi: 10.1097/01.NURSE.0000427988.23941.51. Available online at:

http://journals.lww.com/nursing/Fulltext/2013/04000/Reminiscence_therapy__Finding_meaning_in_memories.11.aspx

Mace, N. L., and Rabins, P. V. (2012). The 36-Hour Day. New York: Grand Central Life & Style. Hachette Brook Group. Pps. 11-12; 38; 39; 49.

Government Accountability Office (GAO). Antipsychotic Drug Use: HHS Has Initiatives to Reduce Use among Older Adults in Nursing Homes, but Should Expand Efforts to Other Settings. GAO-15-211: Published: Jan 30, 2015. Publicly Released: March 2, 2015. Highlights available online at http://www.gao.gov/products/GAO-15-211. Full report available online at http://www.gao.gov/assets/670/668221.pdf.

Still Alice comes to life on the silver screen with help from the Alzheimer's Association. The Judy Fund Newsletter. Available at http://www.alz.org/documents_custom/ALZ_JudyFund2014.pdf. Retrieved August 1, 2016.

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