Special Episode: Five Things "The Father" Teaches Us About Alzheimer's Disease

Welcome to This is Getting Old: Moving Towards an Age-Friendly World, I'm your host Melissa Batchelor, and today I'll be talking about Five Things "The Father" Teaches Us About Alzheimer's Disease A friend of mine recently reached out and asked me if I'd seen "The Father" yet with Anthony Hopkins and Olivia Coleman - Anthony Hopkins won the Oscar for Actor in a Leading Role. I have to say, I agree with this win. The movie plot is a daughter trying to provide care for her father who is living with progressive memory loss – so some form of dementia. Here are some things about what this film can teach us about providing care to a person living with Alzheimer's disease or a related dementia and you can learn more by checking out my podcast "What are the Stages of Alzheimer's Disease; Part I" where I talk about the common symptoms or difficulties you will see in the Early- and Middle-Stages of the disease.  #1: Misplacing or Hiding Valuable or Commonly Used Items  The father has several places around the house where he hides his watch and other valuable items. The caregivers know his hiding places and are able to redirect him to finding his watch that he accuses others of stealing. He's suspicious and is fixated on his watch. You never know what someone will fixate on or why that object becomes so important to them, but rather than getting upset about it, you're better off to address the underlying emotion being shared at the time – whether it anxiety or worry – rather than getting into a fight with them about how they are wrong.   #2: Mood swings when confronted with a mentally or socially challenging situation   The father has angry, explosive outbursts with his caregivers – in fact, he's run 3 of them off in the film before the 4th one arrives. I'd recommend reviewing my podcast, Seven Tips for Managing Behaviors in Alzheimer's Disease; How to Manage Anger and Aggression, and How to Manage Repetitive Behaviors. His behavior is driven by trying to control the situation and having trouble communicating with his caregivers. He is frustrated when words don't work and you're experiencing brain failure, angry and aggressive non-verbal behavior to try to get his way.   #3: Loss of orientation to time, then place, and eventually person I think it was a great play to have this character fixated on his watch. He is obviously already disoriented to time and place, in that he believes he is in his own flat when he hasn't lived there for years. Before the end of the film, he's not sure who he is anymore and his caregiver has to tell him what his name is. By this point, he is institutionalized and is progressing in the disease.  The film doesn't show his character with the functional losses that go with this disease – meaning, he can still walk and is getting around. In real life, the cognitive and functional losses will be in tandem – although they will occur at different rates of decline for different people.  #4: Personality and Behavioral Changes I've mentioned before that you may see delusions, hallucinations and suspiciousness in prior podcasts, but this film plays them out in a way that's much easier to understand than these labels.  First let's talk about his delusions – a delusion is a firmly held false belief. Throughout the movie, the father insists he is living in his own home, insists that nothing is wrong and that he can care for himself. Essentially, the underlying emotion here is feeling a loss of control and that deep rooted part of all of us that wants to be independent and autonomous. No matter what evidence is presented, he doesn't change his belief, so his caregivers keep trying to have a logical conversation with an illogical person – due to brain failure. So as a caregiver, I don't recommend frustrating yourself with presenting evidence over and over. Secondly, his hallucinations. These appear to be both visual and auditory hallucinations for the Father in this film. Hallucinations are hearing, seeing, smelling or feeling things that are not really there. For example, he hears a voice and follows it. #5: Personality and Sexuality I will tell you, that while this is an excellent depiction of what happens with brain failure, if you've seen one person with dementia, you've seen one person. So many aspects of this man's personality shine through – the essence of who he was as a human being without the filter he may have had as a younger person. From idealizing his younger daughter, making cutting remarks to the older one, becoming very amorous with a caregiver who reminds him of someone he once knew…all of these things make up who he was as a person. So overall, I think the film is an accurate portrayal for this one man's journey down the slippery slope of Alzheimer's Disease. I have other thoughts about the caregiver interactions with him – but will save those for another podcast. Several interactions could have been handled differently to prevent and modulate his behavior….but that's a beef for another day. Congratulations to Florian Zeller and Christopher Hampton for an amazing Screenplay and to Sir Anthony Hopkins on his Oscar nab! It was also great to see Olivia Williams again – still love her from Rushmore back in the day – and Olivia Coleman portrayed the very real emotional toll this disease takes on family caregivers and their lives. Leave me a comment below if you have other thoughts about this film's portrayal of dementia – and thanks for tuning in!