Still Alice Case Study Summary

Still Alice (2015) directed by ****** starts with Alice giving a lecture to her Harvard linguistics class while stumbling over words and concepts. She forgets plans with her husband and gets disoriented while in familiar places. She notices that she is not herself and consults with a neurologist where she is presented with a series of memory tests. Alice starts giving herself words to remember while completing housework. The doctor says she has sporadic memory impairment in relation to how young she is. He confirms that there is evidence of decline in her level of daily functioning. Alice told John, her husband about her visits to the neurologist and that she was being tested for early on set Alzheimer’s. She explained how she was having trouble

remembering basic things such as appointments and words. John took what Alice was saying with a grain of salt. Alice tells him "I feel like my brain is dying. My thoughts just drop out from under me." John continues to not take her seriously and remains skeptical that his intelligent wife could have Alzheimers at such a young age. The test results revealed that Alice has early onset Alzheimers. “Early age-of-onset Alzheimer’s disease show more rapid progression, more generalized cognitive deficits and greater cortical atrophy and hypometabolism compared to late-onset patients at a similar disease stage (Rabinovici et al, 2010).” The doctor explained to her that there were a lot of red areas on her brain scan which represents beta amyloid.

Data found by Rabinovici et. al. in 2010 supported that early amyloid beta accumulation increased vulnerability to amyloid beta pathology and plays critical roles in susceptibility to Alzheimer’s in young patients. The quantity of beta amyloid in her brain shows that the build up has been happening for the last few years. The doctors also inform her that there is a 50/50 chance of passing the gene on to the carriers' children and the odds of developing the disease, as a gene carrier is 100%. Alice and John inform their three grown children, Anna, Tom and Lydia of these findings and inform them that there are options if they want to get tested for it. Anna her oldest daughter who is pregnant with twins tested positive, Tom is negative and Lydia chose not to get tested. Alice offers to stop everything and go visit Anna to see if she’s okay but Anna wishes to be left alone. Alice is hurt that her daughter does not want any of her

support. Genetic concerns for transmission to younger generations are unique to this younger population of individuals diagnosed with early onset. This is reinforcing that the life stage and activities of this age group, such as work, retirement planning, and social events, factor into daily stresses for Alice (Klink, 2013). Alice makes the decision to look at nursing homes to get insight at what her future may look like. She sees elderly people dwindling away and nurses attempting (but not succeeding) to make meaningful small talk with the patients. She does not want to end up like this. Once she is home she tapes a webcam video to her future self. She told herself that once it comes to a point where you can no longer answer all the questions on her phone, she is to take all the pills in her dresser and go to sleep. The deterioration of Alice’s cognitive ability at this point in the movie is very clear. She now has a medial alert bracelet saying memory impaired, she’s repeating questions to her husband and she can not remember where the bathroom is in her own home. Her children start talking about her as if she is a deaf person not a person with Alzheimers. Her deterioration is progressing rapidly. Alice does not know who she is any more. She is doing poor on memory tests, her doctor tells her deterioration happens faster in highly educated people. John is continuing to be talking for Alice instead of discussing with Alice. She is selected to give a speech at an Alzhimers conference, she starts by saying:
We are far from who we once were. Everything in my life has been ripped away. This is hell. Who can take us seriously when we are so far from who we once were.
She talks about the struggles to stay connected to her family and to herself. The audience was moved to tears. Once at home Alice asks her husband to take a year off work to spend time together. She believes that he does not want to because he cannot spend a year at home watching her like this. Alice has a breakdown that she cannot find her phone with her questions on it, the director jumps scenes to someone finding her phone. Alice is very happy that her phone is found because she was looking for it last night. John says that she lost it a month ago. Alice looks disheveled and needs help getting dressed. Her family is discussing future plans for Alice without her input whatsoever. “Alice wouldn’t want to be a burden”, John says and wants to get her care. At home Alice accidentally opens up the file of her video she made for herself. She watches the video multiple times. She is about to take the pills only to drop the bottle when interrupted by the housekeeper coming home. John is feeling so upset that he cannot see her like this. Lydia agrees to take her mother into her care. Still Alice follows the diagnostic journey created by the Norwegian researchers with great accuracy. First the pre- diagnosis, with initial signs and effects on the family. Second the changing marital relationship. Third, the pivotal/ life altering transition, in this case when Alice was officially diagnosed. Fourth and finally, the lifestyle transition and acceptance. Alice accepted to appreciate the smaller less significant things in life such as butterflies and ice cream and accepted that her life would forever be changing.
How Disorder is Portrayed in the Film
Even in later stages of Alices condition she is still portrayed with dignity. Her condition is portrayed with a clear progression in the film. The disorder starts as forgetting simple tasks, lost in familiar places and a general dissassociation from herself. Lydia asked Alice what it feels like to have Alzehemers, Alice says that on good days she feels almost normal, but on bad days its as if she can not find herself . Alice was losing her sense of self and identity. "Alzheimer's disease takes away the person's ability to tell their autobiographical story or personal experience. Telling stories that deconstruct personal events is one of the most compelling ways to present one's identity to others (Veazie, 2015).” Alice discusses these concepts while speaking at the Alzheimers conference. She does a fantastic speech on living with Alzheimers moving the audience to tears. She mentions her acts of strange behaviours and how others perceptions of her and her perception of herself has changed. She feels that she is now ridicoulous and incapable of carrying on her normal life, " I struggle to stay connected to who I once was," she says. Still Alice portrays Alzheimers as a struggle with ones own perception of who they are becoming. While also showing the struggle of not being able to remember whom they are because they are continuously losing more of themselves each day.