Still Alice

I knocked off early yesterday to see an advance screening of Still Alice, the film adaptation of Lisa Genova’s novel about a professor diagnosed with younger onset dementia. As a dementia researcher, avid filmgoer, and fan of the book, I walked in with high expectations… but if Still Alice had been a film about anything other than dementia, I would have walked straight back out.

Yes, Julianne Moore is fantastic and it’s great to see younger onset dementia on the big screen. But as a piece of cinema, it’s appalling. The pacing is uneven, the other actors are painfully earnest (Alec Baldwin as a professor? Please!), and the dialogue is straight out of a soap opera. As a vehicle for improving public understanding of dementia, it also lacks depth. The portrait of a white, wealthy, heterosexual woman with a supportive family, a private neurologist, and in-home help misrepresents the reality of life for most people with dementia and their families. To be fair, this portrayal is true to Genova’s book, but I think it’s also indicative of a bigger problem in mainstream cinema.

The mainstream film industry loves an actor who can portray a cognitively or intellectually impaired person with just enough pathos to make us cry into our popcorn but not so much method that we’d be uncomfortable. Think Sean Penn in I Am Sam, Tom Hanks in Forrest Gump, Leonardo DiCaprio in What’s Eating Gilbert Grape, Julie Christie in Away From Her, and Robert Downey Jr’s great line about “not going the full retard” in Tropic Thunder. The mainstream film industry prefers actors and screenplays that make us believe that if we met this character in the real world we wouldn’t treat them with the same ignorance, arrogance, and discrimination they’ve encountered on screen.  And it simply doesn’t option books or greenlight screenplays that are too realistic*, preferring to leave the tough stuff to foreign films, independents, and documentaries which, no matter how good they are, simply lack the reach to change public perceptions.

Still Alice is no exception. Yes, we see Julianne Moore wet herself when she can’t remember where the bathroom is and, yes, we see her raging against the diagnosis. But it’s all comfortably cocooned in cashmere sweaters, summer houses, and a functional family dynamic… and it’s not even half of what people with dementia and their families deal with on a daily basis.  This is not the woman who puts her husband with dementia on the bus while she walks home because they can’t afford two fares. This is not the gay man with dementia who’s forced back into the closet because the nursing home staff don’t want other residents to feel “uncomfortable”.  This is not the Murri man found naked in the neighbourhood playground at 2am and taken to the Watch House instead of a hospital. This is not the migrant who’s lost her English but can’t access a care worker who speaks her native language. This is not the woman who is constantly told “you don’t look like you have dementia”. But it’s only when we see these stories on the big screen that public understanding and attitudes might begin to change.

A film shouldn’t be lauded just because it’s about dementia. Actors shouldn’t receive awards for being the best part of a bad film. If the mainstream film industry is going to ‘do’ dementia, let’s demand they do it well. Let’s insist on great films about real people that are compelling, well scripted, well acted, and beautifully made. Surely people with dementia and their families deserve that much.

Notes:
*Barney’s Version, starring the great Paul Giamatti, is a notable exception when it comes to recent mainstream films about dementia, but despite being a compelling and beautifully uncomfortable film, it still has a white, wealthy, heterosexual protagonist.

Lifting & Leaning

This piece, written by me, was originally published in the Australian Ageing Agenda, under the title ‘Promoting Good Mental Health for Carers’. It appeared as part of AAA’s focus on Mental Health Week and is reproduced with permission.

I read an article earlier this year in which Joe Hockey was described as having the toughest job in the country. After spraying a mouthful of coffee over my newspaper, I wondered what the country’s carers would think of that. Caring is a tough gig, but few and far between are the carers who fly business class, smoke cigars, or can expect to retire with a pension in excess of $100,000 per year.

Instead, carers spend their days lifting, showering, dressing, toileting, feeding, medicating and managing; often at the expense of their own physical and mental health. Carers experience higher than average rates of depression, anxiety and hopelessness, and my own research has found that family carers of people with dementia contemplate suicide at eight times the rate of the general population. In Mental Health Week, it is important we take time to acknowledge family carers – the people who really have the toughest job in the country – and explore how we might better support them in their role.

While systemic change takes time, there are four things we can do right now, this week, to promote good mental health for carers:

  1. Value their contribution: Feeling valued is an important part of good mental health and we can all do something to show carers we value the contribution they make to our community. If you are a neighbor, drop off a home-cooked meal. If you are a service provider, make time for a cup of tea and a chat. If you are a politician, arrange a consultation with the carers in your electorate.
  2. Encourage self-care: Self-care is the key to good mental health, but few carers can find the time. If you know a carer, offer to relieve them for a few hours this week so they can see a movie, get a massage, or go for a swim.
  3. Recognise carers as experts: Carers have a wealth of knowledge and experience, but they are often ignored or relegated to the waiting room. Health professionals, service providers, and other frontline staff should make a commitment this week to see carers as partners in care. This will empower carers and ensure the best possible outcome for the care recipient.
  4. Tackle stigma: The stigma that exists around suicide and mental illness can be a real barrier to help seeking. Many carers also encounter stigma associated with the disability, dementia, or other condition that affects their care recipient. This week, support the journalists, artists and film-makers who are committed to raising awareness, and take a stand against the media outlets that foster ignorance and fear.

In his Federal Budget speech this year, Joe Hockey told us it was time we all became “lifters, not leaners”. Carers are some of the best lifters I know, but in Mental Health Week, let’s lean in and give them a hand.

Carers who are contemplating suicide are encouraged to call Lifeline on 13 11 14 or the Suicide Call Back Service on 1300 659 467. Carers who are experiencing depression or anxiety are encouraged talk to their GP about subsidized sessions with psychologist.