Alice Howland, a linguistics professor at Columbia University, celebrates her 50th birthday with her physician husband John and their three adult children. After she forgets a word during a lecture and becomes lost during a jog on campus, Alice’s doctor diagnoses her with early-onset familial Alzheimer’s disease. Alice’s eldest daughter, Anna, and son, Tom, take a genetic test to find out if they will develop the disease. Alice’s younger daughter Lydia, an aspiring actress, decides not to be tested.
As Alice’s memory begins to fade, she daydreams of her mother and sister, who died in a car crash when she was a teenager. She memorizes words and sets a series of personal questions on her phone, which she answers every morning. She hides sleeping pills in her room and records a video message instructing her future self to commit suicide by overdosing on the pills when she can no longer answer the questions. As her disease advances, she becomes unable to give focused lectures and loses her job. She becomes lost searching for the bathroom in her own home and does not recognize Lydia after seeing her perform in a play.
John is offered a job at the Mayo Clinic in Minnesota. Alice asks him to postpone accepting the job, but he feels this is impossible. At her doctor’s suggestion, Alice delivers a speech at an Alzheimer’s conference about her experience with the disease, using a highlighter to remind herself which parts of the speech she has already spoken, and receives a standing ovation.
Alice begins to have difficulty answering the questions on her phone. She loses the phone and becomes distressed; John finds it a month later in the freezer, but Alice thinks it has only been missing for a day. Alice and John visit Anna in the hospital to meet their newborn twin grandchildren, but Alice doesn’t recognize her daughter.
After a video call with Lydia, Alice inadvertently opens the video with the suicide instructions. With some difficulty, she finds the pills and is about to swallow them, but when she is interrupted by the arrival of her caregiver, she drops the pills on the floor and forgets what she was doing.
John, unable to watch his wife continue to deteriorate, moves to Minnesota. Lydia, who has been living in California, moves back home to care for Alice. Lydia reads her a section of the play Angels in America and asks her what she thinks it is about. Alice, barely able to speak, responds with a single word: “love”.
1). Identify two of Alice’s needs met before the onset of Alzheimer’s disease and two met after the diagnosis.
2). Identify two needs that were not met in Alice’s case a year after the diagnosis. (Note the early symptoms of AD suffered by Alice). What other challenges (needs not met) did Alice and her family faced as the disease progressed?
3). Putting Alice in the Irish context, outline detailed strategies for meeting her needs in terms of individual/family/community and government perspective. (Note how Alice’s family helped her cope and how services in Ireland can help people with Alzheimer’s disease).
4). Detail a thorough understanding of the interpersonal skills required to meet the needs of a person with Alzheimer’s disease, both in the early and later stages.
5). Describe a course of action appropriate to meet the needs of a person with Alzheimer’s Disease.