The Father is a beautiful film that shows many themes of dementia and caregiving. It portrays a man with progressive dementia symptoms and the attempts of family members to care for him. The film has a shifting and creative stage design. The plot is sad overall, but blends in moments of humor, affection, social awkwardness, and even questions of elder abuse.
The film was nominated for 6 Academy Awards and won 2 of them. It took home Best Actor in a Leading Role, Anthony Hopkins, and Best Adapted Screenplay.
Click to watch The Father streaming, starring Anthony Hopkins and Olivia Colman
The Father portrays many aspects of dementia and caregiving for people with dementia. The film depicts these issues very well. It appears to portray Alzheimer’s Disease, one of the most common forms of dementia. But many of the themes of The Father apply to other forms of dementia and caregiving.
Some of these key aspects of Alzheimer’s Disease include memory functioning, changes in personality and emotion regulation, and caregiver experiences.
Background
Research has found that Alzheimer’s Disease and some other forms of dementia are related to key changes in the structure of the brain. One change is the gradual build-up of plaques on surfaces of the brain over time. These are referred to as “amyloid plaques”.
Another change is the gradual build-up of proteins within brain cells, which is known as tau proteins. These proteins cause fibers of brain cells to tangle and bunch up. These tangles are known as neurofibrillary tangles. When brain cells tangle in this way, it usually leads those brain cells to die off.
The brain itself can also atrophy over time. That is, it can shrink. Check out this good book on dementia types, symptoms, and causes that is written for a general audience and professionals. There is also a good book that describes research about ways to help decrease the risk of developing dementia and these brain changes!
All of these changes greatly affect how the brain functions. These changes lead to a decrease in memory functioning, attention, problem-solving abilities, and other intellectual skills. Parts of the brain that help us regulate or manage emotions and stress can also be negatively impacted. These changes lead to difficulties in both intellectual and social-emotional functioning.
The main character, Anthony (played by Anthony Hopkins), is an elderly man who experiences progressive dementia. This appears to be Alzheimer’s Disease based on his symptoms (although we cannot diagnose him from the film itself).
Memory
Anthony also perceives locations differently as the film progresses. He sees the interior of his London flat with changing sets of furniture and design layouts across different scenes. There are also questions for himself and the viewer as to whether this flat belongs to him or to his daughter, Anna (played by Olivia Colman).
Some places remain constant, however. It seems as though the day-lit street corner Anthony sees has some significance to him, so he seems to remember that location in a consistent way.
As the film goes on, Anthony experiences a few of his family members in changing ways. That is, he sees a daughter who is thought to be caring for him, as well as another daughter who is understood to no longer be present.
The many different ways in which Anthony remembers his surroundings and the people in his life sometimes causes the film to seem confusing. But this method is used for literary effect. That is, the intent is to reflect the experience of dementia. Because he is not sure what is really happening or where, Anthony gives us a glimpse into the life of someone with dementia from their perspective.
With dysfunctioning memory, it can be very confusing to know what is currently occurring and why one is having changing experiences. Typically someone with Alzheimer’s does not realize or identify that “my memory is fading”. This is especially the case in later stages of dementia.
A very confusing reality and lack of understanding or ability to differentiate experiences becomes distressing. This is part of why people with dementia may ask repeated questions they do not remember asking.
Emotional Distress and Irritability
There are a number of times in the film that Anthony becomes irritable and highly frustrated. At times he directs this at Anna and other members of his family.
Many people discuss changes in personality that occur with forms of dementia and Alzheimer’s Disease. This is because people with dementia often have perceived drastic mood swings they may not have expressed in the past. They may go from joyful or neutral to irritable or angry.
These swings are less a change in inherent personality as much as a byproduct of distress associated with changes in functional ability, how others might respond to the individual, and brain changes that come with dementia.
Brain changes involve the build-up of amyloid plaques and neurofibrillary tangles (discussed above). These changes affect the brain’s ability to regulate or manage emotional responses. This includes how humans may tailor how we express emotions in social situations.
The result is the tendency for those with dementia to respond harshly to everyday events. This change in their emotional responses can often affect how families and caregivers interact with them. Emotional changes can be even more distressing for family and caregivers when they do not understand why those changes are happening.
Dementia Caregiving and Caregiver Experiences
The Father depicts many dementia caregiving experiences through Anna and her family members. They do what they can to try to care for Anthony. Anna seems to experience stress, worry, and sadness about his condition. Other family members grow critical of him and of the perceived burdens he has placed them.
Caring for someone experiencing a form of dementia can be very complex and difficult. First, there is a lot to manage in terms of the individual’s care. For example, taking them to medical and neurological evaluations, finding resources for them, and more.
Care can also be demanding just in the sense of being constantly available to meet the person’s basic needs. This includes bathing, cooking, and cleaning for them. Managing care in these practical ways can be more difficult as the disease progresses.
And, of course, caring for someone with dementia can be emotionally taxing. It can be very hard for loved ones to see the individual slowly succumb to it. It can also be hard to witness the individual’s personality fade during the moderate and severe stages.
Memory Loss and Dementia Caregiving
The progression of dementia renders the person truly unable to remember things most people can hold in their short-term memory. As the disease progresses, the person experiences increasing memory loss and confusion. This also adds a practical and emotional challenge for caregivers.
It can also be hard to interact with someone who constantly forgets things and needs aid through constant redirection. They do not purposefully forget information. And they are not trying to be annoying or seek attention on purpose. They are living with uncontrollable difficulties with memory and confusion of reality we discussed earlier in this post.
Uncontrollable memory challenges and confusing reality make it so simply telling someone to “be more with it” or to stop asking questions do not work. Direct statements like this can come across as harsh or critical and add more stress for the person, making things even worse.
We see these challenges occur in The Father when Anna and her family members attempt to care for Anthony in day-to-day life. These challenges even occur when they attempt to find a caregiver who may help support him in the home.
Caregiver Coping
Taken together, caring for a person with dementia can be highly stressful, anxiety-provoking, and can even contribute to resentment. Others may experience what is called “anticipatory grief”, or grief about their loved one’s future decline and eventual death. Check out our episode on grief for more or check out themes of grief in another Oscar-winning film.
The challenges of caregiving for someone with a form of dementia can contribute to depression, anxiety, other psychological difficulties, and burnout.
Treatment for dementia will often include resources for caregivers. These resources can include consultation or counseling on ways to cope with caregiver stress, resources on where and how to access care, and how to prepare for the later stages of dementia. Accessing social support available to family members can also be very helpful.
Luckily there is a lot of research on caregiver experiences and ways to help. This good book discusses caregiver experiences and ways to cope with dementia in general. Another good book discusses ways to cope with caregiving for Alzheimer’s Disease in particular.
Conclusion on Dementia Caregiving and The Father
The Father accurately depicts many confusing and difficult aspects of dementia and caregiving. Alzheimer’s Disease and other forms of dementia continue to progress and eventually lead to a complete lack of memory for oneself or one’s life. Family and friends often feel that the loved one is “no longer there”. Eventually, the brain itself can no longer function and it shuts down.
The good news is that there are resources available to patients and their families. The Alzheimer’s Foundation of America and Dementia Society both describe some of these resources to access directly.
And if you’re interested, check out The Father streaming. It’s a great film! –Dr. Matt B
