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Thoughts on Alzheimer’s and the Film What They Had

Walter G. Moss: The wandering of Ruth, her memory lapses, the love but also frustrations of her spouse, the question of where she can best be cared for, and the dilemmas faced by Ruth’s grown children, all seem real.
What They Had

My wife, Nancy, and I recently saw the film What They Had on Amazon’s Prime Video. It is very well-acted with the four main roles played by Blythe Danner (Ruth), Robert Forster (her husband Bert), and their two adult children, Michael Shannon (Nicky) and Hilary Swank (Bridget).

The film begins with Ruth wandering out in the night in a Chicago snowstorm and Bridget soon flying in to join her dad and brother in dealing with her mother’s advancing dementia—apparently Alzheimer’s. The remainder of the action centers on how best to deal with Ruth’s condition. Bert wants to continue caring for her in their Chicago home. Nicky is for placing her in “the best memory care place in Chicago,” while his dad (75 years old) can live in an assisted-living two-bedroom “on the same campus.” (All quotes from the movie script.) Sister Bridget (often called Bitty) is not sure what is best.

The wandering of Ruth, her memory lapses, the love but also frustrations of her spouse, the question of where she can best be cared for, and the dilemmas faced by Ruth’s grown children, all seem real.

Although there are some elements of the film that seem a bit off—Why, for example, does Bitty rather than her dad have power of attorney regarding Ruth?—in most respects it is a realistic portrayal of a family trying to cope with advancing dementia. The wandering of Ruth, her memory lapses, the love but also frustrations of her spouse, the question of where she can best be cared for, and the dilemmas faced by Ruth’s grown children, all seem real.

Besides their concerns for their mom and dad, Nicky and Bitty have their own special problems—which is always the case in families affected by dementia. He seems to have trouble maintaining a loving relationship and has money worries related to the bar he owns: “I got my life savings dumped into this place, and I barely make payroll. I got the fire department, the health department double, triple fining me for shit I didn't even know I wasn't supposed to do. My barback is stealing my tips, and then…I get to pick up Mom and Pop's prescriptions, pick up their dry cleaning. Take them to church.”

Having married when she was 20 and now having a college-age daughter (Emma), Bitty is dissatisfied with her marriage and worried about Emma’s attitude toward education. While Nicky lives in Chicago and resents having the greater responsibility, Bitty, living in California, feels guilty that she is not able to do more for her mom.

All of these circumstances are ones to which any dementia-struggling family can relate. But there are two interrelated aspects of the film that I think are especially noteworthy and deserve special notice—the attitude of Ruth’s primary caregiver, Bert, and the film’s humor.

First, Bert’s attitude. He humorously tells Bitty, “Oh, Honey. Your mother was always a pain in the ass. Gettin' her Irish up, stompin' around, all red in the face over God knows what.” But then he goes on: “Love is commitment. Better or worse, sickness and health, death do you part. That is the promise.” And then he adds, “She's my girl, Bit. You can't take my girl away from me.”

Later on, after Nicky tries to urge Bert to place Ruth in the memory-care facility, Bert responds:

Those pictures on the tree in there, tell her how she takes her coffee, how many ice cubes she likes in her scotch. That's memory care. I was there for every memory she made in last 60 years, and if I wasn't there, I heard about it at least 37 times, so I am the best memory care in Chicago! I bathe her, I feed her, I give her her pills, I wipe her ass and I do it a hell of a lot better than some aide, who does not give one goddamn hoot about over who she spent 60 years becoming!

What I admire about Bert’s words is his understanding of what love means for someone who has been married for so long. So often in movies and TV, characters talk about love when they mean physical attraction or being cared for, or some other partial or even incorrect conception of love.

But love should be primarily concerned with seeking the good of the other, and it implies a depth of concern and commitment that exceeds any mere liking. One of the finest passages about love that I have read comes from Dorothy Day, whom both Pope Francis and Barack Obama identified as one of a handful of great Americans. In a 1938 autobiographical work, Day wrote, “Human love at its best, unselfish, glowing, illuminating our days, gives us a glimpse of the love of God for man. Love is the best thing we can know in this life, but it must be sustained by an effort of the will. It is not just an emotion, a warm feeling of gratification. It must lie still and quiet, dull and smoldering, for periods. It grows through suffering and patience and compassion. We must suffer for those we love, we must endure their trials and their sufferings.”

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Bert not only demonstrates this type of love, but he also displays little self-pity, which is one of the great traps full-time caregivers like him need to avoid. In a review of another film, Amour, which I wrote in 2013, I quoted other words of Day about love: “If we could only learn that the only important thing is love . . . to keep on loving, and showing that love, and expressing that love, over and over, whether we feel it or not, seventy times seven . . . and to be oblivious of insult, or hurt, or injury—not to see them, not to hear them. It is a hard, hard doctrine.”

What They Had

No doubt, the type caregiving demanded of Bert can be “hard, hard.” But love, not self-pity, is the only answer—or at least the main answer. Something else that might help is for the caregiver to reimagine her/his (caregivers are most often women) role. In Alfred Tennyson’s poem “Ulysses” the old warrior addresses some of his fellow mariners:

Free hearts, free foreheads—you and I are old;
Old age hath yet his honour and his toil;
Death closes all: but something ere the end,
Some work of noble note, may yet be done . . .

Caregivers need to see themselves not as drudges, but as heroes—if they perform their caregiving with love. They are every bit as heroic—I would argue more so—than the other type of heroes we usually celebrate such as among soldiers and athletes. Psychologist William James once wrote, “What we now need to discover in the social realm is the moral equivalent of war: something heroic that will speak to men as universally as war does, and yet will be as compatible with their spiritual selves as war has proved itself to be incompatible.”

Too often in our society, we make heroes of the wrong people. In my review of the film The Soloist I expressed my admiration for the work of many social workers. My wife, Nancy, is a nurse, and worked for many years in an emergency room. Compared to such caring work, can we really say that hitting a winning homerun or making a decisive touchdown or basket is heroic?

Soldier have to train, exercise self-discipline, and undergo hardships, but they often do so because they see such activities as a challenge and because society convinces them that their service is meritorious—even though I was in the military only in peacetime, I have heard “Thank you for your service” more than once. And soldiers sometimes receive medals. Caregivers, on the other hand, often receive no appreciation. Thus, if they follow Day’s advice and “keep on loving” day after day, they should see themselves as heroes—and challenge themselves to be so—for nothing is more heroic than exercising that “hard doctrine” of love.

Besides love, the other impressive characteristic that What They Had exhibits is humor. Nicky especially possesses it, but the other major characters display it also. After being told that the memory care center that Nicky is proposing for Ruth has a restaurant, art classes, and a Jacuzzi, Bert responds, “Jacuzzi? Your mother can't swim. What do you want? To drown her?” Even Ruth can display humorous flashes. Between a comic scene in which various family members argue about whether Ruth knows that Bert is her husband and Bert being told that Ruth is giving people the finger (flipping them off) in church and “drinking the holy water,” the phone rings. Ruth goes to answer it, but then says, “This damn thing doesn't work.” The problem is that what she is holding to her ear is not the phone, but a stapler. When she realizes her mistake, she asks, “What the hell am I doing with this?” And she adds, “Life's just one big riot. Just ship me out. Put me on a canoe and ship me out [as once purportedly occurred to old Eskimos] to the ice float.”

The famous U. S. theologian Reinhold Niebuhr once stated, “To meet the disappointments and frustrations of life, the irrationalities and contingencies with laughter, is a high form of wisdom.” And there is little doubt that along with love, empathy, and patience, a good sense of humor is a precious virtue for caregivers to possess.

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A recent Washington Post article, “Changing ‘the tragedy narrative’: Why a growing camp is promoting a more joyful approach to Alzheimer’s,” mentions a “growing camp of people determined to approach dementia care differently, coming at it with a sense of openness, playfulness and even wonder.” The essay also refers to supporting case studies and to the opportunities dementia provides “to be improvisational, to be silly, to play, to free ourselves from the constraints of truth and knowing and assumptions.”

Humor and laughter are not the answer to all our problems. Sadness and tragedy, frustration and discouragement, are also part of the human condition, but Shakespeare was correct when in The Taming of the Shrew he wrote “And frame your mind to mirth and merriment, / Which bars a thousand harms and lengthens life.” One of the virtues of What They Had is that the film does not ignore this timeless truth or the quiet heroism of love.

walter moss

Walter G. Moss

Check out Walter’s most recent book: In the Face of Fear: On Laughing All the Way Toward Wisdom. Wood Lake Publishing, 2019.