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"Away from Her" - Character Presentaion - Alzheimers

Affects of Alzheimers on a loving couple.

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"Away from Her" - Character Presentaion - Alzheimers

  1. 1. Movie Character Presentation
  2. 2. Overview of Presentation  Away From Her documents the events that take place when Alzheimer’s disease affects a spouse.  Alzheimer’s is the most common form of dementia. The late great medical essayist Lewis Thomas called Alzheimer’s “the disease of the century”. The worst of all diseases for both the person and the family (Brussat, M. 2007).  This presentation will review points of the movie, and an assessment of Fiona’s husbands’ progress through this life-changing experience.  Nursing diagnosis and plan of care
  3. 3. Background of Movie and Character  Couple married for 44 years, enjoying their “golden years” in their tranquil rural home  Wife “Fiona” starts to show signs of Dementia; misplacing things, forgetting words, getting lost  Fiona, realizing her disability is proactive in moving into a 24 hour care facility  Grant has a very difficult time with the transition and questions the need for Fiona to leave.  Grant is left with feelings of past regrets and guilt as he watches his wife devote herself to another man in the home  Despite his wife’s loss of affection and memory he continues to support and encourage his wife’s happiness
  4. 4. Functional Assessments I selected to assess Grant from this movie to show his functional health patterns with the dynamics of loss, regret, change, and restoration through out the movie. He must overcome the love of his life while at the same time come to terms with past decisions. Health Perception/Health Management  Grant perceives his wife’s declining health as unpredictable (she a sudden memory of a trip while on the way to the facility) which causes him to question what he is doing.  Grant maintains his own health management by continuing to exercise as a way to release stress. Nutrition/Metabolic  No obvious change in nutrition, weight loss , weight gain during this process.  Grooming and general presentation remain the same throughout.
  5. 5. Assessment Continued - Pattern of Activity/Exercise  Grant continues to cross-country ski during this stressful time.  His new hobby is visiting his wife daily – who remains polite but distant.  Grand also seems to enjoy observing the nursing home’s clients, and the events that play out. Pattern of Sleep and Rest  There are no signs of sleep or lack of energy associated with the situation Grant finds himself in.
  6. 6.  It is made obvious that Grant has doubts of his self worth to himself and also to his wife.  There is an underlining guilt brought on by Fiona’s memory of Grant’s affections toward his female students and possible infidelities. Fiona brings this up as they are driving to the facility. Acknowledging how he must have enjoyed the attention of his “pretty young students”, yet grateful that he never left her. Assessment Continued -
  7. 7. Assessment Continued - Role/Relationship Patterns  Grant has to remove himself as the husband and become an observer to stay involved in his wife’s life.  Grant continues to question if he is responsible for his wife’s transfer of affection to Aubrey.  Uncertainties remain if Fiona’s visual devotion to Aubrey is payback for Grant’s past transgressions.  Grant describes his continued affection and devotion often through out the movie.  Grant decides to meet Aubrey’s wife Mariam, who is unreceptive at his first approach.  As Grant begins to let go of his wife, he finds friendship in Mariam. A scene is shown during a Christmas family gathering at the facility. Grant is watching his wife sit and share desert with Aubrey, her “new man”. A teenage girl joins him on the couch, she questions what he is doing, “I’m watching that woman over there”, she hesitates and states “the one with her husband?”, Grand enlightens her that “no, I am her husband”.
  8. 8.  It is obvious that Grant and Fiona have a “soul mate” bond, and a sexual chemistry that has lasted throughout their lives together.  Fiona’s last wish before being left at the facility is for Grant to make love to her, in her new bedroom – and then leave. “If you don’t I may start crying and never stop”  As Grant’s need for companionship deepens his friendship in Mariam leads to sexual fulfillment and a laugh at their lives. “It’s not bad luck – It’s just life”
  9. 9. Assessment Complete Pattern of Coping and Stress Tolerance  At one point Grant does show his anger over the situation while shoveling snow and has a break-down.  Also while visiting Fiona and again, observing her helping Aubrey, Grant grabs Fiona by the hands “willing” her to acknowledge him has her husband.  Fiona’s way of coping and answer to Grant regarding Aubrey – Pattern of Values and Beliefs  Grant often verbalizes that “it’s life”.  Despite the internal conflicts he seems to appear to have no regrets.
  10. 10. Analysis of Health Assessment Normal assessment findings –  Grant continues to care for himself despite losing his wife’s affection and acknowledgement.  Keeps open communication with care home staff, sharing his thoughts and concerns. Abnormal or risk-based findings –  Guilt and regret from past misgivings.  Risk for emotional difficulties and uncertainties. Fiona, Grant and Aubrey
  11. 11. Additional Observations  Cultural – It appears that no other family is involved or important cultural rituals or activities.  Geographical – The movie is played out in the Canadian country, where cross country skiing is views often as a way to show the scenery.  Religious – no obvious religious activity is shown.  Ethnic – There is a reference that Fiona is from Iceland – but has never traveled there.  Spiritual – No spiritual activity or reference is offered.
  12. 12. Nursing Considerations Nursing Diagnosis Ineffective Individual Coping related to illness of family member and situational transition and/or crisis. Interventions  One – Provide information on community resources for support , counseling, and educational opportunities (Gulanick, M. G., Meyers, J., 2007).  Two – Provide opportunities to express concerns, fears, feelings and expectations (Gulanick, Meyers, 2007).  Three – Assist the patient to grieve and verbalize fear or regret (Edelman, C., Mandle, C, 2010). Resources  One - Alzheimer’s Foundation of America; http://www.alzfdn.org  Two - Alzheimer’s Caregiver Center, Alzheimer’s Association; http://www.alz.org/care/overview.asp
  13. 13. Conclusion Throughout the movie, Grant’s love and devotion to his wife of 44 years is a testament to marriage and a lifetime commitment to each other. Then watching her slowly disappear mentally and then to relinquish her to a “new friend” Aubrey tests that commitment. Grant identifies with his feelings of jealousy, as he realizes the pain his wife must have years ago due to his infidelities. He decides to befriend Aubrey’s wife Marian to share his feelings of loneliness and hurt. The ending is unexpected as Grant may have a second chance to repair his relationship with Fiona and continue their love affair.
  14. 14. References Brussat, M.,, (2007) Away from her – review. Sprituality Practice, Resources for Spiritual Journeys Edelman, C. L., Mandle, C. L., (2010), Health Promotion Throughout the Life Span, 7th Edition. Mosby. Gulanick, M., Myers, J. (2007), Nursing Care Plans: Nursing Diagnosis and Intervention, 6th Edition. C.V. Mosby.