Affects of Alzheimers on a loving couple.

1. Movie Character Presentation

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. 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. 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. 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.  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. 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.  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. 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. 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. 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. 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. 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. 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.