Keri-Leigh Cassidy critiques how old age and dementia are depicted in the film Wrinkles.

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Wrinkles is an animated film about life in a nursing home. It offers a rare glimpse of a subject generally avoided in popular culture and film. Wrinkles follows Emilio through stages of dementia, with a focus on his relationship with his roommate Miguel who bears witness to Emilio’s decline.

The subject matter of the film is particularly welcome to me as a geriatric psychiatrist who works with patients with dementia and residents of long-term care. My main concern with Wrinkles, however, is that the film plays into many negative stereotypes with little to challenge common fears of dementia and aging. Despite a few touches of humour and an unexpected twist at the end, for me the film’s tone is decidedly depressing.

Meanwhile, I find working in long term care and with patients with dementia to be very rewarding. Contrary to the common view of dementia being “worse than death,” the vast majority of people diagnosed with dementia do not wish to commit suicide. Rather, they continue to enjoy and appreciate their lives. By the time a person with dementia needs the level of care people fear most (in Wrinkles, the upstairs floor of the nursing home) they are no longer aware of their deficits. Yet, they do continue to respond to human kindness and simple comforts – a warm embrace, tasty food or a familiar song. Music therapy can have a dramatic impact, even in late stage dementia. Here is a documentary on the subject.

Negative stereotypes of aging in general dominate our society and there is little public awareness of scientific research contradicting these negative views. Research has shown that our brains have a capacity for learning into very old age, and can improve with use in a variety of ways. For example, with age comes wisdom: our life experiences improve our brains to make us more resilient, better at handling intense emotions and more compassionate and altruistic. And surprisingly, with age comes the potential for greater happiness. Research shows that we grow happier after 50. This is called “the paradox of aging” – that despite more loss and disability associated with age, life satisfaction and happiness increase with successive decades.

Furthermore, scientific research also suggests that culturally entrenched negative views of aging are harmful to our health. They can serve as a self-fulfilling prophesy – people with negative views of aging die earlier than those with positive views. Negative beliefs are also linked to lower adherence to health promoting behaviours, such as physical activity, while positive views enhance it. For example, one study found that seniors who received an intervention to improve their beliefs about aging adhered more to their exercise regimes than seniors who did not receive this intervention.

The above scientific evidence has implications for our perceptions of old age and dementia:

First, the brain is plastic (neuroplasticity), so there are things we can do (physical, cognitive and social activities) to prevent dementia and/or attenuate its course.

Second, our fear of and negative outlook about aging is misguided and harmful. It increases our risks of illness and disability, while positive attitudes are linked to many improved health outcomes.

Third, despite inevitable losses and/or crises in health, we tend to get better at handling these things over time. By the time we face these challenges, through wisdom and the paradox of aging, we appear to be more capable of handing it. As a geriatric psychiatrist, I feel privileged to have the opportunity to regularly see remarkable resilience and strength in my patients and their family members.

Finally, although there is no question that dementia is devastating for individuals and families, it also has a humane side that few people consider. Compared to many other illnesses, dementia is not physically painful. Further, its changes are generally slow and gradual, giving people time to adjust to them and plan their lives accordingly. It is also one of the few terminal diagnoses that can end without conscious suffering.

While largely playing to negative stereotypes, Wrinkles does offer a few insights into a more complete understanding of aging and dementia. For instance, the relationship between Martin who has severe Alzheimer’s and his caring wife Dolores, reveals the extent to which kindness, a memory, or a familiar voice continues to reach and comfort a person living with dementia. Hope is also evident in Miguel’s transformation from someone who fights his own fear of death by making jokes and taking advantage of more vulnerable residents, to someone who grows more responsible and caring, especially towards his friend Emilio.

Nevertheless, in my view, the balance in Wrinkles between an overarching bleak storyline and a more hopeful one was not successfully struck. For me, the part of the story that can bring meaning and a truer understanding about aging and dementia arrived a little too little, a little too late.

For more information please visit The Fountain of Health Initiative for Optimal Aging.

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Keri-Leigh Cassidy is the Clinical Director, Seniors’ Mental Health Team at QEII Health Sciences Centre in Halifax Nova Scotia and an Associate Professor in the Department of Psychiatry at Dalhousie. @cassidy_kl