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Wednesday, 4 November 2015

The Father - remarkable play portraying decline into dementia

In recent decades, Alzheimer’s disease has become an epidemic cause of dementia, typically now affecting increasingly older patients than in the initial encounter in 1901 between German psychiatrist and neuropathologist Alois Alzheimer and a 51 year old woman suffering from progressive short-term memory loss. In 1906, he was the first  to relate the finding of amyloid plaques and neurofibrillary tangles in the brain to clinical symptoms of pre-senile dementia, abnormalities which are still the focus of research into causes, biomarkers and clues to treatment of this currently inexorable dementia syndrome.
Although families and health and community care services around the world are increasingly pressed by the condition, it is only recently that Alzheimer’s disease and other common causes of decline into dementia, such as vascular disorders of the brain, have been portrayed to public audiences in print and on the screen, for example in Iris, Amour, Still Alice, and The Iron Lady. 
A new remarkable addition on this theme is 2014 Molière award winning The Father (Le Père), by 35 year old French playwright Florian Zeller, now on stage in the West End in a translation by Christopher Hampton: moving, faithful to the condition and its wider consequences, and well acted by an outstanding cast led by Kenneth
Cranham and Claire Skinner. The play was first produced in France in 2012 at the Théâtre Hébertot in Paris and is due for transfer to Broadway in March 2016.
Important not to say too much so as not to spoil the impact on a future audience of the many themes of the play and the dramatic effects used by the writers, scene designers and musical director. Zeller is very effective, with a surprising amount of humour, in involving the audience directly in the confusing experiences of the failing protagonist Andre, his family and carers, and in the natural history of the condition. He is also excellent at describing interactions between the relative with dementia and relatives who take on the caring role, as well as possible attitudes and the behaviour of a carer’s partner.
The programme notes – and interviews in the French and English press – give little away on Zeller’s inspiration for the themes of the play. In interview, the translator Hampton – around twice Zeller’s age – alludes to universal concerns about the significance of senior moments, such as forgetting a name, as hints of the possibility of much worse to come. The programme notes also provide beautiful colour scans of the brain in health and in patients with dementia. The images are left to the reader to interpret. However little effort is needed to decipher the dramatic general and local effects of dementia shown in the images.

Public domain image from the Center For Functional Imaging, Lawrence Berkeley National Laboratory Alzheimer’s Disease Neuroimaging Initiative (ADNI)

The Father merits adapting for film as soon as possible, so that the play can be seen as widely as possible by all health professionals dealing with patients with dementia, their family and carers. Despite the many poignant facets of The Father, it will also be appreciated by the increasing many with direct experience of a family member or friend with the syndrome.

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