As Alice's memory begins to fade, she daydreams of her mother and sister, who died in a car crash when she was a teenager. She memorizes words and sets a series of personal questions on her phone, which she answers every morning. She hides sleeping pills in her room, and records a video message instructing her future self to commit suicide by overdosing on the pills when she can no longer answer the questions. As her disease advances, she becomes unable to give focused lectures and loses her job. She becomes lost searching for the bathroom in her own home and does not recognize Lydia after seeing her perform in a play.
Alice begins to have difficulty answering the questions on her phone. She loses the phone and becomes distressed; John finds it a month later in the freezer, but Alice thinks it has only been missing for a day. Alice and John visit Anna (who is positive to the test) in the hospital to meet their newborn twin grandchildren, but Alice does not recognize her daughter.
After a video call with Lydia, Alice inadvertently opens the video with the suicide instructions. With some difficulty, she finds the pills and is about to swallow them, but when she is interrupted by the arrival of her caregiver, she drops the pills on the floor and forgets what she was doing.
John, unable to watch his wife continue to deteriorate, moves to Minnesota. Lydia, who has been living in California, moves back home to care for Alice. Lydia reads her a section of the play Angels in America and asks her what she thinks it is about. Alice, barely able to speak, responds with a single word: "love".
Julianne Moore was Glatzer and Westmoreland's first choice for the lead role. Moore prepared for the role over four months, watching documentaries about Alzheimer's disease. She met with Elizabeth Gelfand Stearns, the co-producer of the film and the head of The Judy Fund, which partners with the Alzheimer's Association in the fight to cure Alzheimer's Disease. Introductions were made to Dr. Mary Sano, the director of Alzheimer's disease research at Mount Sinai Hospital. Through Skype, she talked to three women with early-onset Alzheimer's disease; she also visited a support group for women with Alzheimer's disease and a long-term care facility for Alzheimer's patients. She also undertook the cognitive testing used for diagnosing dementia with a neuropsychiatrist. Moore suggested Alec Baldwin to play Alice's husband, since they had previously worked together on the sitcom 30 Rock. Kate Bosworth was cast after she told Glatzer and Westmoreland "how important and personal the subject matter was" to her; she had family members with Alzheimer's disease and, after reading Genova's book, set out to become involved in the film adaptation.
The production's $4 million budget was funded by the French financier BSM Studio. Post-production on the film was completed ten days before its premiere at the 2014 Toronto International Film Festival. The score was composed by Ilan Eshkeri, who wanted to work on Still Alice because of his experience with people affected by Alzheimer's disease in his personal life. He had worked on several Alzheimer's-related projects before, including the 2012 film Ashes, Tim Wheeler's 2014 album Lost Domain, and an advertising campaign for the Alzheimer's Society; he said of working on Still Alice, "in many ways this was a culmination of an artistic expression of something that has deeply touched me." Eshkeri wrote the score to be performed on piano, which he intended to represent Alice's family life, and by a string trio, of which he thought the challenge of composition was similar to "the challenge of coping with the disease".
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