I want to share with you a few very different situations that I have encountered in my clinical work that are all unified by single diagnosis.

1. I was doing a home visit at the request of a wife who wanted me to assess her husband. He was unwilling to speak to me, so as I was sitting and talking with the wife, he lurked behind me with a pickleball paddle and kept slamming it loudly on the table in an attempt to scare me, saying, “Yeah! How about that, huh?”

2. In another home visit, I had an elderly patient talk about my graying hair and how it reminded me of her of her ex-boyfriend, whose semen she was allergic to. She further went into graphic detail about their sex life and described details about her body that had nothing to do with our appointment.

3. During an office visit, during the pre-test interview, a family informed me that the male patient was no longer allowed at family gatherings because he would tell graphic and horrifying war stories to young children without their parents’ consent.

4. When doing a home visit for Adult Protective Services, law enforcement was present to keep an abusive roommate from interfering. My patient (an elderly woman) was extremely handsy with one of the police officers, touching his arms, grabbing at his vest, and reaching in places that could be extremely risky.

These are just a few real-life examples from my experience working with people that have Frontotemporal Dementia. It is a devastating disorder that not only causes dementia, but it leads to drastic behavioral changes that the person has little to no control over.

If you’ve never had hands-on experience with frontotemporal dementia, it’s difficult to understand just how hard it can be to navigate and cope with as a family member or loved one. That’s why I was fascinated when Emma Heming Willis shared in a recent ABC News interview that their family has made the decision to move her husband and famous actor, Bruce Willis, into another separate home with a 24/7 care team.

As you might suspect, this immediately sparked a ton of backlash from people online who criticized the move as cruel and selfish. As a neuropsychologist, I have a lot of experience working with families and individuals with frontotemporal dementia. There is no perfect way to navigate process, but if someone has the means to work out a situation like what the Willises have, I am all for it. Let me explain why.

They Are Not Who They Were

By nature, any form of dementia is going to be difficult. However, not all dementias are created equal.

As a very quick review, dementia refers to the level of functioning that someone has. When someone is so cognitively impaired that they can no longer functional well in daily life, they are considered to have dementia. This graph shows the breakdown of how prevalent different types of dementia are (in the US):

As you can see from the chart, Alzheimer’s disease is the most common form of dementia at about 60%. That’s why it is the one that most people probably think of when you hear the term dementia. You envision confusion, repetitive questions, getting lost, and maybe some quirky behaviors. Frontotemporal dementia is an entirely different beast.

Frontotemporal dementia (FTD), or frontotemporal lobular degeneration, is a disease process in the brain that is very similar to Alzheimer’s disease in that it is driven by abnormal proteins that stop neurons from functioning properly, which ultimately results in cell death and atrophy of the brain. Technically, the process is driven by different proteins for Alzheimer’s vs FTD, but that’s more than we need to go into here. The most important thing for you to know is that both disorders cause a progressive degeneration of the brain that starts in one area and spreads to eventually encompass a large portion of the brain.

As the name may suggest, frontotemporal dementia begins in the frontal lobes of the brain. This is why it is so different in nature than Alzheimer’s and why it can be such a devastating and confusing illness. The frontal lobes of the brain play a major role in behavioral control and personality. People with damage to the frontal lobe from FTD or from a different source like a brain injury can show drastic changes to their personality. Often, it seems like they are an entirely different person. For example, I have had sweet old ladies that have practically never said a bad word in their life suddenly start screaming expletives when they are upset with their spouse or family.

Frontal lobe issues can also cause a decrease in someone’s inhibitions and social filter. We all have thoughts about others that we keep to ourselves, but someone with frontal lobe damage may comment on someone’s weight to their face or tell someone to “hurry the hell up,” in a grocery line. I have also had people show up to do door naked during a house call because they didn’t think it was important to put on clothes.

The potential changes caused by FTD can range from subtle to extreme and may include:

• Apathy and emotional blunting.

• Disinhibition and impulsivity.

• Loss of empathy.

• Severe mood swings.

• Obsessive and compulsive behaviors.

• Sweets cravings and oral fixations.

• Decrease language functioning.

• Coordination issues and falls.

• Decreased hygiene and self-care.

• Anxiety, irritability, and delusions.

Imagine your closest loved one completely changing their personality and behaviors. If you live with a sweet partner that asks how your day is and tries to make sure you are taken care of, imagine they could not care less about how you are and only make snide comments about how you aren’t cleaning the house to their liking. Imagine your parent used to be trustworthy with your kids, but now they can’t babysit anymore because they let them watch sexually graphic movies. FTD can be completely devastating, and the most difficult part is that the behavior change often happens before you see issues like memory loss, so it’s difficult to know what is going on.

Bruce Willis and FTD

Bruce Willis is a famous American actor known for roles in blockbuster movies like Armageddon, Die Hard, Pulp Fiction, and RED. Given his fame, it’s been extremely interesting to see his progression of symptoms and eventual diagnosis of frontotemporal dementia as part of the news cycle. Here is a general timeline of his journey with this illness:

• 2015-2021: Multiple filmmakers have opened up about struggles that Willis has had on set for his later films. They described that he had trouble remembering his lines and required an ear-piece to have dialogue fed to him. At times, Willis also appeared confused and needed accommodations like shortened shooting days.

• March 2022: A joint family statement posted to Instagram explained that Willis was diagnosed with aphasia (difficult with language – often a symptom of dementia), and he would be stepping away from acting.

• February 2023: The family confirmed a more specific diagnosis of frontotemporal dementia in an update through the Association for Frontotemporal Degeneration (AFTD). In this statement, they described that the communication issues were only one part of a broader syndrome.

• May 2023: Tallulah Willis, the daughter of Bruce Willis and Demi Moore, published a personal essay in Vogue. She shared details about her own psychiatric difficulties and her perspective on her father’s decline. She described “anticipatory grief” when she realized that she wouldn’t get a “father of the bride” moment.

• September 2023: Emma Heming Willis, Bruce’s wife, appeared on TODAY and described dementia as a “family disease.” She also expressed that it is difficult to tell how much insight Bruce has into his illness.

• August 2025: In a feature with Diane Sawyer, Emma Heming Willis explained that she and the family have “made the decision to surround Bruce with professional caregivers in a new home that is safe, quiet, and easier for him to navigate.” Further, she added that Bruce would want their daughters “to be in a home that was more tailored to their needs, not his.”

Backlash

As expected, after explaining that the family has set Bruce up in second home, Emma was the target of intense criticism by people online. She put out a statement on Instagram explaining that she expected this, and that she predicted there would be two camps: people with opinions and people with experience.

While Bruce is living separately, Emma described that he is not isolated. He has round-the-clock care, and the environment is less complicated and more tailored toward his specific needs. Beyond that, she explained that the family and personal friends visit him constantly, which lights up his mood. In the original living situation, there were apparently factors like noise and unpredictability that served as triggers for Bruce’s behaviors, and in the new living situation, there is more control over how much stimulation he gets.

They Didn’t Do Anything Wrong

Now that you have the story, let me give you my take on all of this. I wish more people could make this type of arrangement happen for their loved ones. This is an example of what you can make happen with a great deal of financial resources. It would be amazing if everyone could have this level of support.

While the family has been very open about Willis’s condition, I’m sure there is a lot they also have not shared. People with frontotemporal dementia often struggle with poor personal hygiene, inappropriate social behavior, and even complications like incontinence or moments of violence. If these things are happening in the home environment, it makes total sense for the family to keep that to themselves to preserve his dignity.

The later stages of a degenerative condition like FTD or Alzheimer’s are not pretty. The person ultimately dies from complications like poorly managed physical health, refusing to eat, getting lost, or aspirating food while eating. People with FTD tend to live about 7-13 years after symptoms emerge, and while it’s difficult to estimate a timeline, Willis is probably at least 5 years into his symptom progression. With the higher level of medical care and observation that he has, he will have a better chance of living longer with less medical crises.

For many individuals with FTD, they end up being placed in long-term care facilities. In the early-to-middle stages, assisted living is often appropriate, where there is oversight, but residents are still expected to be somewhat independent. From there, as the disease progresses, people might be placed in memory care, which is a locked unit to prevent wandering with more direct one-on-one care. Essentially, Willis’s family has been able to create their own private memory care unit with intensive care, personal luxuries, and unlimited access to visitors. If only we could all be so lucky!