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Rebecca’s Alzheimer’s disease progresses at Kate's wedding on ‘This Is Us’

Tuesday's episode, set in the future, shows how her condition has deteriorated and has her family worried.
/ Source: TODAY

With the fate of Toby and Kate’s marriage officially sealed on last week’s episode of “This Is Us,” the NBC drama turned its attention to another major storyline on Tuesday, as the Pearson family continued to grapple with Rebecca’s worsening Alzheimer’s disease in an episode set in the future during Kate’s wedding to Phillip.

As the family prepped for Kate’s big day, Rebecca slid into moments of confusion when she referenced Jack, while everyone was concerned she may not be able to perform a song at the reception.

“I just can’t wait for your father to get here,” she told Randall.

This Is Us - Season 6
Rebecca struggled with her Alzheimer's while attending Kate's wedding.NBCU

“Very funny, Jack,” Rebecca told Kevin when the family joked around while taking wedding photos.

When Randall said Jack hasn’t been with them for some time, she became irritated.

“Why would you say that?” she said.

“It’s not true. I don’t know why he would say that,” she added, visibly upset.

This Is Us - Season 6
Rebecca mistook her son Kevin for late husband Jack, who died many years ago.NBC

Later, Rebecca mistook Kevin for Jack and, when they went for a walk, she talked about his marriage to Sophie as if it was happening in the present. The episode also hinted at Kevin's romantic entanglements, as he appeared to have gotten involved with Sophie, Cassidy or the wedding singer the night before the wedding.

The pressure of taking care of Rebecca also seemed to get to Miguel, who insisted he and Randall go drink wine. Miguel repeatedly balked at Randall’s attempts to discuss Rebecca’s health, saying they need a break before Randall said he noticed his hand trembling and found some blood pressure medication for him.

Miguel flashed some insight into the stress he’s feeling when he opened up to Randall.

This Is Us - Season 6
Miguel confided to Randall that the stress of taking care of Rebecca is getting to him, while he also struggled with his own health.NBCU

“You know what I handle on a daily basis?” he asked, while noting his hand shaking was a “harmless response” to his medication.

Miguel said he wanted to drink wine to “to feel like a human being” for a brief moment.

“I just needed a day, Randall, because it is moving fast now. It is moving so fast that I have whiplash,” he said.

“What’s moving fast?” Randall asked.

“All of it,” Miguel snapped back. “All of it.”

This Is Us - Season 6
Randall gave a moving toast while reflecting on the passage of time.NBCU

During his wedding speech, Randall waxed poetic about how fast time moves.

“The years just keep flying by faster and faster. Can give a guy whiplash just thinking about it,” Randall said, while Miguel smiled at the reference.

Randall then introduced Rebecca, who seemed confused and remained seated, but Miguel then whispered something in her ear. She got up, walked toward the keyboard and proceeded to flawlessly perform her song, leaving many people in tears.

This Is Us - Season 6
It looked like Rebecca wouldn't be able to perform, but she rose to the occasion and left many guest crying.NBCU

Mandy Moore, who plays Rebecca, says researching her character's condition led her to make it an authentic moment.

"I discovered that, oftentimes, if someone suffering from dementia has done something repetitively in the past, as Rebecca has with playing music, then their cognitive reserve makes that same skill available to them, even years into a diagnosis," she told People. "I loved that Rebecca was able to rise to the occasion and sing such a meaningful song at her daughter’s wedding."

Moore also says Miguel's potential health woes emphasize the strain Rebecca's Alzheimer's has put on him.

"If anything, I think continuing to show Miguel’s unending dedication as a partner further highlights how easy it is for caregivers to put their own well-being on the back burner, and that can — and will — slowly catch up to you," she said.