Notable films made by Hitchcock during the fifties were Dial M For Murder (1954), a suspense seen through the eyes of the antagonist; To Catch a Thief (1955), a charming comedy which remains suspenseful and intriguing, and Hitchcock's re-made classic, The Man Who Knew Too Much.  Alma and Hitch are pictured right in Egypt before starting shooting of The Man Who Knew Too Much in Morocco.

Four outstanding films were Rear Window (1954), Vertigo (1958),  North By Northwest (1959), and Psycho (1960) which explored Hitchcock obsessions - fetishism and psychological disturbances. With Psycho Hitchcock directs the audience more than he does the actors, using pure cinema to arouse the audience's emotions. He also experimented with shots, settings and music. 

In 1963 Hitchcock's successfully directed the The Birds but Marnie (1964) was initially panned by critics, lacking the suspense they came to expect from the director. Torn Curtain (1966) did not measure up to his previous films, and in Topaz (1969), Hitchcock experimented with colour but had to admit that it did not work. As the 'Master of Suspense' Hitchh was having trouble living up to the standards he'd set for himself and the expectations audiences had of his work. 

Over the years, Alfred had become dependent upon Alma who always had to dine with him since he could not bear to eat alone. As he himself said: 'I dread being alone. Alma knows that, too . . . she puts up with a lot from me.' When he was considering books or scripts for films, he always took them to Alma for her judgement. She had become his surrogate mother, his muse and the force behind his creativity. As Karl Malden said: 'Alma was Hitchcock's stabiliser. He could balance everything off her, for she was his literary mind. She knew when the dialogue was right, when speech rythms were right.'

In London, during the filming of Frenzy in 1971, Alma suffered a stroke which presaged a slow deteriation in health of both Alma (pictured right) and Alfred. Despite the film's success, the couple returned to Los Angeles and a tired Alfred, worried about Alma, increased his drinking. By spring of the following year Alma's strong determination had enabled her to walk unaided and speak well enough so that the Hitchcocks could return to England for the gala premiere of Frenzy. Alfred was showing signs of too much alcohol.

During 1974 Hitch had a pacemaker fitted after suffering dizzy spells and began work on his final film Family Plot (1974) which celebrated Hitchcocks' 50th year in movies. It turned out to be his last film. Alma suffered a second stroke, and since her walking had become difficult, her spirits began to wane.

By 1978 Alma was spending her day watching television while Alfred insisted that he was at work on several projects. At home, Alfred would often read Alma a scene that he was working on, acting out the dialogue, proving he was still a great filmmaker. It was then that the American Film Institute decided to award Hitchcock the Life Achievement Award though Hitch looked on the occasion as if it was his obituary and delayed involvement in any arrangements.

On the morning of 7 March 1979, the day of the presentation, Alma, his wife, assistant, and chief collaborator for the past 50 odd years, read in the newspapers that she was not expected to attend because of her illness and was bedridden. Small and frail and suffering from several strokes, Alma showed her stubborness by deciding to go. And why not? Hadn't she contributed her lifetime to help Hitch win this award. Credited in 16 Hitchcock films with story adaptation or screenplay collaboration, she assisted him in finding and developing literary works for his films.

A swell of applause greeted Hitch's entrance into the International Ballroom and he sat down at the table of honour, Cary Grant on his left and Alma on his right. Ingrid Bergman acted as mistress of ceremonies, setting aside the script and introducing clips from his movies, actors, writers and directors who warmly spoke of Hitchcock's genius as a filmmaker. As the praise and accolades heaped on Hitchcock, it was only fitting that Alma should be at his side as she had been for most of the great filmmaker's life - his leading lady, first and last.

Hitch dedicated the award to Alma, commenting: 'without whom I probably would have ended up at this banquet as one of the slower moving waiters.'

Much later in 1997, Patricia Hitchcock O'Connell recognised her mother's contribution to Hitchcock's films by endowing the University of Southern California with the Alma and Alfred Hitchcock Chair.