Dignity at the end of life – and a great movie

Language that denegrates older people has no place in a caring society – particularly in caring organisations – and should be as unacceptable as racist or sexist terms.

Commission on Dignity in Care, 2012

One of the most depressing recurring news stories of last year was the stream of damning reports of elderly people being left in the most degrading circumstances imaginable in the very places where they had a right to expect care and compassion – NHS hospitals and care homes. This week brought the release of the draft report of the Dignity in Care Commission, chaired by Sir Keith Pearson. One of its many recommendations was that health care professionals in particular, but by implication everyone, should think about the language they use when talking to and about elderly people. They are not “old dears” or “bed blockers”. They don’t want to be in hospitals blocking beds – they want to be looked after in their own homes with the minimum of fuss.

It’s depressingly inevitable that The Sun has described this reasonable and humane recommendation as political correctness gone mad (I have no doubt that they ran their fair share of horror stories on elderly patients left hungry and thirsty in their own excrement on NHS wards last year). And admittedly, minding our language around the frail and vulnerable can only take you so far when resources are lacking. But it’s a start, and an important one. We need to challenge the sentimentality that rattles tins and runs marathons for sick children while the unglamorous demands of old age are overlooked. And the language we use when talking about vulnerable people is generally a good indicator of our prejudices and attitudes.

A generation ago the mother-in-law joke was a working-class stand-up comedian’s stock in trade, and The Goodies made homophobic and racist jokes on BBC2 in prime time. The idea of people not being allowed to smoke in restaurants and pubs was inconceivable, and people in wheelchairs found many such places impossible to get into. Society can and does change.

I went to see a movie last night, “The Best Exotic Marigold Hotel,” following the fortunes of a group of English retirees who decided for various reasons to move to India for their final years. It was a joy – not just because of the beautiful settings, the warm and witty script and the superb performances of the stellar cast, but because it flew in the face of the prevailing Hollywood values by recognising that people over 60 are perfectly capable of trying something new, adjusting to and thriving in a completely different culture, looking for sex, companionship and, above all, the feeling that they still have something worthwhile to offer the world. It may seem blindingly obvious, but it is so rarely acknowledged that the middle-aged and elderly are not a separate species – they are human beings with their own needs, dreams and visions.

Admittedly it was a little sentimental in places, and the happy ending was slightly contrived. It isn’t a film that will win awards for redefining cinema or offering new insights into the human condition, although in its own gentle way it does both those things and manages to be entertaining, too. The characters go on journeys – Maggie Smith’s progresses from a woman who’d rather lie on a trolley for hours in A&E than let a non-white doctor touch her, to a woman of rare perceptiveness and courage who carves out a meaningful role for herself in another country. Other stories tell of late-flowering sexual love, the damage done by a youthful love affair healed and the joy of it celebrated, and a woman who once left everything to her husband discovering the joy of independence. And there are sadder stories, too. Not everyone adapts.

It is not the kind of movie that will impress the critics, but it is perhaps the kind that we need more of. After race, feminism, post-colonialism, the gay rights struggle and all the other campaigns that have been fought to remind us that everyone is human and deserving of dignity, perhaps ageism is the last frontier. I read one sneering tweet that said the movie stank of rose-water and incontinence pads, or words to that effect (I can’t look it up, it’s disappeared now and that’s probably no bad thing). Let’s hope that was a minority view.

Other movies that celebrate dignity towards the end of life are:

Ikiru (Living) dir Akira Kuwosawa (1952)

Gran Torino dir Clint Eastwood (2009)

Up dir Pete Doctor, Bob Paterson (2009)

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