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Senior Power: The Experience of Dying
From 1967-2005, Canadian writer-director-producer Allan King created notable documentary films, usually with only a camera operator and sound technician, typically without interviews and narration. Five of them are on DVD collectively titled The Actuality Dramas of Allan King: Warrendale (1967,) A Married Couple (1969,) Come on Children (1972,) Dying at Grace (2003, 148 minutes,) and Memory for Max, Claire, Ida and Company(released in 2010, 112 minutes.)
Dying at Grace commences with the on-screen declaration that “This film is about the experience of dying.” Close examination of the final days and nights of two men and three women follows. They are terminally ill patients in the Salvation Army’s Grace Medical Center Palliative Care Unit in Toronto. Fourteen weeks.
When asked why he made this film, King responded, “Self-interest is the reason I make most of my films. I'm getting older and I'm going to die. I thought I'd better find out what it's about.” And he expressed interest in hospice.
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King followed Dying at Grace with one more film, his late-in-career masterpiece. Memory for Max, Claire, Ida and Company follows eight elders who are suffering from dementia, memory loss, and old age. They are residents in Baycrest, a large Toronto Jewish home for the aged. A special facility whether in Toronto or Riverdale. King does not overdo Baycrest’s uniqueness. His sights are on Max, Claire, Ida and company.
Don’t assume that most so-called church homes, nursing homes, etc. are like Baycrest. Alas, it is not a typical facility. If you are able to purchase or borrow this film, recognize Baycrest’s uncommon aspects. A productive exercise for a gerontology or social work class would be to note individually and follow with a facilitated group discussion of some of them. Would you recommend this film for a senior center showing? King’s skillful small crew follows eight Baycrest residents for five months. There is no narration, no one tossing clipboard questions at them. Rarely do they glance in the camera’s direction. The same social worker talks several times with each resident, never down-- physically or condescendingly. And there are other special things about this person.
The film opens on Claire's 89th birthday. Max, a cheerful little man, always with hat and cane, is her close friend. Rachel is lonesome and dejected, missing her son, consumed by his failure to visit. (What about that visit?) Ida relies on memory for her solace. Helen has no memory and does not recognize her daughter, while her moods swing violently. Murray keeps his cap on and likes women. (Is either a unique factor of old age?) Memory is fleeting: Claire re-experiences the death of her close companion several times, each without remembering her previous grieving. Staff members bring medications and nutrition, provide care, and offer small talk.
Demented people do not always totally lose their minds, feelings or identity. Spontaneously and without direction, they may express their feelings of love, hate, and humor. They may be happy, angry and lonely.
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Hospice is a type and a philosophy of care that focuses on the palliation of a terminally ill patient's symptoms, which might be physical, emotional, spiritual or social. Palliative care aims to reduce the severity of disease symptoms, pain and stress. The modern concept of hospice includes palliative care for the incurably ill provided in such institutions as hospitals or nursing homes, as well as care provided to those who would rather die in their own homes. Strictly speaking, the palliative care unit of Grace Hospital shown in Dying at Graceis not hospice.
“Sometimes doctors and patients confuse palliative care with hospice care, which is for people who no longer need or want to treat their condition but want help managing their pain. Palliative care on the other hand, is often meant to help people who are still fighting their disease. But some fear palliative care because they think it means giving up. As a result, many patients don’t seek this care early in the course of their illness, when it could do the most good.” [“Easing pain; Palliative care is not what you think” by Karen Rafinski. AARP Bulletin. June 2011 v52 #5 pp14-15]
The Salvation Army is an international evangelical Christian church known for charitable work. Its theology is mainstream Protestant. The five patients focused on in Dying at Grace are not interviewed by the filmmakers. Salvation Army female staff members do, however, “question” them. “I just feel finished,” responds one. Two Salvation Army officers appear, credited as Major R.N. and Major Chaplain. “Oh come all ye faithful joyful and triumphant” blares forth as Salvation Army instrumentalists and singers gather in the corridor outside rooms where a few feet away patients are in their death throes. An emphasis on death leading to green pastures permeates the film, but it is not an expose.
Carmela is an elderly, religious Italian-Canadian with a family. She shares a room with Joyce, who is reluctant to take painkillers because she is afraid her powerful medications, vaguely termed "breakthroughs" by the center's staff, will cause her to die in her sleep. Towards the end, Major R.N. asks Carmela if she would like her to get a priest. An off-camera visitor’s voice asks how she would do that. She responds “I could ask around.” We are not privy to whether she did so.
Eda is the most “active,” moving about in her wheelchair. But stuff happens. Her cancer had gone into remission, granting her a renewed sense of hope until a check-up reveals its return. She must cope with the disappointment. She is articulate even as we watch her descent over a few weeks until her body shuts down. Rick, a former Satanist biker who resists the discipline of the hospital, says he would rather die in a shootout than a hospital bed. Lloyd suffers from brain cancer and is supported by the constant presence of his partner of thirty years.
Much of Dying at Grace is filmed in tight close-up, capturing the fear, confusion and medicated blankness of terminally ill human beings. The featured people are victims of cancer and other health problems. They also suffer from the effects of the palliative drugs. They are “terminal” and in pain. Filmmaker Allan King recorded their last days, motivated by the desire to manage the fear of death more effectively through understanding and insight. He died of brain cancer in 2009, age 79, at his home in Toronto.
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As I watched these experiences of dying, I was reminded of the novel and film, They Shoot Horses, Don’t They? And of Dr. Jack Kevorkian’s death-sentence by means of imprisonment. There’s no doubt in my mind that his years in state prison shortened his life.
For an attempt at a jovial look at another, very different hospice, read Art Buchwald’s 2006 book, Too Soon to Say Goodbye;Reflections on Life and Death, written from a Washington, D.C. area hospice.He died in 2007 of kidney failure.
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NEWS
In September 2009, a 43-year old Alameda County mother of three learned she had advanced pancreatic cancer. Her pain and symptoms escalated quickly. She received home hospice care from VITAS, the nation’s largest for-profit hospice chain, which, following corporate policy, did not inform her about her options (a violation of California’s Right to Know End-of-Life Options Act.) She died in misery and severe pain.
Nearly 6 in 10 voters in Washington state approved Initiative 1000, the 2008 Death with Dignity Act. It allows terminally ill patients with less than six months to live to end their lives with the help of a physician. In 1998, neighboring Oregon became the first state to legalize physician-assisted suicide.
According to a new study quoted in an article by Nick Collins in The Telegraph (Great Britain, June 22, 2001), “Married men should be careful not to retire before their wives because there will be no one at home to look after them….”
MARK YOUR CALENDAR: July, August, September. Confirm date, time, place.
Wednesday, June 29. 2 – 3:30 P.M. Become a genealogical super sleuth at the Berkeley Public Library, ready to research your family history. Electronic Classroom of the Central Library, 2090 Kittredge, for the popular introduction to Ancestry.com, an online resource that offers searchable census tracts, immigration records, photos, stories and more. (510) 981-6100.Wednesday, June 29 Noon – 1 P.M. Playreaders at Central Berkeley Public Library. Meets weekly to read aloud from great plays, changing parts frequently. Intended for adult participants.
Wednesday, June 29 6 P.M. Mastick Senior Center, 1155 Santa Clara Avenue, Alameda. Movie: Get Low: A True Tall Tale.
Saturday, July 2 12 Noon Albany branch of the Alameda County Library, 1247 Marin Av. Beef Bowl Anime Club meeting for adults. Contact: Ronnie Davis (510) 526-3720 x16. Also Saturday, August 6.
Wednesday, July 6 Noon – 1 P.M. End of Life Planning Workshop at Central Berkeley Public Library. Responsible end-of–life planning can save heartache and help preserve family legacy. Learn the basics about wills, trusts, powers of attorney, advanced health care directives and more in a supportive setting. Also August 6.
Wednesday, July 6 10 A.M.-noon North Berkeley Senior Center Advisory Council meeting. Public invited. 1901 Hearst. (510) 981-5190
Wednesday, July 6 6-8 P.M. Albany branch of the Alameda County Library. 1247 Marin Av. Lawyer in the Library. Free 15 minute consultation with an attorney who will clarify your situation, advise you of your options, get you started with a solution, and make a referral when needed. Advance registration is required. Sign up in person at the Reference desk or call 510-526-3720 ext. 5 during library hours. Also Wednesday, August 3 and Sept. 7.
Monday, July 11 7 P.M. Author Talk at the Kensington Library, 61 Arlington Av.. Amy Block Joy, author of Whistleblower, the nail-biting true story of what happens when someone with a lifelong habit of going along to get along is confronted with criminal activity she can't ignore. Whistleblower poignantly illuminates the dark for future truth-tellers. Free. (510) 524-3043.
Tuesday, July 12 9 A.M. Mastick Senior Center, Alameda. Cane Do. Join John Dexheimer for self-defense and exercise. This specialized senior self-defense training class incorporates the use of a cane. Learn to hold, twirl, strike, poke, jab and block while exercising with your cane. Wear comfortable clothing and bring your cane! Sign up in the Mastick Office. A suggested donation of $3 per person is appreciated.
Wednesday, July 13 6:30 PM - 8:00 PM Albany branch of the Alameda County LibraryPoetry Writing Workshop. Christina Hutchins, poet laureate of Albany, will facilitate. Free. No registration required. Work on your poetry with a group of supportive writers. Contact: Dan Hess (510) 526-3720 x17. Also Wednesday August 10 and Sept. 14.
Thursday, July 14 1 P.M. Mastick Senior Center, Alameda. Drumming Circle. Join the Mercy Retirement Community Drum Circle for a musical experience. Drumming is known to improve circulation in the hands and body, loosen stiff joints in the shoulders, arms, and wrists, and stimulate the mind. Sign up in the Mastick Office. Free.
Friday, July 15 8 A.M. – 2 P.M. Compassion & Choices of Northern California is a participant in the Healthy Living Festival. Oakland Zoo, 9777 Golf Links Road. For information, email admin@compassionandchoicesnca.org
Wednesday, July 20 1:30 P.M. BerkeleyCommission on Aging. Meets on 3rd Wednesdays at South Berkeley Senior Center, 2939 Ellis. Check to confirm (510) 981-5178.
Monday, July 25 7 P.M. Book Club. Kensington Library, Seeing, by Jose Saramago. In his follow up to Blindness, Saramago returns to the capital on a rainy election day, where no one has come out to vote. The politicians are jittery… What began as a satire on governments and the efficacy of democracy turns into something far more sinister. Meetings are held on the fourth Monday of every month; each starts with a poem selected and read by a member with a brief discussion following. New members are always welcome. Free. (510) 524-3043.
Tuesday, July 26 3-4 P.M. Berkeley Public Library, Central. Tea and Cookies. A book club for people who want to share the books they have read. Monthly on the 4th Tuesday. (510)981-6100.
Wednesday, July 27 1:30-2:30 Alameda County Library, Albany branch. Great Books Discussion Group. Caesar and Cleopatra by George Bernard Shaw. Meets on the fourth Wednesday of the month. Facilitated discussion. Come to one meeting, or all meetings. Books are available at the Library. Parking! 526-3720 x 16.
Wednesdays, beginning in August – 10:30-12 noon Parkinson's Yoga & the Art of Moving. Jewish Community Center East Bay – Oakland Branch, 5811 Racine St. (58th & Telegraph). $120./month. Enhance mental focus, balance, strength, flexibility, voice function, and peace of mind through the Mind/Body practices of Yoga, Meditation, Toning, Chanting and Specific Movement Techniques. Perform the activities of daily living with greater ease, happiness, safety and effectiveness. Instructors Carol Fisher, RYI with John Argue. (925) 566-4181.
Wednesday, August 3 10 A.M.-noon North Berkeley Senior Center Advisory Council meeting. Public invited. (510) 981-5190.
Thursday, August 4 1:30 P.M. – 2:45 P.M. Emergency Preparedness. Free program for older adults, caregivers and service providers. Colleen Campbell, Senior Injury Prevention Coordinator, will discuss materials, display a sample GO KIT, and lead discussion. Alameda County Library Albany branch. Contact: Ronnie Davis (510) 526-3720 x16. Also at other branches; contact Patricia Ruscher, Older Adult Services (510) 745-1491.
Wednesday, August 10 10 A.M – 2 P.M. Compassion & Choices of Northern California is a participant in the Healthy Aging Fair Festival. Chabot College, 25555 Hesperian Blvd., Hayward. Email admin@compassionandchoicesnca.org
Wednesday, August 17 1:30 P.M. BerkeleyCommission on Aging. Meets on 3rd Wednesday at South Berkeley Senior Center. Check to confirm (510) 981-5178.
Saturday, August 20 11 A.M. Landlord /Tenant Counseling. Central Berkeley Public Library. Also Sept. 17.
Tuesday, August 23 3-4 P.M. Berkeley Public Library, Central. Tea and Cookies. A book club for people who want to share the books they have read. Monthly on the 4th Tuesday. (510)981-6100.
Wednesday, August 24 1:30-2:30 P.M. Alameda County Library, Albany branch. Great Books Discussion Group. Eliot's The Hollow Men and The Waste Land. Meets on the fourth Wednesday of the month. Facilitated discussion. Come to one meeting, or all meetings. Books are available at the Library. Parking! 526-3720 x 16.
Wednesday, September 7 10 A.M.-noon North Berkeley Senior Center Advisory Council meeting. Public invited. (510) 981-5190.
Wednesday, September 21 1:30 P.M. BerkeleyCommission on Aging. Meets on 3rd Wednesday at South Berkeley Senior Center, 2939 Ellis. Check to confirm (510) 981-5178.
Tuesday, Sept 27 3 P.M. Tea and Cookies. Book club. Central Berkeley Public Library.
Wednesday, September 28 1:30-2:30 P.M. Alameda County Library, Albany branch. Great Books Discussion Group. Morrison's Song of Solomon. Meets on the fourth Wednesday of the month. Facilitated discussion. Come to one meeting, or all meetings. Books are available at the Library. Parking! 526-3720 x 16.
Helen Rippier Wheeler can be reached at pen136@dslextreme.com. Please, no phone calls.
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