How do you care for a suffering loved one? “Amour,” the sublime French-language nominee for best picture directed by Michael Haneke, encourages discussion surrounding the end-of-life by highlighting the pain one aged couple faces navigating caregiving, medical treatments and death.
Amour’s first scene takes place in an elegant Parisian apartment. Firefighters bash in the doors and cover their noses from the smell of human decay. They proceed to the bedroom, only to find a woman’s corpse wreathed in carefully arranged flowers. The rest of the film is flashback.
The apartment belongs to Georges and Anne, a posh couple in their eighties who care deeply for each other. They have been married for decades and are finally enjoying the rewards of having lived successful music careers. However one morning, Anne (Emmanuelle Riva) goes into a catatonic state during breakfast. This state triggers a flurry of health problems, including paralysis. Georges (Jean-Louis Trintignant) dutifully does the best he can to care for her. He promised he would not put her in a nursing home or let her die in a hospital. The film suggests they do not have advance care directives, a living will or power of attorney. If they did, the film would have ended much differently.
Planning for the end of life
Advance care planning involves learning about the types of decisions that need to be made in case of a medical crisis and aims to ensure an individual’s desires are carried out.
One common form of planning is a living will, a written document that tells doctors how a patient wants to be treated if incapable of making decisions about emergency treatment, according to the National Institute on Aging. A power of attorney is a legal document that names a healthcare proxy, someone to make medical decisions on behalf of a patient unable to do so.
Illinois is currently paving way for a new form known as POLST. The Physician Orders for Life-Sustaining Treatment program is designed to improve the quality of end-of-life care. POLST forms allow patients to indicate preferences regarding resuscitation, intubation, intravenous antibiotics and feeding tubes- something Anne could have used.
So why do so many ignore end-of-life planning? Economic status may play a role, as Americans with fewer financial means plan less for the end-of-life than wealthier individuals. According to the Journal of Health and Social Behavior, “One of the most enduring findings in health research is that people with less education, income, assets, and lower status jobs fare worse on every possible health outcome and health behavior,” explained researcher Deborah Carr, Ph.D.
Language proficiency may also be a barrier to planning. University of South Florida researchers recently published a study on the advance care plans of Colombian, Mexican and Puerto Rican women living the in the U.S. The researchers found a lack of English language proficiency contributes to readiness and willingness to prepare.
Individuals may avoid end-of-life planning because it is hard to talk about. Accepting death and dying is uncomfortable, partly because it is less common than at anytime in human history.
According to practicing cardiologist and former hospice director Dr. Bruce Wilson: “Death has become a taboo subject, but it hasn’t always been so… Medical science has evolved very rapidly, and over the past 50 years we have become so good at treating illnesses that we somehow have come to view death as an option.”
Perhaps “Amour” will encourage more individuals to keep the end-of-life in mind. After winning the coveted Palme d’Or, Haneke told the Village Voice the film has a universal timeliness to it because old age awaits us all, “it’s inevitable.”
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Daniel Gaitan is content producer for Life Matters Media, a 501(c)3 providing information and support for all involved in end-of-life decision-making. Randi Belisomo, a reporter for Chicago’s WGN-TV, and Mary F. Mulcahy, M.D., a medical oncologist and Northwestern University faculty member, founded Life Matters Media. Visit blog.lifemattersmedia.org.
