Health and Social Care for Older People

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“Iris” a film by Richard Eyre based on the book Iris, by John Bayley.

I was very interested to see this film for two reasons. First, because it was about a powerful woman, Iris Murdoch, who has been an important figure in my own life, one of my heroes. Not only did she succeed as a philosopher at Oxford, a pre-eminently man’s world, she also wrote some extraordinary novels about the class and kind of people that I grew up amongst: cosmopolitan intellectuals, the thinking upper middle classes, bo-bo (bohemian bourgeois) and blue stocking. Her complex, carefully observed stories uncover how such people can be incarcerated by their egos as well as the sacred cows of the British, middle class society that some of them, at least, are attempting to be free of. She shows us just how hard goodness is, the difficulties that a specific time and place in history make for being not just true to self, but to a sense of a greater good. Whilst Iris Murdoch is associated with the libratorary movement of the ‘60s, she is very cautious of how a revolution in attitudes and mores can be attained to the good, and she preserves a sense of the importance of duty, and a particular kind of moral freedom which is not centered on the self but on relations. Most of all, then, Iris Murdoch was for me brave – not just because she represented the special relation between language and the mind, a relation that enables truth and freedom, but because she was so direct and true in her pursuit of goodness, and spoke out at a time when all around were advocating a bonfire of institutions she was thinking through their worth, and how we need institutions, such as duty, to be able to be good even when we are at a loss, incarcerated by our own false gods, such as the need to keep up appearances. I loved her wit but also the grace that comes from a passion for finding truth, rather than mere correctness(1), a grace that shone from her eyes.

Secondly, I wanted to see Iris, because I have an academic interest in dementia. I am interested in understanding the affects and effects dementia has. Here rather than just thinking of dementia in terms of a diseased brain, I see dementia in terms of how it disorders identities and relations. In particular how it disorders the complex social processes that produce the appearance at least of cooperation, what sociologists such as Erving Goffman and Harold Garfinkel observe as a person’s capacity to fit in, get along and ‘do’ member. Thus I am also interested in offering a complementary discourse to the medical and policy discourse of waging a war on dementia. I want to help find a way of understanding dementia and explore how dementia, in its many different forms, is disordering of more than cognition. Dementia disorders forms of social organization, and challenges deeply held cultural preoccupations with particular forms of identity, especially the relation between personhood and the capacity to be social - fit in, conform, know how to get along. Dementia makes difference visible. So I am interested in finding ways to ‘dwell’ with dementias forms of difference.

The film represented what it is like to live with dementia, but not from inside dementia, from outside it. By giving us the perspective of the person who ended up as the ‘carer’ – John Bayley - it was a poignant portrayal of what it is like for others who are close, even dependent, to live alongside and attempt to cope with the degeneration, and seeming loss, of their loved one. And I think on this score the film will have spoken to many who have been in similar predicaments.

But through the use of flashback, we are able to see how the marriage between John Bayley and Iris Murdoch was rooted in Iris’ strength. We are shown just how dependent John Bayley is on Iris – she animates his life, from the very beginning: she, in Johnny Cash’s words, ‘carries’ him. He is portrayed as a repressed, stuttering, absent-minded and very sweet young man, one who is good at making himself a figure of fun. And we see how he is carried along, sometimes in ways he cannot understand, or even at moments participate in. Not only is their relationship portrayed as highly intellectual and eccentric, but also as contributing to an experimental and liberating force in British history. The flashbacks to scenes of them riding their bikes at speed, of swimming naked in the river, and of Iris' commitment to the politics of sexual freedom, all help convey the entanglement of their relationship in the liberating politics of post war England that challenged what had gone before, and, crucially, how Iris leads here, pulling John along with her: he is always behind, riding in her slipstream. We also learn that it is Iris who is central to the, albeit rather minimal, order in their lives.

We see how the dementia gradually excludes Iris, and therefore John, from the intimacy of a life lived in the relationship between the mind, language and a particular kind of freedom. Here, the metaphor that underpins the film is one of being gradually excluded from the clear light that comes from the relation of language and mind, the relation at the heart of Iris’ world.

The film shows how Bayley and Murdoch begin by trying to give dementia room. On the one hand as leading academics and intellectuals they attempt to contribute to knowledge and understanding, and participate in the clinical work of studying dementia and in the new technologies that enable the representation of the diseased brain. On the other, portrayed as deeply eccentric, they seem perfectly suited to adapting to dementia's disordering power. But because it is words, not as mere referents, but as metonymic for worlds of ideas, the stuff of Iris' life, that are most affected, they find that as the disease progresses, any room for them, for a free life inside language and thought, becomes obliterated. We see dementia's disordering power here vividly represented not just by Iris’ retreat from writing, or her blankness and anxiety, but by the increasing disorganization of the household: as her mind deteriorates there is literally less and less space for thinking and living as the clutter and the filth gradually take over.

As the scanning machines and the doctors abandon all hope, predicting that the lights are going out, Bayley tries to find his (and the world’s) Iris again, convinced that she is there somewhere. He encourages her with paper and pen, and tries to get her to retrieve her former self by writing, and discoursing. But we see scenes in which a very different person is becoming present – one who watches Teletubbies, and pees on the carpet, one who repeats things and makes no sense any more, one who escapes and gets lost on the streets of Oxford, and found in a supermarket by an old flame. She is not just in a state of disorder but is disordering, and as Derrida put it, ‘elsewhere’. She is no longer competent in her and John’s former world, and Bayley becomes less and less competent in hers – to the point of exasperation and abusiveness.

The scene in at the seaside for me is a profound one. After the greetings, in which Iris does not seem to make any sense of who anyone is, we see her running down the shingle to the sea, childlike, clutching her rather tatty notebook in her hand. We then see Iris sitting on the shingle, tearing pages from her reporters notepad, laying them out carefully in rows, and placing her beloved stones on them, beautifully, and in perfect symmetry. She is creating a new kind of writing, a new kind of ordering, perhaps even a new kind of book. But what happens next reveals the profound distance between her reality and that of the world she once helped create. Critically, the old order intrudes at the moment Janet and John arrive and ask her to sign her ‘real’ book, her last novel, holding out the page of the book to be signed and a pen. Iris can't (or wont?) do it, she refuses, she is like someone for whom the world that the book, and the signing of it, no longer mean anything. Janet and John don’t see the sense in her new pebble book, and Iris destroys it, freeing the blank pages from the weight of the rounded stones, so that are caught by the wind and taken towards the see.

Eventually, then, dementia becomes an adversary for John, one that obliterates the Iris he once had, and it seems not to give their old ways of being together any room. But nor does that old world, those old forms of ordering, have room for the new Iris. And we see her taken to a home, reasonably happily, a space that seems to have room for her. We see Iris dancing and singing alone, along a corridor, with huge windows down one side, filled with billowing, translucent curtains. The corridor and Iris seem light and mysterious and calm, yet quietly joyous. In the home, then, she seems to have regained the light, before she dies there, as John says, peacefully.

Finding ways to make room for dementia, and the reality and personhood of the one with dementia is hard, because it disorders the very foundations of our living together in the world: it can undermine a person’s capacity to be social, conform (more or less!), negotiate, or even resist, but intelligently, accountably, with reason. Perhaps we can think then how dwelling with dementia is about seeing the sense in the reality and world of the person with dementia, becoming more competent in that world and letting the person who they once were, ‘go’, at the same time as letting the person they are becoming dwell with us, cherishing their difference.

(1) I am alluding to one of Martin Heidegger’s distinctions here.

Joanna Latimer, Professor of Sociology, Cardiff University

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