Intended for healthcare professionals

Views & Reviews Review of the Week

Up with ageing

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4215 (Published 14 October 2009) Cite this as: BMJ 2009;339:b4215
  1. Desmond O’Neill, consultant in geriatric and stroke medicine, Dublin
  1. doneill{at}tcd.ie

    At its heart Up, the new Disney/Pixar film, is a remarkable study of ageing, thinks Desmond O’Neill

    Few animated family movies feature courtship, infertility, and death in the opening 10 minutes. That Up, the new film from Pixar, can do this with sensitivity and assurance is only one of its remarkable features. Not only do the film makers understand that they do not need to condescend to children but they deliver an extraordinary insight into the reality of ageing that can easily displace any amount of worthy lectures on ageism.

    Ageing at all stages of life means both growth and loss, but our society has tended to overemphasise the negative aspects of later life and often fails to recognise the importance of older people in the fabric of our everyday lives. Ageism, including that prevalent in health care, is the unsurprising consequence. Countering ageism requires a mechanism for communicating complex concepts of simultaneous growth and loss, contribution, and need: this may be best served by an artistic metaphor.

    Up manages this with considerable brilliance and a lightness of touch that has a truly Ovidian sense of “ars est celare artem” (art lying in the concealing of the art). Although older people have figured in lead roles in increasing numbers of films over the past decade—About Schmidt and The Straight Story, for example—none have combined the hero role in quite the same way with the pains of ageing, bereavement, intergenerational solidarity, and grappling with stairlifts and quad canes.

    The 78 year old retired balloon seller Carl Fredericksen, accompanied in his quixotic journey by an 8 year old scout, Russell, as a modern day Sancho Panza, has had a lifelong yearning for an adventure trip with his childhood sweetheart and eventual wife. At the point where he finally books the trip, she falls ill and dies. It takes the machinations of an unscrupulous developer for him to attach a cloud of helium balloons to his house and embark on an adventure, unwittingly bringing along the hapless Russell.

    Without spoiling the plot for those who have yet to see this film, the engagement with ageing works at many levels. The evocation of the experience of later life is acute. As many older people do, Carl adapts his adaptations: to prevent his quad walking stick from slipping he has attached tennis balls to each of the four feet (which feature in a helpful role later in the plot). The film makers have developed tropes on ageing that are achingly funny: our hero’s initial descent on the stairlift to the habanera from Carmen, and the sword fight between Carl and the even older villain where both men’s shoulders lock in osteoarthritic mid-swing.

    But the film also succeeds brilliantly in its evocation of the wider themes of ageing: wisdom, altruism, negotiation, and that combination of “tough but frail” that increasingly characterises older people in the 21st century. The house and mementoes, as well as the plot, act as a vivid enactment of the Robert N Butler’s seminal “life course” theory of ageing, which sees ageing in later life as a time of review of one’s life course. Carl’s attachment to his house and mementoes is an effective rejoinder to adult children who are concerned that their parent is “not stimulated” by “looking at the four walls” at home: imbued with memories and palimpsests of relationships, this is a very rich environment indeed.

    Eschewing sentimentality, the film develops a further theme: the valuable support of older people and grandparents across the generations. Russell, from a decidedly non-nuclear family with an absentee father, is collecting a final “assisting the elderly” scouting merit badge, with the hope of attracting his father to the ceremony. At the end of the film his father doesn’t turn up and Carl steps up to the plate, representing the increasingly recognised role of older people for younger generations, whether standing in for the missing generation in countries affected by AIDS or providing warmth and continuity in equally important and less dramatic ways all over the world.

    The potential of older people to change and undertake radical new directions is encapsulated by Carl’s eventual letting go of the house and its contents to embrace a new life. To those who follow the lives of the great artists, such radical changes in the work of Matisse, Picasso, Beckett, and Frank Lloyd Wright provide eloquent examples of late life plasticity, but the general public has an unfortunate tendency to classify older people as inflexible.

    So, as they convulsed with laughter and enjoyed the action, did my children appreciate Pixar’s gerontological Trojan horse? My sense is that they did not need to—children seem to have an intuitive ability to see and value older people for what they are. It is we, the adults, who undergo a coarsening of our sensibility, perhaps born of a fear of disability and death that we took more calmly in our stride as children, who have the most to learn from this marvellous film.

    Notes

    Cite this as: BMJ 2009;339:b4215

    Footnotes

    • Up

    • Pixar, 96 minutes

    • UK release date 9 October

    • Rating: ****