Introduction
Movies have a profound effect on people’s attitudes. Over many decades, movies have portrayed some of the important social issues, educate the general population, and promote health. However, portrayals of such matters may not always be perfect but are mostly close enough to understand and analyze the issues at hand. From movies featuring psychiatry from a negative perspective to almost correct portrayals of major psychiatric illness to the new genre of legal psychiatry, we see a growing interest in people understanding psychiatry through movies.
The movie I Care a Lot follows a con artist who makes her living out of getting elderly into care facilities and making profit from their assets.
The movie has picked up a heavy issue and flavored it with its several comic relief moments. Although inaccurate, the movie takes the audience through the already existing guardianship laws, forcing them to think about this unchartered topic.
About the Movie
I Care a Lot, the movie by J Blakeson, follows a court-appointed legal guardian, Marla Grayson, played by Rosamund Pike. Marla Grayson is a con artist who makes her living using the medical and legal system to declare the elderly incapable of taking care of themselves and placing them into an assisted living facility where they are sedated and lose contact with the outside world. She then sells off their house and assets, pocketing the profits. Throughout the movie, we can see the character’s struggles in personal life, lack of emotions for the clients, and the complete lack of regard for the system.
The movie then follows how the system fails to contact any family member of these selected elderly. It also shows that a doctor is involved in identifying these targets of solid financial background and exploiting them by declaring them to have dementia. Marla Grayson is the perfect embodiment of unchecked greed within the system. All through the movie, we see the cold-heartedness of the protagonist and the total lack of emotions.
As the movie proceeds, the viewers feel intrigued by the character and feel disgusted towards the whole system of care developed by the State. A breakthrough comes when Marla Grayson meets her match, a crime lord, Roman Lunyov, and one of her client’s sons, played by Peter Dinklage. The client here is herself conning the world by adopting a fraudulent identity due to the gangster status. The client’s characterization is that of a fearless woman who is at the same time dependent on her son, whom she meets monthly in an inconspicuous way. Unexpected turns then unfold, including the murder of the doctor involved in recruiting the cases, assault of the protagonist’s love interest, and kidnapping of Mary Grayson. The audience expects justice to prevail by now, but what follows opens our eyes towards the flawed legal system and its victims. The crime lord deals with Marla and ends up running a successful business and providing care to people who are declared incompetent by the State. However, the movie ends with Marla being shot by one of her client’s disgruntled son and eventually dying.
The movie deals with the guardianship laws in the American Legal system but has wrongly portrayed some very intricate and strict procedures followed by the courts for such guardianship. The movie’s portrayal of the ease with which the guardianship process is manipulated is cinematic liberty taken by the filmmakers in portraying a fictional scam played by the lead character on vulnerable older adults. In an individualistic society like the USA, guardianship laws can be a boon in protecting and helping in the care of individuals without competency and social support in their life.
Social and Legal Aspect
Content analysis is used for a better understanding of the spoken and visual communication. Through hermeneutics, true meaning inclusive of factors such as history, culture, and context, the analysis is done.1 The same can be used while viewing movies and understanding the various aspects of the portrayal of issues through these movies.
The movie I Care a Lot deals with a serious issue of guardianship of the elderly with several comic relief moments. With an elderly population of 104 million and counting,2 the focus on their mental health and wellbeing is immense. The increasing cognitive dysfunction and vulnerability of the elderly need to be addressed. The movie throws light on the status of the incompetent elderly who come under the court’s purview in the United States of America without any family member to take care of them. We learn an important aspect of the legal status of the elderly citizens which lacks in our country. Although provisions have been made on paper for the court to form a board that shall be responsible for these individuals, little has been done in this respect.
Although fictional and far away from reality, the movie introduces us to the American guardianship system, which is made to safeguard the individual rights of the elderly. The guardianship laws that are unknown to many are made familiar to intrigue the audience to explore more about it. A majority of states use clear and convincing evidence standards to set up, change, or end guardianship. However, like any other law, the guardianship laws are ever-evolving and found to lack systematic processes to establish and follow-up on guardianships to ensure the wellbeing of the individual subject to guardianship. The growing concern is that these laws, in some states, do not require detailed, individualized examinations of skills and disabilities. A 2018 study from the National Council of Disability (NCD) confirms some disturbing loopholes in guardianship systems nationwide.3
Another aspect that the movie forces us to ponder upon is the concept of capacity. As wrongly shown in the movie, a single doctor declared the patient incapacitant, which was never verified by any other doctor or the court itself. The NCD states that many laws are flawed and even discriminatory in determining whether a person’s legal capacity is lacking—specifically, there are many societal misperceptions about the ability of people with disabilities to make autonomous decisions. To inform a person’s need for a guardian or some other alternative, health care experts should perform a detailed independent examination to analyze three main areas of adaptive functioning: conceptual, social, and practical. Under all guardianship laws, if the situations that originally required guardianship have changed, the Court is required to review and determine if guardianship is still mandatory.3 The same holds good for the testamentary capacity of the elderly, which required them to allocate their possessions. The elderly during the lucid period can take these decisions instead of the State deciding for them.
In India, to protect our elderly, clear laws are laid down. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007, is one such Act that provides for effective provisions for the maintenance and welfare of parents and senior citizens. It requires children to provide maintenance for their parents and the government to provide old-age care homes and ensure medical services for senior citizens.
Economic Perspective
As the population is increasing, the number of people who have dementia is also increasing, a solution for the elderly to gain benefits from economic transactions is required. The situation is further aggravated for people who do not have a durable power of attorney over economic decisions or have not provided complete directions about important economic decisions.4 The State takes full responsibility of incompetent individuals and utilizes its assets to ensure proper care is something that needs to be applauded. The Indian legal and medical system should try and deliver on the protection of elderly and senior citizens. It also gives the possibility of decreasing the burden of already overburdened government by giving them the power to utilize the assets of the elderly for their wellbeing. However, we would face challenges when greed overpowers the basic motive of caring.
Psychological Aspect
The movie may rub many people wrongly, putting a black spot on an already stigmatized topic. But a ray of hope that the State may provide the best in their hands for taking care of the elderly should not be overlooked.
The movie rests on many biases exaggerated to showcase the problem of State appointed assisted living for the elderly. The movie introduces very strong social cues from the opening scene to nudge the audience to form their bias while it introduces the protagonist. With the protagonist’s persona, the audience is led to believe that the elderly care system is in the hands of a responsible caregiver. In contrast to her, the son (family) is surely flawed.
We see striking elements of revenge, no remorse, lack of empathy in the protagonist’s personality. Greed, which is seen as the movie’s basic theme, represents her defensive reaction related to her attitude to material values. The total personality of the protagonist revolves around greed and the need to prove herself. She is also portrayed with exaggerated type A traits. She operates at a high level of impatience, a competitive nature, gets upset easily, and associates self-worth with achievements.
The movie highlights the need of an advance directive and nominated representative. Had there been an advance directive, the fate of the elderly would not have been decided by money mongers who have a free run in the current overburdened system and its corrupt officials. The presence of a nominated representative might have completely changed the story, and the older woman in the movie would not have fallen prey to the cunning plans of the protagonist.
The moviemakers have tried to give us an engrossing black comedy that deals with the serious issue of the rights of the elderly in a state governed by laws made to protect them. The Guardianship Laws and the general theme of formal care for the elderly have been introduced to the audience. It makes us think and learn more about what the State provides for the elderly in need. The requirement of regular capacity assessments, advance directive, and nominated representative, which has somehow lost its significance in our country, has been highlighted in a way that hits the correct chords and motions a series of intriguing thoughts and actions.
Footnotes
Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The authors received no financial support for the research, authorship, and/or publication of this article.
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