Evening: A Movie about a Dying Woman Reviewed by a Hospice Worker
I went to see Evening last night, ostensibly a movie about a dying woman's last few days of life. I was intrigued after my colleague told me there was a hospice theme to the movie. Typically, I do not scrutinize movies for their realistic depictions of real life. I enjoy fantasy movies such as Harry Potter and do not stop to contemplate how a boy wizard can fly through the air on a broom without gravity getting in the way. Unfortunately, my job as a hospice social worker interfered with my ability to appreciate Evening as any type of a believable movie.
I attended the screening with a colleague from hospice. I feared we may be tossed from the theater as we giggled from the very beginning. Vanessa Redgrave is lying in bed throughout the bed. Two or three IVs are shown in the bedroom, but they do not appear to be hooked up to her at all. She moves freely about the bed as if she is not attached to any wires at all, with only a simple gauze bandage on one arm. Vanessa Redgrave was portrayed as being days from death, a time period in hospice that is sometimes called preterminal. If someone is dying at home, IV fluids are typically not given. As the body shuts down, whether due to advanced age or disease, the kidneys are one of the first organs to become nonfunctional. All of the extra fluid intake causes an added strain on the body, and distracts from hospice's primary goal of having patients be as comfortable as possible for the remainder of their life.
Evening is told in a series of flashbacks as Vanessa Redgrave remembers her life from childhood throughout adulthood. Some of the memories while appearing to be happy ones, cause a great deal of distress for the main character. Confusion is common at the end of the life, as the brain is receiving less oxygen. Supplemental oxygen via nasal cannula, which is simply a tube running into the nose, can help alleviate preterminal confusion. Vanessa Redgrave's family appeared quite disturbed by what they termed "fever dreams," but there was no mention of any attempt to provide care to help her be more comfortable. Dying people will speak commonly of their third grade teacher, their childhood dog or a college roommate. Family may have no idea what the dying person is speaking of, as in the case of the daughters in Evening when Vanessa Redgrave begins to speak of an old love interest from her youth. The story could have been so enriched by seeing Vanessa Redgrave receive comfort measures such as oxygen, knowing that the memories were not causing her any distress but encouraging life review.
My friend and I sighed as we realized not only was there no mention of oxygen or any other palliative measures to help the patient become more comfortable, there were aspects of the movie that caused us to question how much research went into the technical aspect of the movie. There was a nurse, but where was the social worker, the chaplain, volunteers, a home health aide to assist with personal care? The movie depicts the main character and two daughters as clearly in crisis as death approaches. Hospice consists of a multidisciplinary team designed to support the patient and the family. Multiple mentions were made of the hospice nurse's role in the patient's care, but there was no mention of anyone else. I was disturbed by this limited representation of hospice. From a social work perspective, it was simply painful to watch the family struggle with issues that commonly arise at the end of the life. The daughters appeared upset and confused by their mother's behavior. Why was she calling out the name of a stranger from her past? The daughters examine their own lives, and wonder how the choices they have made compare with their mother's experiences. Hospice cannot take away the pain, or reduce the grief of patients and family members, nor is it designed to work in such a fashion. But hosipice can be there to support, counsel, educate and provide respite as needed.
I hesitate to spoil the ending of the movie, but it is after all a movie about a dying woman. In the final seconds of the movie, there is a view of a beautiful sky and the waves lapping at the ocean shore. I left the movie confused, did she die? What does the sky and the sea have to do with a woman's death? I wish they had shown her death, to help alleviate some of the actual mystery surrounding a person's natural death. This movie did not stay away from other painful issues, why resort to a romanticized ending?