Professor June Andrews, Stirling University

The movie depicts a day in the life of Margaret Thatcher, now an old lady. 

Whatever you can say about it politically “The Iron Lady” depicts the subtleties and dilemmas of dementia better than any artistic endeavour I’ve seen in the increasing and almost overwhelming cultural chatter about the disease. 

The story starts at breakfast one day and ends the next morning.   In the course of it she buys milk, sees her daughter and a doctor, and signs her signature a few times.  She watches TV and attends a dinner, has a restless night and starts to bag up and dispose of her dead husband’s clothes.  Such a day could be banal, but in fact it is riveting and moving and raises some of the key ethical questions around current dementia research and fundraising enthusiasms.

For example, Thatcher hallucinates her husband Denis, and those occurrences are very real to her.  She converses with him out loud, laughing at his jokes, and telling him off.  Clinical people describe hallucinations in their patients as if they are a problem.

Money is spent on medication and on research into medication to make them go away. But phantom Denis seems amusing and kind to Margaret, tells her poems, and reminisces and keeps her company.  To take phantom Denis away would be cruel and unfair.  In the end he does leave her and she is distraught.  

I wonder when scientists will stop trying to “cure” unusual experiences, and spend more time finding out if they are a problem for the “patient”.  It is bizarre that we ignore a lot of what is said by people with dementia, and then prevent them saying things that we don’t feel comfortable with. It must feel like being a teenager again.

It might be odd for carers to only hear one side of the conversation – but they learn to live with it.  Only professionals seem not to understand that the symptoms that don’t bother the carer or the person with dementia should not be the focus of scarce resource.  

Once, Denis’s presence does cause a problem.  At that point he starts to mock her and she puts the television on loud, and the radio, and every noisy machine in the kitchen and the rest of the flat to drown him out. 

If they can’t see the world from the point of view of the person with dementia, the carers will do things that seem irrational and arbitrary to that person.  The person with dementia is confused, not stupid.   How we respond often seems very stupid to them.

The interview with the doctor is interesting.  As she is middle class and imperious (character often does not change in dementia) she sees him off when he tries to find out what is happening in her head.  She lectures him and hectors him and he backs off. I wonder if this could explain the apparent delay in dementia symptoms in well educated older people. They can dupe clinicians who think “She’s more intelligent than me...she can’t have dementia.”  

Sounds logical, but it’s a fallacy.  The Thatcher children have apparently denied that this is an accurate portrait of what her life is like, but as an illustration of what it is like for someone to make this journey, it’s rather touching and painfully truthful. 

So what about the politics?  The people who hate Thatcher because of the Falklands, the miners, milk snatching, her friendship with Pinochet, the poll tax  or the handling of H-block will not find that she is tortured enough in this film. 

Thatcher fans are furious that she has been portrayed in a weakened state.  The dementia lobby are just happy to have another high profile name on which to hitch their publicity wagon.  For me the political message is “Look carefully and listen...because this may be you.”  Talk to your children and your lawyer today, just in case.

June Andrews author of Ten Helpful Hints for Coping with Dementia