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The Royal College of Psychiatrists Improving the lives of people with mental illness

Wrinkles or Arrugas

This is the second blog in my short series about elderly residential care. 

Introduction Wrinkles

Wrinkles is a feature length animated film directed by Ignacio Ferreras and first released in Spanish in 2011. An English language version has been released in April 2014, with a soundtrack dubbed into English as well as with English subtitles. The screenplay is based on the award winning graphic novel of the same name by Paco Roca. The film won 3 awards in 2012. I would highly recommend first watching the film in the original Spanish with English subtitles as the tone is significantly different in the dubbed version voiced by Martin Sheen and Matthew Modine. 

Ending with the dedication ‘To all the old people of today and of tomorrow’ this is a film intended to place the viewer in an environment that all of us may one day encounter. It explores the very real vulnerabilities brought about by memory impairment in dementia but also the value of later life friendships that may develop in a residential setting. In particular, Wrinkles focuses on the bond that is formed between Miguel and Emilio, two elderly gentlemen in a residential care home, one of who has Alzheimer’s type dementia. 

The Film 

Wrinkles begins cleverly by introducing us to Emilio, a bank manager, turning down a mortgage application for a young couple. This is revealed as a misperception as, in reality, he is refusing to cooperate with his son and daughter-in-law who are trying to persuade him to eat his supper and take his medication so that they can leave for a concert. This incident appears to be the trigger for Emilio’s admission to a residential care home, arranged by his son, where he is immediately confronted by an elderly man who repeats everything that is said to him. Perplexed and lost, Emilio says good-bye to his family and is shown to the room he will share with another man called Miguel, who has no apparent cognitive impairment. Miguel immediately undertakes to show Emilio around the home and becomes his support in the new and unfamiliar environment. However, as he does so it becomes apparent that Miguel makes money from a number of other residents by charging them for favours that they do not actually get from him. Emilio learns from Miguel that the upstairs in the home is for the more severely ill residents who can no longer care for themselves and that he must avoid going there at all costs. To this end, Miguel tries to cover up Emilio’s failing memory and abilities by diverting attention during the doctor’s mental state test of him. Emilio’s family only visit him at Christmas when he fails to recognise his young grandson who asks him why he is wearing his jumper over his suit jacket and startles him by taking flash photographs. The lost family connection is palpable. 

With the exception of some slightly improbable incidents involving the care home swimming pool and a car ride near the end of the film that causes a final deterioration in Emilio’s mental state, the day to day routine is captured very well. The group of friendships formed at the dining table serve as a focus for certain conversations that trigger poignant flashbacks from childhood for several of the residents, including Emilio, and the nature and strength of earlier bonds of love become apparent. It is only when Emilio has deteriorated sufficiently to need care upstairs that Miguel becomes sad at the loss of his friendship, but this in turn prompts a change in his behaviour toward other residents, perhaps proving the old adage that ‘it’s never too late....’. 

Relevance to the Field of Mental Health 

Wrinkles provides the viewer with a vicarious experience of life in a care home environment with numerous examples of residents vulnerable to emotional and financial abuse as a result of their dementia, who are being exploited by Miguel without the knowledge of staff. The film highlights an important problem for dementia sufferers who have significant memory impairment, in that they are often unable to clearly recall wrong doing of any kind and therefore cannot report it to others. This aspect of the film would make a very good focus for teaching about such abuse. A viewing of Wrinkles alongside a reading of the Safeguarding Policy from the Office of Public Guardian in the UK would offer an excellent platform for discussing the important topic of safeguarding adults at risk (previously called vulnerable adults). The film also illustrates the problem of paranoia that can arise as a result of impaired memory when Miguel eventually finds Emilio’s watch and wallet hidden carefully for safekeeping in their shared room, after Emilio has repeatedly accused Miguel of taking both things. 

With the care home sector under particular scrutiny at present and with the prospect of many more elderly people needing care in such settings, these are important topics to discuss openly within our society. A very interesting account of her own move into a residential home, by the 96 year old author Diana Athill, in The Guardian in 2010, would make additional complementary reading to the film. In contrast to Athill’s personal decision to move in to residential care, Emilio, who is suffering from dementia, is not happy to leave his home and the move is arranged by his son. This issue presents an opportunity for teaching about the deprivation of liberty safeguards (DOLS), a part of the Mental Capacity Act, and whether such a move is in Emilio’s best interests. One could debate whether, if the care home was in the UK, Emilio should have his deprivation of liberty authorised by the procedure known as DOLS, especially in light of the recent supreme court judgment in March 2014 stating that anyone under continuous control and supervision of staff and who is not effectively free to leave whenever they choose, should be protected by the independent scrutiny that DOLS provides. For a good summary on the supreme court judgement, see the RCPsych web page. 

Wrinkles is a warmly moving and at times humorous animation that deals with a difficult subject extremely well. It is essential viewing for all care home staff and might encourage greater empathy and understanding about the plight of residents, and assist in the training of staff dealing with some of the most vulnerable individuals in our society. 

  •  More information about Wrinkles can be found at IMDB as can a short trailer. 

  •  Minds on Film is written by Consultant Psychiatrist, Dr Joyce Almeida 

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Re: Wrinkles or Arrugas
Hi Dr Almeida

Thanks for sharing your discovery of Wrinkles.

I have recently co-directed a very short (3min!) observational documentary exploring the passing of time in a rest home in Auckland, New Zealand - you can watch it for free, if you are so inclined, at the following link:

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About this blog


Minds on Film is a monthly blog that explores psychiatric conditions and mental health issues as portrayed in a selection of readily available films.

Please note that this blog may contain plot spoilers. Any views expressed are purely my own.

Dr Joyce Almeida
Dr Almeida is a consultant
psychiatrist working in the private sector in the UK.