Juliette Binoche in Singular Dementia Drama

Revolving around three generations of women — played by Anna Calder-Marshall, Juliette Binoche and Florence Hunt — within one troubled family, Berlinale competitor Queen at Sea offers a scathingly unsentimental look at the complexity of caring for an elderly person with dementia.

Shot in London, this scrupulously realist work by multi-hyphenate Lance Hammer (his first directorial effort since 2008’s Ballast) reportedly evolved out of intensive rehearsals and input from social services and policing experts who, in some cases, play fictionalized versions of themselves. That commitment to both technical and emotional veracity pays dividends all round, creating a work that’s not exactly fun to watch but one that feels sincere, urgent and unflinchingly honest.

Although Hammer is an American, he’s either picked up or been well-advised by cast and crew about the nuances of British life in the capital because so many of the details here feel precisely, thoughtfully calibrated. That goes for the set dressing in the elderly couple’s north London townhouse in Tufnell Park (exactly the sort of address the couple would have been able to afford years ago that’s now worth a gazillion times what they paid), the kind of puffer jackets the teenage daughter and her friends would wear, and the slang they’d use. (My only quibble is that Englishwoman Leslie, the character played by Calder-Marshall, would far more likely spell her name “Lesley,” because Brits consider “Leslie” to be the “man’s way” to spell that name. Ask me how I know.)

Otherwise, everything here rings true as a newly cast church bell, right from the plunge-right-into-it opening scene. This finds Amanda (Binoche, immaculately natural as always) letting herself and her teen daughter Sara (Hunt, a Bridgerton veteran holding her own with ease) into the home of her mother Leslie and stepfather Martin (British national treasure Tom Courtenay). Not hearing a reply when she drops off the groceries downstairs, she goes up to check on them in the bedroom and catches them in flagrante delicto.

Amanda’s reaction is not so much shock as anger, like this has happened before, and she angrily tells Martin off for having sex with his wife; in Amanda’s opinion, and that of the family’s general practitioner, Leslie’s dementia is bad enough that she can’t be considered capable of giving full consent to marital relations, no matter how much she seems to be the one who initiates intimacy. Martin, on the other hand, insists that not all “experts” agree that dementia patients are incapable of consent, an impression he’s clearly gleaned from that debatable fount of knowledge, Google.

This is all explained through Amanda and Martin’s arguments, shown sometimes fully in shot and sometimes just heard from another room as the camera sits motionless on the stairs like someone (Leslie or Sara, perhaps?) listening in and looking on from a distance. Furious and hoping to give Martin a good enough scare to teach him a lesson, Amanda calls the police and uniformed officers show up and arrest Martin, much to his and Amanda’s distress. Later, special police liaison Emma (Michelle Jeram, a real-life sexual offenses investigator for the police) shows up and takes over the investigation, which leads to Leslie going to the hospital for a rape-kit assessment (performed by another real-life professional), which only distresses Leslie, and on it goes.

From that phone call, a small, arguably well-intentioned if passive-aggressive act of do-goodery on Amanda’s part, a whole series of unfortunate consequences cascade down upon the family. For starters, Leslie is hastily placed in a local care home, but that too goes horribly wrong. With nowhere else to go, Martin ends up coming back to his and Leslie’s house, even though he’s not supposed to be there. But it’s soon obvious to both him and Amanda that he’s much more adept at looking after Leslie’s needs when it comes to getting her to eat, bathe and go to sleep.

Meanwhile, it’s not as if Amanda wants to be the one to lay down the law. An academic with a fully tenured position at a university in Newcastle up north, she’s taken a sabbatical in London at a rented flat in a typically grotty-looking British high-rise so she can try to persuade Martin to put Leslie in a home. Although separated from Sara’s father, whom we never see, it’s clear from a phone call (that we only hear one side of) that she has a pretty good relationship with her ex.

But things have gone irretrievably wrong there, too, perhaps mirroring what went on years ago in Leslie’s own marriage to Amanda’s (presumably French) father. The script subtly contemplates how dysfunction passes down through generations — or, to quote the great British poet Philip Larkin’s most infamous poem, “This Be the Verse”: “They fuck you up, your mum and dad./They may not mean to, but they do./They fill you with the faults they had/And add some extra, just for you.”

Larkin goes on to liken the familial destruction to a coastal shelf, deepening with every generation, and Sara also takes her first steps into this abyss. Left alone to make her way to school, she decides to have sex with local boy James (Cody Molko) after just a few sessions of vibing and hanging out together. As it happens, like Martin, James seems like a really nice guy, a bit gormless and willing to put himself at the disposal of this young woman’s strong sexual urges. At one point, someone says the line “it’s not desire, it’s fear,” and the film quickly edits in a fleeting shot of an urban fox trotting through an overgrown London cemetery. The moment is never contextualized or explained, but perfectly pulls together Queen‘s unique blend of animality, hunger, lust, death and picturesque urban decay.

Similarly, the older actors unabashedly show off their aging, sagging, beautifully wrinkled bodies, well-loved vessels that can give pleasure and also betray their inhabitants. It’s an extraordinary, painterly duet from Courtenay and Calder-Marshall, two actors who’ve known each other for half a century as friends; that familiarity shines through throughout.

The finale of the movie kicks this all up a gear as bodily fluids start to leak out, laying waste to the family’s rational arguments and well-laid plans. Observed in a creamy, wintery, stark daylight designed by DP Adolpho Veloso (Train Dreams), the end is all kinds of bleak, and everything that anyone who has had to look after a disabled relative might have feared. But isn’t it better to look at this straight-on, no flinching, no forgiving, no apologies?