At the start of Michael Haneke’s rigorous, heart-rending Amour, Georges (Jean-Louis Trintignant) and Anne (Emmanuelle Riva) are in their 80s but still vital and connected and in love. They are cultured and erudite — they’re retired music teachers — and their minds remain sharp and clear. They attend a piano recital by one of their former students, then come home and engage in the sort of comfortable small talk that is the privilege of people who have spent their entire lives together and haven’t grown tired of each other. “Did I mention you looked very pretty tonight?” Georges asks Anne. Over breakfast, he tells her a story from his youth she had never heard before: They’re still discovering each other, like young lovers, all these years later.

Then Anne has a stroke that paralyzes the right side of her body. She’s confined to a wheelchair, her right hand curled into a useless claw, but her intellect and speech are spared. She makes Georges promise her never to take her back to the hospital, no matter what happens. He agrees. Their middle-aged daughter (Isabelle Huppert) drops in for occasional visits to check in on Mom. Georges and Anne develop a routine — he cuts her meals for her, washes her hair, reads her the newspaper, helps her go to the bathroom. By casting Trintignant (… And God Created Woman) and Riva ( Hiroshima, Mon Amour), who have been making movies for 50 years and are familiar to many film buffs, Haneke makes us feel the couple’s history. We can remember them when they were young, which enriches the illusion of a life-long marriage.

But Anne starts growing tired of the routine, of having to depend on her husband for every little thing. “There’s no reason to go on living,” she tells Georges, “because it’s only going to get worse. I don’t want to go on. For my sake, not yours.” Pain and suffering make you selfish. But Georges won’t have any such talk. “Put yourself in my shoes,” he replies. What is he expected to do?

Then comes a second stroke, this one much more severe, and Haneke begins to turn the screws, going much further than you had imagined. Shot in long, static takes, Amour stares directly into the indignities of old age and the curse of a slow death. To say that it is difficult to watch does not begin to describe the movie. Trintignant and Riva (who earned a Best Actress Oscar nomination for her performance) are in perfect sync: They make you feel each other’s distress. Haneke ( Funny Games, Caché, The White Ribbon), who is 70, has never been one for cheery movies, but Amour is something entirely different. This one hurts more, perhaps because the filmmaker is not working within a genre as he usually does but writing from a deeper, more personal perspective.

We all struggle hard to protect the lives of the ones we love, but when couples edge into their 70s, and the kids have flown the nest, their importance to each other becomes even more critical. Georges can’t let Anne go — how could he continue without her? — but he’s prolonging her torture by keeping her alive. This is the sort of small, intimate drama about unpleasant subject matter Hollywood rarely deals with, but Haneke isn’t worried about turning off his audience, because death is something everyone has in common. It fascinates us, the way it also scares us. Will it hurt? How will it come, and when? Those things you can’t control. But love and compassion are within our reach, and despite its grueling nature, Amour feels strangely optimistic. Late in the film, Anne is leafing through some old photo albums containing pictures of herself from childhood to the present. As she turns each page, we see a new stage — adolescence, marriage, motherhood.

Of her life, she says, “It’s beautiful.” So is this movie.