What?

Framing, Lines, and Shot Composition

Notice that the grandfather is framed by vertical cabinet lines in the background, and the horizontal line of the mail in the foreground.  This gives the photo an intimate, or claustrophobic, feel.  I’ve outlined the frame using blue arrows.  He is boxed in by everything and everyone in the room, which makes the audience uncomfortable.  The fact that the woman’s head is partially out of frame in this mid-ground shot contributes to that feeling of claustrophobia.
 
In addition, I’ve drawn an orange diagonal line starting at the top of the woman’s head and angling downward to the grandfather’s head.  The grandfather is hunched over eating his soup, which makes him appear even smaller and much lower than the woman.  What could this positioning suggest?  The composition of the photo seems to communicate the grandfather’s helplessness next to his more powerful caretaker.  Visually, there is a distance between the two of them.  The lack of eye contact and warm facial expressions suggest they are disconnected from one another. 

Main Idea

All of these techniques work together to communicate that people can feel isolated or lonely even when others are nearby.