Something about pathography sets my teeth on edge, but some is better than others. Both “The Aviator” and its fellow Best Picture nominee, “Ray,” fall into this category. But where the former has no higher purpose and so seems merely voyeuristic, the latter is more a celebration of Ray Charles’s music than of his private life and addictions.

Fictional accounts of illness smack of the soap-operatic. Like tragedy they evoke our pity, but pity rendered safe and just a bit smug by the lack of terror, which Aristotle first identified as pity’s indispensable twin. This is because the illness creates a barrier between us and the sufferer and gives us a ready-made excuse for distancing ourselves from him.

This is not to say that a story of illness cannot be turned into a good movie, and I think that Damien O’Donnell, working from a screenplay by Jeffrey Caine, has accomplished the trick in “Rory O’Shea Was Here” – though perhaps these two could scarcely have done so without outstanding performances in the two principal roles by James McAvoy and Steven Robertson.

Mr. Robertson plays Michael Connolly, a young Irishman suffering from severe cerebral palsy who has been parked in a nursing home by his sole surviving parent, a prominent barrister (Gerard McSorley), and forgotten. He has come to accept his own helplessness and even the enforced isolation caused by his inability to make himself understood.

Along comes Rory (Mr. McAvoy), a young man of about Michael’s age who suffers from Duchenne muscular dystrophy, a wasting disease which has left him only the use of the two fingers he uses to operate his electric wheelchair. But he still has the use of his witty and cutting Irish tongue and, even more remarkably, he can understand what Michael says.

“I spent six years in a class next to a kid who makes you sound like Laurence f–in’ Olivier,” he tells him.

To Michael, the fact that someone can understand him and interpret for him to others seems almost miraculous, and he reverently refers to the ability that Rory himself seems hardly to value as his “gift.” To Rory, however, the process of liberating Michael from the prison of his illness has only just begun, and he infects him with his own longing for what is “out there.”

“Don’t you want to be like everyone else?” he asks him. “Don’t you want to get drunk? Get arrested? Get laid?”

Such things have always seemed impossibly remote to Michael, but soon he is participating in Rory’s various acts of rebellion against the nursing home’s authority, especially as represented by the brilliantly understated Nurse Ratched-figure played by Brenda Fricker. The two of them scam a government commission for the disabled and blackmail Michael’s father in order to get a home, the kind where you have the front door-key, “out there” – and an attractive home-help called Siobhan (Romola Garai).

The ending will not be as unexpected to most of us as it is, very movingly, to Michael, but it is saved from sentimentality by the spikiness of Rory’s character, his refusal to be pitied. At one point Siobhan says to him, “You know what your disability is? You’re an ass–!”

And he is: undisciplined, anarchic, intensely annoying to all around him and especially those who care about him. But, as he says when reprimanded for breaking the peace of the nursing home with his stereo in the middle of the night, “At least they know I’m f–in’ alive!”

It is this desire to make a mark in the world and be remembered, even in a small way, however unpromising the materials one has with which to make it, that makes the movie rise above the particular disabilities it chronicles and gives it the universality that is the mark of the cinematic real thing.

Elliot Greenebaum’s “Assisted Living,” also set in a nursing home, is an interesting combination of drama and documentary. The nursing home is a real one, in Kentucky, and there are enough shots of its actual elderly residents going about their sad daily tasks – bingo, television, happy talk, religion, old-folks exercises – to give us a sense of bleak authenticity. But because we never see anyone from outside the home visiting, it takes on the aspect of a world unto itself.

Against this background, Mr. Greenebaum presents a fictional (or quasi-fictional?) story of a young slacker of an orderly called Todd (Michael Bonsignore) and his relationship with one of the home’s resi dents, Mrs. Pearlman (Maggie Riley), who is in the early stages of Alzheimer’s disease.

The documentary feel of the film is heightened by mock interviews with the fictional director (Clint Vaught) – a secret drinker who is constantly interrupted by efforts to resolve some half-comic domestic crisis over the telephone – and other employees of the institution about why Todd has had to be fired.

These interviews are in the movie’s present tense, as it were, and when it cuts back to Todd himself in the presumptive past we see for ourselves his late-coming, his sneaking off to smoke weed, and his pranks at the expense of the residents, including a hilarious one in which he pretends to be an old woman’s father telephoning her from heaven.

Like Rory O’Shea, Todd is irresponsible and undisciplined, and I’m guessing we’re meant to find him equally attractive in spite of these qualities. This I was not quite able to do. But his relationship with poor Mrs. Pearlman, who comes to believe he is her absent son, and that the home itself has been somehow relocated to Australia where the son lives, is a little gem of filmmaking that promises better things for the future.