Frail and blind in her wheelchair, Stella relies on her nurse Sadia for the affection and comfort she won't seek in her daughter. Meanwhile, in a bar somewhere in North London, Martin nervily clasps an attaché case and awaits his date - known to him only as 'Top for Hungry Bottoms.' Over in a well-appointed town-house Avril, valiantly pickling her liver in Waitrose pinot noir, torments her lover Helen with exquisitely delivered insults.

This play is considerably greater than the sum of its parts. While there's little to surprise (when it transpires that the stout daughter who has so thoroughly disappointed Stella is none other than Helen, who happens also to work for Martin, there's a comfortable sense that we know where this is going), the dialogue acutely reflects the rhythms and language of real speech, and is often breathtakingly funny. The acting is astonishingly well-observed, with each cast member so thoroughly inhabiting their role that in moments of silence the audience is left gasping with laughter or manfully suppressing tears merely at a gesture or look.

As Martin, Daniel Hill combines a beautifully Eeyorish demeanour with a radiant good nature and impeccable manners: he is, from the start, the kind of man it would be impossible to dislike. 'Tops For Hungry Bottoms' turns out to be Leo (Jason Wing), who - with his slicked-back hair and biker jacket over a white vest - made me think of nothing so much as Graham Greene's Pinkie, if only his life in Brighton had taken an altogether merrier and more benevolent turn. 'What I really like,' he says, giving Martin a sexually charged but rather kindly once-over, 'Is an older hairy man with a beer gut who doesn't take himself too seriously.'

Amanda Boxer as Avril has the kind of comic timing I could cheerfully have watched for hours: perpetually three sheets to the wind, dismayed by forced retirement from the BBC, she's gifted by Permutt with lines of the most fabulous malice, all delivered in a voice that could engrave crystal at thirty paces. Gillian Hanna's Helen is a weak uncertain thing, and certainly no charmer, but we are stoutly on her side from the off, so that when she finally faces up to her mother and lover it's tempting to rush onstage and give her a cuddle.

But it's Miriam Karlin as Stella who's most touching: this actress in her ninth decade grasps the arms of her wheelchair with shivering hands, and her bones are visible through tissue-paper skin. This is no Werther's Originals view of old age: the playwright has understood that character - with every bit of kindness, spite, disappointment, hope - remains undiminished even when the mind fails. Only her nurse Sadia, played with immense warmth and spirit by Elizabeth Uter, responds to her as a woman still living as best she can.

As a teenager I worked as a care assistant in a nursing home, and it's perhaps because of this that I laughed less often than others at Stella's poignantly funny lines. I remember that there was terrible sadness in every thin square of carpet and every half-drunk cup of milky tea - and the saddest thing of all was to see that betrayals and losses from decades before resurfaced daily, with hardly any dulling from the passage of time. What this deeply compassionate play exposes, with clear, kind sight, is how unbearably long-lasting life's wounds can be. It seemed to me a plea to avoid causing hurt at all costs, and to remedy it as soon as one can, since 'too late' comes without any warning. This play and its excellent cast deserve a transfer to a larger venue.

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