Yes, I guess it could even be staged in the sense that it is his own grandmother and he asked her to act as if she didnt like her picture taken. In that case my comments would be missing the mark. All I see is an elderly lady that does not like to have her picture taken, and she even seems upset about it. I could even imagine her being upset about it for a longer period of time. But hey, it's all perfectly legal, so it must be o.k.!
Also, am I really that wrong about him being humorous about this picture and the reaction of the lady? To me his comment to this picture seems be intended as a humorous comment. As well as using exactly this thread to post it in. By posting it here the context changes, making what he is saying with this photo different than if he would post it somewhere else. In a sense this woman's discomfort is exactly the point he is trying to make.
As for the intended motif, even the greatest art can be quite rude or exploitative. And sometimes I can even agree that it was worth it. In this case I only see a disrespect for this lady's wishes (IF I'm reading her emotions right and IF she is not acting those emotions), and while it is a competent photo, in this case I question whether the artistic weigth is worth it.
One last thing to add: another problem is that this picture could now start to lead it's own life, as it were. The fact that I am now using it as a grandstand and example of rude photography means that this lady's image has become more than the original photographer intended. After posting it online the photographer has no control over it any more. Somebody else could start using it in rude and unethical ways. The lady might not even like that her image now serves as my argument. As long as you can't really control what this picture will say because you cant control thecontext is all the more reason as to why this lady's wishes deserve some respect.