Tag: Residential Care Facility

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Films

What They Had

Bridget (played by Hilary Swank), rushes back to her hometown of Chicago after her mother is found wandering, confused in a snowstorm. Her father Burt, (Robert Foster) and brother, Nicky, (Michael Shannon), spend Christmas arguing over whether their mother, Ruth, (Blythe Danner), should be moved into a residential care facility or retire to Florida as the couple had planned. Ruth’s dementia has progressed rapidly. She confuses her children, wanders around the house at night and at one point even makes a pass at her son, mistaking him for someone else. Burt’s reluctant to let his wife move out of the marital home. Nicky’s bluntly adamant that Ruth needs professional care. Bridget sits on the fence, constantly trying to keep the peace and, in the background, Ruth wanders in and out of conversations, talked about, but rarely talked to.

In What They Had, Elizabeth Chomko has captured a very recognisable scene from contemporary American family life. Moving a loved one into permanent residential care is always going to be an emotional experience and Chomko’s managed to include so many of the tropes familiar to this scenario. This film will really resonate with many people who’ve been through a similar experience. This is a family trying to make a difficult decision when there’s no easy solution to the problem they’re facing. For the most part What They Had honestly and realistically explores this distressing situation with a fair degree of warmth and the occasional humorous moment.

Unfortunately, Chomko seems to bottle her nerve towards the end and the final third of the movie resolves too neatly for my liking. Burt passes away quite suddenly. Ruth has a miraculous moment of cognisance where she reassures her daughter that it’s all for the best. He has died at the perfect moment. Any later and she wouldn’t have remembered who he was. Any earlier and she’d have been devastated by the loss. This scene irked me. It felt like a contrived Hallmark moment and completely unbelievable; by this point in the movie Ruth’s dementia was very advanced. With her mother’s blessing and her father no longer around to raise objection, Bridget and Ruth road trip out to California, (Thelma and Louise style in a Cadillac), where Ruth takes up residence in one of those flowery, sunny, quaint care facilities where everyone’s content and smiling. It’s as close as you’re going to get to a happy ending in a movie which centres around dementia. It didn’t work for me. The first two thirds of the film are pretty decent (with stand-out performances from Danner and Shannon), everything goes downhill from there.

What They Had was directed by Elizabeth Chomko and released in the UK in May 2019 

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Book Reviews

“Happiness” by Aminatta Forna

Happiness is definitely a London novel. The city is as much a character in the book as the two main protagonists around whom the plot resolves. Attila is a recently widowed, Ghanaian psychiatrist, visiting London to present a paper about trauma at an academic conference. Jean is a recently divorced American who is spending some time in London whilst conducting an extended study into urban foxes. The two, quite literally, bump into each other whilst crossing Waterloo Bridge and strike up a friendship which eventually becomes a relationship. As the novel progresses Jean helps Atilla search for his niece’s missing son, mobilising the network of volunteer fox-spotters she’s developed across inner city London. The people who populate this novel, like the foxes Jean tracks and the traumatised individuals Atilla has worked with in the wake of various conflicts, exist on the margins of society and yet are very much interdependent and reliant upon each other for survival. Forna is asking her readers to consider questions around co-existence and community.

Whilst in London Atilla also takes every opportunity to visit his former lover and lifelong research partner, Rosie who is living in a residential care facility. Rosie has developed early onset dementia and is increasingly incapable of recognising Atilla when he visits though she retains some motor memory of their physicality. Atilla is determined to find better care arrangements for Rosie. He’s concerned that the nursing home staff aren’t being as vigilant with her care as they could be. In Atilla’s absence, Emmanuel -the carer whom Rosie had been particularly close to- has been fired and she’s been unable to bond with anyone else. Atilla’s particularly concerned about Rosie’s loss of appetite and disinterest. She isn’t receiving much stimuli or attention in the home. He conspires to set her up in her own apartment where he will pay Emmanuel to be a live-in carer. This plan never comes to fruition as Rosie’s condition deteriorates quickly and she eventually dies. Forna’s depiction of dementia only takes up a small amount of the novel but it’s significant for its portrayal of how care staff are treated and the pressures they face within a residential care setting. On the whole it’s an accurate depiction of dementia : Rosie exhibits ongoing confusion, an inability to tend to her own physical needs and, by the novel’s conclusion has become occasionally violent. Forna intersperses these darker snapshots of the dementia experience with moments of genuine fondness and even levity between Atilla, Rosie and Emmanuel.

I thoroughly enjoyed Happiness. The metaphor of the fox community which runs throughout the novel exists as a perfectly drawn exploration of interdependence between all the living beings who call London home. These complex ideas of community, connection and dependence also exist in the care setting which Forna gives us a glimpse into

Happiness was published by Bloomsbury in 2018 

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Book Reviews

“The Imposter” by Anna Wharton

I was lucky enough to get my hands on a pre-publication proof copy of Anna Wharton’s first novel, The Imposter which is due for release in early 2021. Anna has been a journalist, writer and ghost writer for many, many years and most notably worked alongside Wendy Mitchell on her bestselling memoir about her life with early onset Alzheimer’s, Somebody I Used to Know. It’s easy to see how the time spent working on this amazing non-fiction book impacted Wharton’s first novel. Dementia is a key theme running through The Imposter and the description of both the illness and Grace, who is living with Alzheimer’s are both incredibly accurate and deftly written.

I want to be careful not to give away too many spoilers when describing The Imposter. Suffice to say if you enjoy a well-written thriller with twists and turns and surprises along the way. You’re going to really enjoy this novel. The main protagonist Chloe is an almost reclusive young woman who works as an archivist in a local newspaper by day and spends all her spare time caring for her Nan who has recently been diagnosed with Dementia. Chloe’s life changes really quickly when her Nan’s condition begins to decline so rapidly she’s forced to move the older lady into a residential care facility. As Chloe faces this huge life change she also becomes obsessed with a decades old, missing child case she discovers in the archives at work. Chloe begins to lose touch with her Nan as she becomes more and more entangled in the lives of the missing child’s parents who have never given up hope that their daughter might someday come home.

I’m not going to say too much about the missing child storyline in The Imposter except to say it had me hooked from the start and still on tenterhooks four hundred pages later. Wharton is a brilliant storyteller with a gift for building up tension and introducing believable twists in her plotlines. As a Dementia narrative I also found The Imposter very convincing. It includes so many familiar tropes I’ve come to associate with Alzheimer’s: wandering, confusing times and not recognising family members, forgetting when and what is appropriate to eat. Anyone who’s spent time with a family member or loved one living with Alzheimer’s will recognise both Grace’s behaviour patterns and the ways in which Chloe attempts to protect and reassure her Nan. There’s a scene near the start where Chloe is forced to buy yet another identical electric kettle to replace the ones her Nan has melted on the hob, which I’ve experienced personally with family members who have Dementia. Wharton’s depiction of Chloe is also spot on. Chloe both resents and relies upon the support of the care facility and social worker and Wharton does a wonderful job of capturing her frustration. It’s abundantly clear that Wharton has done a huge amount of research into Dementia and as a result Grace is one of the more believable and accurate of the characters I’ve encountered in my reading so far.

I was also incredibly relieved to find that Dementia has not been reduced now to a plot device in The Imposter. The storyline which explores Grace and Chloe’s relationship runs parallel to the more thriller-like storyline in the novel and exists as a wonderful piece of character development, allowing us to get an insight into who Chloe is and how her relationship with her Nan has developed. I really enjoyed this novel. It was great to see a character with Dementia included in such a well-developed way in a novel which is not primarily about Dementia. I’m looking forward to reading more of Anna Wharton’s work.

The Imposter was published by Mantle Books in 2021 

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Book Reviews

“Three Things About Elsie” by Joanna Cannon

Joanna Cannon’s second novel Three Things About Elsie is set in a home for the elderly. The book takes place across a single evening just after 84 year old Florence has taken a tumble. For the duration of the novel, she’s lying on the floor of her flat waiting to see if anyone’s going to come and offer her help. As her mind skips backwards and forwards between her early life and the more recent events which have brought her to this place, the reader goes on a journey with Florence, piecing together a very old mystery. Florence is clearly living with dementia. She’s frequently confused and often forgetful. There’s a wonderful scene where a cleaner opens her kitchen cupboard to reveal she’s been inadvertently stockpiling Battenberg cake.

Florence is troubled by the sudden appearance of a new resident in the old people’s home. Though this man claims to be someone else, she’s absolutely convinced he’s a man she knew when she was a girl. A man she’s incredibly afraid of. A man whom she thought died fifty years ago. Florence begins her own investigation though it’s increasingly hard for her to keep track of what’s true and what’s not. She’s ably assisted by her friends Jack and Elsie though by the novel’s conclusion we realise Elsie is not exactly what she seems. None of the staff in the older people’s home take Florence’s concerns seriously. She’s frequently dismissed, often ignored and lives in constant fear of being sent to live in a specialist dementia care facility. 

Three Things About Elsie is very similar to Elizabeth is Missing in tone, theme and approach. It’s part of the increasingly large canon of fiction using dementia as a trope within crime fiction and thrillers. It’s a pleasant enough read if somewhat unsurprising. You’ll spot the big twist coming from quite early on. At times it feels like the symptoms of Florence’s dementia fit all too neatly around the plot. She’s confused when the plot requires a little ambiguity and at other times crystal clear and more insightful than many of the other characters. Without giving away too many spoilers I think Cannon effectively handles the conceit of having Florence imagine people who aren’t really there. The reader gets to see both sides of the conversation. The other characters only hear what Florence says. I also enjoyed the aspects dealing with how the care staff perceived their roles and felt the ongoing issue of older people being dismissed and infantilised was handled very well in this novel. It’s not the best dementia narrative I’ve ever read but it is an enjoyable read and you’ll not regret spending time with the characters.

Three Things About Elsie was published by Borough Press in 2018 

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Book Reviews

“Frangipani House” by Beryl Gilroy

Frangipani House, Guyana born novelist Beryl Gilroy’s first book is set in her own birthplace. The novel’s title refers to a residential care facility where elderly women are sent to live out their final days. Mama King, the novel’s chief protagonist is forcing to move into the home by a delegation of absent children and grandchildren. She’s quite convinced that she’d be better off managing by herself and goes out of her way to be as obstreperous as possible, frequently clashing heads with the home’s owner and ultimately making a break for freedom, to live on the streets with a rag tag collection of other homeless people who give her the care and kindness she has not experienced from either her family or the people they’ve paid to look after her.

Frangipani House, like many texts of its era, does not use the term dementia, however it’s clear that Mama King is becoming more and more confused as the novel progresses. She frequently forgets where and when she’s living, mixing the past with the present and has conversations with people who aren’t present. She is not as capable of looking after herself as she’d like to think. Mama King also gives us an insight into how the other residents of Frangipani house are treated. Several are much more confused than she is. Including one ninety year old lady who inconveniently passes away, just before her birthday celebrations. The staff decide there’s no point wasting all the party food. They wheel the dead woman out in her chair and tell the other residents she’s just napping so they can continue to celebrate. A number of anecdotes like this reveal how the elderly residents are not treated with the respect and honour they deserve.

Frangipani House is a wonderful exploration of how ageing is perceived within this particular African community. The younger people talk a lot about respecting their elders and yet, when it comes to delivering physical care, they are quick to institutionalize their parents and delegate responsibility. Gilroy also explores the role of the older woman. Mama King has been a mother not only to her own daughters, but also to their children. Her girls, having emigrated to America, send their children home to be raised in Guyana. Gilroy’s novel questions how fair this system is. The children expect their mothers to provide free childcare, but when it comes to caring for these women in their later years, the same children shirk their responsibility. Frangipani House is a slim novel yet it is rich with detail and colour and full of well-placed observations about what it means to be elderly, female and African.

Frangipani House was published by Heinemann Educational Books in 1986 

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Book Reviews

“Flight” by Oona Frawley

Irish novelist, Oona Frawley’s debut novel Flight is a beautifully observed portrait of four lives intersecting. It’s set just outside Dublin in 2004 as a referendum on citizenship approaches. Sandrine is a pregnant Zimbabwean women who has left her husband and son at home seeking to better herself and ultimately gain citizenship for them all in Ireland. Sandrine finds herself working as a live-in carer for Tom and Claire, a rich retired couple who have lived in Ireland, America and Vietnam, following Tom’s career as a spice importer. Tom is now living with advanced dementia and their daughter Elizabeth hires Sandrine to look after him and also keep an eye on Claire, who is increasingly confused herself. Tom is soon moved to a residential care facility and passes away soon after. Within a few month’s Claire’s conditioned deteriorates in a similar way and she too passes away in a nursing home.

I really enjoyed reading Flight. The prose is so carefully crafted and evocative. As the perspective moves between the protagonists it’s really easy to imagine the same situation as slightly different when seen through their eyes. It’s very much a novel concerned with the idea of memory. Whilst Elizabeth struggles with how she was brought up, flitting between various countries and various homes, Claire longs for Vietnam and the lifestyle of her younger days. As her memories merge and become confused, her senses frequently take her back to Vietnam. Sandrine is also constantly interrogating her understanding of the past and what it means to belong to a place. Thrown together, the big quiet house the three women inhabit, comes to feel like a kind of dream scape where time and reality are both confused. There’s also a sense that the women are struggling to connect. They all seem to be lonely, though they’re constantly together. They don’t seem to know how to communicate with each other. It’s only when Sandrine has her baby that she and Elizabeth finally connect, bonding as equals over the baby and talking honestly about their lives.

As a dementia narrative, Flight is intriguing. There are very few of the common tropes played upon here. Neither Tom nor Claire is prone to wandering. They don’t seem to forget each other or confuse their daughter for someone else. Their journey with dementia is more of a kind of gentle erasure. They are less and less present as the novel progresses. Both pass away calmly in their sleep as if succumbing to the last stage of what’s been a kind of extended dream.

Flight was published by Tramp Press in 2014 

Categories
Films

Quartet

Based on Ronald Hardwood’s successful stage play of the same name, Quartet is actor Dustin Hoffman’s directorial debut. The film adaptation’s absolutely packed to the gills with wonderful British actors of a certain vintage. It’s refreshing to see a film with so many meaty parts for older people. The plot’s quite simple. Beecham House is a retirement home for elderly musicians and it’s threatened with closure. When the movie opens Cedric (Michael Gambon) is rallying the troops. They’ll organise a gala performance showcasing their talents in order to raise enough money to save their home. The gala’s in need of a headline act and when Jean (Maggie Smith) moves into Beecham House, everyone assumes the concert is saved. Back in the day Jean was the star turn in a fantastic quartet comprising of fellow residents, Reg (Tom Courtenay), Wilf (Billy Connolly) and Cissy (Pauline Collins). You’ll not be too surprised to hear that their plans don’t go smoothly but eventually the gala concert takes place and the home is saved. 

As the film depicts a large residential care facility, a number of the minor characters are living with dementia. The film makes much of their forgetfulness and general confusion but shies away from exploring the more difficult aspects of the illness. For the most part, this is a very gentle exploration of dementia. The older people are depicted as a little doddery, sometimes in a comedic fashion, but never angry or disturbed. The character of Cissy, played by Pauline Collins is given a little more scrutiny. She’s clearly living with dementia. At the film’s opening Reg and Wilf discuss her condition and agree she’s starting to deteriorate. However, aside from several small incidents, (a fall which leads to a marked decline in her cognisance and a brief lapse in awareness when she tries to “check out” of Beecham House, mistaking it for a cruise ship), it is almost possible to dismiss Cissy’s dementia as an artistic affectation or part of her “ditzy” personality. I didn’t find the depiction particularly believable although I thoroughly enjoyed her character and could see Hoffman was using this aspect of her character as a device to aid the plot and the comedy.

Quartet is a thoroughly delightful film. It celebrates and champions older people and also highlights the importance of friendship and community. I’m not sure it’s the most accurate depiction of dementia I’ve ever seen but it left me thinking it was heartening to see a character with dementia being allowed to perform and show that she’s still an amazing singer. It’s also lovely to see a depiction of the kind of support networks and community between older people I often come across in the real world. 

Quartet was directed by Dustin Hoffman and released in the UK in January 2013 

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Book Reviews

“Gratitude” by Delphine De Vigan

Translated from the French by George Miller

Gratitude is the sixth book by French novelist Delphine De Vigan. It’s a slender little novel, I might even call it a novella, and explores one simple idea in a really beautiful and tender way. Michka is an elderly lady living with dementia in a residential care facility. As her life draws to a close and her mind becomes increasingly confused she becomes more and more intent upon tracing the young couple who hid her from the Nazis as a child. She wishes to express her gratitude to these people before she dies. Marie is a young woman who visits Michka in the care facility. She’s pregnant with her first child and as she transitions into her new role as a mother she becomes more and more grateful for the way Michka cared for her as a child when her own mother was incapable of giving her the support she required. Jerome is a speech therapist who visits Michka twice weekly in order to help her retain her fading language skills. He grows fond of the elderly lady and, as she deteriorates, begins to rethink his broken relationship with his own father. Michka teaches him an important lesson about seizing every opportunity to make amends before it’s too late.

I really enjoyed this little book. Each of the characters is simply but powerfully drawn. The emotions are neither over nor under-played. I particularly appreciated the way De Vigan does not shy away from the more difficult aspects of ageing and dementia. Her story encourages the reader to sit with grief and sadness rather than try to avoid it. “Sometimes you need to acknowledge the void left by loss. Abandon distractions. Accept there’s nothing more to say.” And yet it is also an incredibly uplifting book. There is so much warmth and genuine fondness between the characters it is impossible not to acknowledge that Michka’s experience of her last days and weeks is anything other than meaningful. As the title would suggest, this is a novel about being grateful for the life you have been given, even when that life doesn’t turn out the way you’ve expected. It’s about finding peace in the midst of turmoil. It is a novel shot through with hope.  

I also appreciated the close exploration of how dementia has impacted Michka’s use of language. As a speech therapist Jerome is able to give the reader an insight into the aphasia and linguistic confusion Michka has to navigate every time she tries to speak. It’s intriguing and powerful in the English translation. I only wish my French was good enough to read it in the original version. This isn’t a high concept novel. There’s not a terrible amount of plot. It’s all about De Vigan’s exquisitely drawn characters and the way they pivot around each other, grateful for their friendship with Michka and determined to make the most of it.

Gratitude was published by Bloomsbury in 2021 

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Book Reviews

“May” by Naomi Kruger

Naomi Kruger’s beautifully written debut novel May is a story about how we remember the past, what we choose to hold on to and what must be let go. It centres around May, an elderly women living with dementia in a residential care facility. The novel is structured around a single day in May’s life. May’s own voice is the leitmotif running throughout the novel. After each chapter we hear fragmented snippets of her thoughts which allow us an insight into the confusion and cacophony of different memories and ideas all competing for May’s attention.

The chapters of the novel are narrated by a handful of different people who’ve had an impact on May. We hear from her daughter, Karen, her grandson, Alex, May’s husband, Arthur and Sana, the young female carer who’s grown close to her in the nursing home. Each of them gives us a little more understanding of May’s story and helps us piece together both who she was and who she now is. Kruger also slowly reveals a decades old mystery which May has become more and more obsessed with since her move into the nursing home. The multiple narrative voices work well here. They’re each strong and developed enough to feel like complete stories in their own right. Though they patch together May’s personal story, they also show how each of the characters has been influenced and impacted by their relationship with her. I particularly appreciated this. Often in dementia narratives, it falls to secondary characters to shape and establish the character living with dementia. Here the secondary characters have been just as impacted by encountering May as she is shaped by their testimonies.

May is an exquisitely written novel. The prose is clean but warm. It doesn’t sentimentalize the family’s relationship with May or approach her illness too emotionally. However, the fondness is apparent, particularly in her grandson’s and Sana’s narratives. I loved the humour Kruger brought to the scenes which showcase interactions with the residents of the nursing home. May is also notable for its exploration of the fractured thought processes of someone living with advanced dementia. We are given multiple opportunities to see how May’s thoughts have become confused and distorted. Kruger does a stellar job in translating this confusion into words. 

May was published by Seren Books in 2018 

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Book Reviews

“The Boiling Point for Jam” by Lynda Tavakoli

The Boiling Point for Jam is Northern Ireland-based poet, Lynda Tavakoli’s debut collection. It covers a wide range of themes including war, personal loss, ageing, the natural world and Tavakoli’s connection to both Fermanagh and Tehran. The poems are both assured and characterised by a lightness of touch which often had me re-reading lines a second and third time as an image or metaphor slowly impacted with devastating effect.

The collection begins with a handful of poems which explore both her mother’s experience of dementia and her memories of her parents. The second poem in the collection, “Dead Dog” shows her mother distinctly unimpressed by a stuffed dog which has been brought in to the residential care unit to amuse the residents living with dementia, 

‘That’s a dead dog,’ you say,

The words raged from that part of you

Still holding and holding on.

It’s shot through with dark humour and Tavakoli’s signature unswerving gaze. Small, deft touches such as the repetition of the line, how you love my coat/and how you love my coat, reveal her ability to not only capture snapshots of her mother’s life with dementia, but also place those moments under an analytical poet’s gaze. There’s both beauty and profundity to be found next to the deep sadness inherent within these poems. Lines like,

this posse of souls,

eyes-eternity filled already,

struck be as both deeply upsetting and also incredibly poignant. Tavakoli tackles her subject with a great deal of respect and a sense of shared humanity. The poems which deal explicitly with her mother’s dementia are interspersed and set beside poems exploring her memories of both her parents, so the reader gets a real sense of the fondness which exists between the poet and her mother and the deep connection they have. When, in “Is This What I Do” she writes,

I say your name, see the reluctant

wakening of your eyes, the disappointment

you had not slept your way to heaven.

You have told me this before.

there is no judgment of her mother’s despair, no sense that they are meeting as anything but equals. It is the way Tavakoli records her mother as suffering, but not diminished as a person, which really struck me as I read these poems. I found them incredibly moving and would gladly have read quite a few more. 

The Boiling Point for Jam was published by Arlen House in 2020