Nursing Home Reform


Filmmaker Q&A

ALMOST HOME filmmakers Brad Lichtenstein and Lisa Gildehaus discuss why they chose to profile the elderly, negotiating the line between subject and sympathetic filmmaker and why seniors can always surprise you.

What led you to make a film about nursing home reform?

Brad: The truth is that my wife inspired this film. She’s a theater professor and playwright and also runs the University of Wisconsin-Milwaukee’s Center on Age and Community. Over the years, she and her work have opened up our circle of friends to include many older people. She opened my eyes to the depth of our fear and denial of aging. I wanted to make a film that refused to hide the reality of aging.

What do people want to know, after viewing ALMOST HOME?

Brad: I love it when, after the film, people ask me whether those were actors or if it was real life. They can’t believe that we could have made a documentary so laced with drama. It either means we did a very good job in telling our story, or we so manipulated reality, it is no longer recognizable as real life. I’ll opt for the former.

How did you choose Saint John’s by the Lake?

We wanted a place in the process of “culture change” so we could have a story that allowed the audience to see the challenges, triumphs and shortcomings of the process. We also wanted a place willing to give us total and unrestricted access, and a place where everyone was under one roof to achieve a kind of Robert Altman style, with characters who wander in and out of each other’s frames throughout. Finally, we wanted someplace nearby since we’d have to be there so often. We investigated about a half-dozen places, but settled on Saint John’s. Kathie Eilers, Saint John’s president, led her team to the courageous decision to let us in and to assume significant risk—against her lawyers’ advice, by the way.

Did anything surprise you about your subjects or nursing home life?

Many things surprised us. We were surprised by the lucid interview Lloyd gave us at 3:15 AM about what it is like to be inside his head and to deal with Parkinson’s. We were surprised by the way in which matters of racial disparity within Saint John’s—no black managers and almost an entirely black direct care staff—had gone unaddressed for so long. We were surprised on the first day of filming on Christmas 2003 when two adult sisters caring for their mom, who has advanced Alzheimer’s, expressed their desire that she be granted the Christmas gift of death. I [Brad] came home and told my wife that this was going to be a very trying film to make.

What were some of the challenges you faced in making this film?

Brad: The line between filmmaker and subject was in need of constant negotiation. When is it appropriate to stop filming and hug Amy Blumenthal while she is dealing with her mom’s sudden stroke? It was also difficult to persist with some of the people in the film and stick around long enough in order to understand what a person with a disease like Parkinson’s or Alzheimer’s is trying to express. Editorially, one of the difficult challenges was to fairly and sympathetically portray Edie Sr.’s decision to leave Lloyd’s care and companionship to others. It’s not an uncommon phenomenon, but no one wants to admit that they might make the choice that Edie makes. It assigned us added responsibility to portray her sympathetically to an audience predisposed to condemn her due to their own fear and denial.

Lisa: My biggest challenge was a personal one. I was very unsure about my ability to relate to people in a nursing home because I don't have much experience with older people. The first few weeks, I worried that I'd say something inappropriate or, worse yet, that I'd have nothing to say at all. I soon realized that they are simply people and, while some may be hard of hearing or sight, have varying degrees of dementia, or are just old and frail, they all want to have normal conversations or share stories about themselves and their families.

How did you handle privacy issues when filming your elderly subjects in intimate moments?

The first step was getting over 500 releases, and for many a HIPPA [Health Insurance Portability and Accountability Act] release as well. Once the filming got going, however, intimacy became a constant. That said, we did plan and discuss the filming of Lloyd in the shower to make sure he and the nursing assistants were comfortable with it. But that was the only intimate moment that we consciously contemplated before we filmed it. Still, in many cases we talked with families after filming certain scenes to keep them in the loop about what we were shooting.

Was there any footage that you liked that did not make it into the finished film?

Brad: Of course; we shot 286 hours for an 83-minute film. I miss a whole storyline with Pauline Coggs, a dear woman who had a great impact on Milwaukee politics as a social worker. I had hoped to include her deep connection to Enchantra. And I had hoped to include John George’s visit to his grandfather’s farm and his grandmother’s grave in rural western Wisconsin. In that footage, we learn how his grandparents inspired his career choice and about his own thoughts about mortality. Some of it is on our Web site,, but none made the film.

What impact do you hope this film will have?

Simply put, we hope the film helps people to overcome their denial of aging and at least to have a profitable and honest conversation about their future, or a loved one’s future. And we hope that people are inspired by Saint John’s efforts to create better alternatives for all of us when we are old and need help.

What period of time did filming take place and when did it conclude?

We started getting releases and “campaigning” for the film in October 2003. By December, we were rolling. We shot on a near-daily basis for a year, then spent two more months getting pick-up shots and pick-up interviews. Editing began in July 2004 while we were still shooting. We had a final cut, ready for post, by summer 2005.

The independent film business is a difficult one. What keeps you motivated?

Brad: One of the hardest aspects is raising money but I actually enjoy it. Pitching and writing about the film helps me focus on the story. My father and mother are active fundraisers in their Jewish community in Atlanta, so the fundraising and business necessities of independent filmmaking is in my bones. I relish gaining access, which allows me to be the social person I love to be and to convince others that their story is worth telling. The great thing about being a documentary filmmaker is that I get to knock on any door and say “Excuse me, I’m a documentary filmmaker. May I get to know you and tell your story?” It’s a license to travel to any world I wish.

Lisa: The thought of choosing one career seems unbearable, but being an independent filmmaker means re-inventing who you are and what you do.

Why did you choose to present your film on public television?

Brad: I’m an advocate for public television because it’s PUBLIC. Too much of our society’s media is motivated by profits—that is a narrow sieve for ideas to filter through. Public television is motivated by a diversity of ideas, and it provides millions access to culture and programming that they might not ordinarily experience. Plus, public television is relatively “hands off” in dealing with filmmakers, which affords us freedom. So, as corny as it may read on a public television Web site, I really believe in the value and mission of public television.

What are your three favorite films?

Brad: Dog Day Afternoon
Ain’t Gonna Shuffle No More, Eyes on the Prize, Episode 11

Lisa: The Muppet Movie
The Firemen's Ball
Man with a Movie Camera

What didn’t you get done when you were making your film?

Brad: Sleep...I also have two kids.

Lisa: Graduate school, and a kitchen remodel in our 100-year-old house.

If you weren’t a filmmaker, what kind of work do you think you’d be doing?

Brad: I’d probably run for political office. Seriously. After all, what’s the difference? You have to raise a lot of money, refine your vision to a succinct story (or message) and recognize and seize opportunities to create social change.

What is the most inspirational food for making independent film?

Lisa: Anything with dough because it gives you time to focus and think.

What advice do you have for aspiring filmmakers?

Understand that if you have the talent, all that separates you from those who do not succeed is the willingness to persist in every aspect of the process.

What sparks your creativity?

Lisa: Working on films leads to ideas for other films. Traveling abroad and talking with artists also sparks my imagination. Talking to my husband is the best way to keep my brain spinning out new thoughts and ideas.

Which filmmakers have most influenced your work?

Brad: Robert Altman, Michel Negroponte, Alan Berliner and Errol Morris for invention. Maysles and Wiseman for the art of making American direct cinema. People like Peter Davis and Deborah Hoffman for the inspiration to create films that cause change, both personal and societal. Penelope Spheeris for fun.

Lisa: In terms of technique, I'm a big admirer of 1920s Soviet filmmakers and 1960s Czech and Polish filmmakers because they implemented a lot of what we now consider documentary-style techniques. It now makes for such interesting and uncalculated films that make the viewer feel a part of a specific time and place.


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