Not My Home

Introduction

Life for the residents of Seaview Manor, a nursing home in Glace Bay, Nova Scotia, is routinized and often lonely, despite the efforts of an efficient and caring staff. A variety of viewpoints are given in this profile: residents and family members share their stories and admit their frustrations with limits imposed upon their freedom, and nursing staff explore the constraints of their busy schedules. But their complaints about restrictions on personal freedoms, regulations, and limited budgets are balanced by a portrayal of the nursing staff's genuine concern for the quality of life for the residents of Seaview Manor. The video is structured around three distinct parts. The first ten minutes introduces viewers to the facility. A new resident is admitted. Long-time residents share their points of view. The routine of life in the nursing home is emphasized. A staff person explains rules and regulations to the new resident. Set against the themes of routine and regulations are two intimate moments: the first an interaction between Philip and Mamie, residents who have become close friends, and the second a quiet and caring interaction between two nurse’s aides and an old woman.

The second section, twenty minutes long, incorporates long sections of direct interview and voice-over commentary by two family members who have placed their parents in the nursing home. Each provides sensitive commentary on the emotional strain caused by that decision and their frustrations with the routine and “institutional feel” of the place. Mamie and Phillip, who were introduced in the first section, share their stories in more detail, and provide perspectives on the loneliness and restrictions on personal freedom felt by residents. Nursing staff add their viewpoints on the latter subject. Many of their comments are as heartfelt and revealing as those of the family members who begin this section. The last section, about fifteen minutes long, develops one of the issues considered in the second section: the conflict between providing adequate physical care vs. the emotional needs of residents. The administrator of the home, in a brief interview, defends the choices he makes based on limitations in budget. Nursing staff are portrayed acting on their values--providing sensitive, caring assistance for a resident near death. Mamie and Phillip’s relationship is developed further in this section. Their intimacy and perspectives on life are refreshing and credible. Although the video suffers from an inflated length (its running time of 45 minutes), at its core it provides an effective portrayal of the ambiguities and ambivalence that lay at the heart of the nursing home experience.

Pre-Viewing Notes and Activities

Viewers may want to make a list of "stereotypes" associated with life in a nursing home. After viewing the video, assess to what extent those stereotypes are either addressed in the video or not considered in the context of this portrait of life in Seaview Manor. Here are some of the statistics about this nursing home that are provided in graphics throughout the film:

• There are 101 residents in Seaview Manor
• Two residents are admitted per month
• The staff to patient ration is 1 to 6
• There are two staff persons in charge of activities for 101 residents
• 25% of the residents die each year

Summary of Scenes

The video is divided into distinct three parts. Each of the first two parts ends with a slow fade to black. After a few seconds the next scene begins. [Part One]

1. A new resident is admitted to Seaview Manor, a nursing home in Glace Bay, Nova Scotia. “It’s a very difficult thing to do,” her daughter says. “I know she would rather come home with me.” She holds back tears. “It’s a tough decision to make for her and for me. I hope to get her back again.” The mother is shown through a doorway into her room. Suddenly the sounds of a nursing home prevail--clanging sounds, elevator bells ringing, carts rolling down hallways, and as the title comes up, residents calling out--“Is there anybody around?” “Can anybody hear me?”
2. Close shot of an old woman: “It’s not a hospital. It’s a home. That’s what they say.” Another resident compares the nursing home to the Army or jail. “It’s a sad, lonely life,” a third woman, Lillian, says, “and I could bring a hundred here to say the same.” An old man, standing next to a parakeet in his cage, asks, “Do you think he should be penned up?” A woman’s voice: “No, I don’t.” A graphic notes there are 101 residents in Seaview Manor. “Few are here by choice.” Christina, a new resident, says, “I don’t know. I just can’t take it here.” Then she adds, “But they don’t want to take me at home. They think this is the place for me.”
3. A nurse’s aide says, “Everything we do is on a clock. While we’re getting breakfast we’re thinking about dinner. And that’s how it works.” Two women roll a food cart down the hall. Christina, the new resident, shares how difficult it is to get through the nights. Florence, who has lived at Seaview Manor two years, refers to being awakened at 5:15--and says it’s a long day after that. “We are breaking them in,” says a nurse’s aide. “To our routine. It’s not like home. But they have no choice. It’s structured. They have to.”
4. An old couple sit next to each other. A close-up shows them holding hands. Philip and Mamie met at Seaview. Mamie says, “I’m very lonely. I’ve got nobody. My daughter is really good to me. I’ve got him, and he’s really good to me.” Then Philip says, “There’s lots of times I see her crying. It brings me back. We both get along good.” They roll down the hallway together in their wheelchairs . Philip and Marie are often frustrated because the rules of the nursing home restrict their freedom.
5. Blair, on maintenance for 18 years, is introduced. He welcomes a new resident and explains to her some of the rules--no more than one chair, one small dresser, a television and stand, and three family pictures or objects of art. 6:30 a.m. Eggs frying. A woman complains about being awakened early. “You do lose a lot of your freedom here,” says a nurse’s aide. Two aides, who have raised a woman off her bed in a Hoyer lift, comb her hair and speak to her in soothing voices. Then back to Philip. He talks about crying sometimes when he remembers the “good times I used to have.” The scene ends with a cut to a black and white photo of Philip in middle age. [Part Two]
6. Fire alarm drill. The maintenance man, Blair, says, “This is their home, but there are restrictions in any institution. . . .” He explains that there are about two fire drills per month. A scene shows the residents doing crafts. But Blair complains that residents often attached crafts to their walls. The Fire Marshall warned that this behavior created a hazardous condition.
7. Two black and white photographs--first of a woman with her daughter, and then the same woman in virile old age. Then to a scene in the nursing home, where a middle-aged woman, Carol, talks about her mother, who is a resident. The old woman lies in bed. Her eyes are open, and she appears to be in some physical or emotional distress. Her daughter rubs her arm gently. Carol notes that her mother was “terrified” when she first came. “Her philosophy was, you came here to die.” She talks about trying to make her mother’s room into a room like the one she had at home. “I’ve exceeded the limit. I said the heck with it.” Carol complains about the institutional feel of the place--the uniforms, the overcrowding, the lack of privacy. “You don’t have your own space. There’s no place to go that you can be by yourself.” Her mother was a private person, and she knows her mother is made uncomfortable by these surroundings.
8. Mealtime. The staff are busy, efficient. Then Jeanette, a middle-aged woman, talks about her mother’s deteriorating mental state. “When I came in here last week, she didn’t know me.” She cared for her mother twenty years. The interviewer, off screen, asks, “Do you think her mind is going because she is in here?” As she asks the question, we see photographs of Jeanette’s mother in various stages of healthy middle age and old age. “It probably would have, but it wouldn’t be gone completely. There’s not enough people talking to her.” The scene changes to show women sitting in the day room around the table. No one is talking to anyone else. “They’re put here to die. They’ll never go out again. That’s what hurts me.”
9. Carol, who appeared earlier with her mother, massages her mother’s feet. “They care very well for the persons’ physical requirements. But I don’t know about the emotional.” She praises the professional attitude of the staff, but concludes, “She is at their mercy.” The interviewer asks, “What about the guilt?” “Oh, the guilt! There’s not been a day since that I haven’t thought, could I have worked something out and gotten someone in the house.” During Carol’s voice-over more photographs of her mother are shown. She looks happy and healthy.
10. Black and white photograph of Philip, a big strong man in middle age.” He came into the nursing home because he “had no other choice.” He explains why his son and daughter could not take him in. Then to Mamie, who tells the story of how she came to the nursing home. Lillian, dressed in a pink sweater, tells how her son brought her up from Boston. In a photograph she is shown dancing with her grandson. She is beaming in the picture. ”I would like to be home. But I don’t have one now. I sold it. I wanted to cry all the time. That’s what I do almost every night. I cry my eyes out. I haven’t got a tear left.” Why does she cry? “I’ve got nobody to say ‘Good morning’ or ‘Good night.’”
11. Mamie admits, “I don’t say nothing to nobody. I keep it all to myself.” The staff never talk to her about her loneliness. “I never let on to them. I cry all the time, but they never see it. They think I’m really happy, the ‘happiest one in here’ they say. I just go along singing and carrying on and joking.” Two staff people walk past Mamie, who is playing the harmonica. She wears large earrings and a big necklace. An old man nearby dances a jig to the upbeat music and then walks away.
12. Two nurses respond to the constraints of time they face in their work. One admits the importance of one-to-one contact. But when working with Alzheimer’s residents, the only one-on-one occurs when staff bathes them. Then that staff person has to worry about how many more residents they have to take care of. “It’s a rush job.” Scenes of staff interaction with the residents. A graphic notes that the staff to patient ratio is one to six. Jessie, an RN, says, “You don’t know about the residents until you read their obituary column. Sometimes you go around and you don’t even have time to look at the pictures on the wall.”
13. Christina, the new resident who spoke earlier, explains that one-to-one contact is rare. “They just do their duty.” Philip seconds this concern: “They don’t even talk to you.” Scenes show staff moving quickly, hauling food carts, holding onto residents’ wheelchairs. “Dinner is now being served!” sounds over the loudspeaker. Jacquie, from the dietary department, admits, “I don’t know how they cope. “ She sits on a sofa, her head in her hands. “You think maybe we’re better off losing our mind. Better off not knowing what’s going on. It would be an awful sad situation to be somewhere you don’t want to be, and have this rushed ‘no one cares about me,’ if you had your mind.”
14. A nurse’s aide washes a resident and then dresses her. Bedtime. An aide notes that sometimes the residents strike out at staff. Jessie, one of the nurses, explains the buddy system used with violent residents. One staff person watches the resident while the other washes the resident or changes the resident’s clothes. In those moments of close physical contact, the staff person is vulnerable to the residents’ sudden fit of rage. Staff members always fill out incident reports so that family members are aware of their parent’s or relative’s abusive behavior. Jessie explains, “Put yourself in their place. I’m going to come in and put you to bed. I’m going to take your clothes off, and I’m going to wash you.” She likens these incidents, from the old prison’s point of view, to “where they’re feeling like an assault.”
15. Jacquie, the dietary aide, asks, “Is this where I end up? I hope not. My kids keep telling me they’re going to put me in a nursing home. But I would much prefer to die when I have all of my faculties, when I know what I’m doing, when I’m me. Not when I’m someone else’s problem. And that’s what's happening today. I would wager that if you were to stop any staff member in a nursing home they would say the same thing.” She characterizes Seaview as an “ideal nursing home.” She worries about the fate of residents in other facilities.
16. Christina, the new resident, says she feels weary sometimes when she is alone. “You can’t sleep all the time. But it’s a good place,” she says as she looks off. Another fire drill bell. More carts moving down the hall. The interviewer asks Christina, “Are you afraid? “I’m not afraid, dear.” Mamie all dressed up. Sitting in the hallway. She sings, “Once I had a charming beau, I loved him as dear as life. . . “ She sings a few verses. Then she laughs. This scene ends with an old photograph of her as a vital younger woman. [Part Three]
17. Philip looking through binoculars. “There’s nothing to do,” he laughs. Scene of a bingo game. A graphic explains there are only two people in activities for 101 residents. One of the activities’ staff says, “We provide support. Most of the day i isn't’t regimented. They really need that one-on-one.” A scene of an outside concert with residents watching. Then more scenes from inside the nursing home. People eating or sitting quietly. Then a nurse complains, “We always state that we look at the quality of life. But if we’re only looking after the physical needs, are we really looking after the quality of life for the resident?” She notes that additional staffing requests are not funded.
18. An interview with the administrator. The nursing home is funded by the Nova Scotian central government. His concern: He could take money out of the food budget and the medical supplies, “and do something about your emotional problem. But then what happens to the other areas.” He concludes, “We’re tight everywhere. ‘We might be lacking on one side, the emotional care, but if we’re keeping the physical standards what it should be. . . .” He concludes, “If we try to do both of them, you can’t do it, and you’re going to be hurt in two ways then.”
19. Philip listening to country western music on his stereo. Later, he talks about being a gunner in WW II, among the first to land on Normandy Beach on D-Day. He holds several war medals in a case in his hand. Mamie tells how they met. He would tease her, “You can’t sing. You can’t play that harmonica!” She would tease him back. We see the two in wheelchairs, Mamie leading, Philip following. She tells the interviewer she would like to “be back home and doing what I always did, going shopping . . . “ Then she admits, “I’ll never have it no more. Those days are gone, darling. And my days are going. So that’s the end of my life.” Cut to Mamie looking out a window in her room.
20. Graphic. One quarter of the residents die each year. A nurse goes into Alice’s room. A graphic notes that Alice died two days later. Several shots show the nursing staff talking to Alice, then helping her into the bed. The camera looks down on the old woman as she lies in the bed. Later, a nurse describes the process used when the staff knows no family member will be at the dying person’s bedside. The staff take turns sitting with the resident. Of course, with staff demands there may not be someone who can be there continuously. The nursing staff’s highest value is not to let the resident die alone. A graphic notes that Alice died in her sleep. Photograph of Alice in middle age. Another resident, Lillian, muses on death and says, “When you’re number is called . . . “ Aides clear out Alice’s personal items. We hear Lillian say, “She was in agony, the poor thing.” Then the bed is disinfected. One of the housekeeping aides explains the process, then adds, “You’ve got to try not to get too close to them. Once you’re here a long time you get used to it. In another way you never get used to it. It’s not a good feeling.”
21. A nurse refers to a memorial service held monthly. Philip comments, “You think your turn might be next.” He laughs, and adds, “I was walking everywhere when I came here. My legs just went. Life is queer sometimes, when you think of it.” Cut to images of Philip with two small children, then Philip in late middle age. Then more images of Mamie interacting with another resident, staff at work, and an ambulance bringing a new admission, Tom--one of the average of two residents admitted each month. His daughter Diane talks about the new experience. Her two brothers are shown walking down the hall while Tom is wheeled in on a gurney. Diane’s voice-over: “I would take him home if I could do it.” The last image is a long shot through the doorway of Tom, the new resident, now sitting up in his bed. Through the credits we see two pictures of Tom when he was younger, first with his wife, and then in old age, a healthy man surrounded by family. Cut to Tom in the nursing home singing "Happy Birthday" to himself while his family stands around him.

Discussion Questions and Sample Worksheet

Text of The Great Circle of Life: A Resource Guide to Films and Videos on Aging, copyright © 1987, 1999, 2005, Robert E. Yahnke. All photographs copyrighted by Robert E. Yahnke.  All rights reserved.  Contact author for permission to copy photographs or reprint portions of text.

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