Interview: Deirdre Fishel & Tony Heriza

Deirdre Fishel’s film Care is both a documentary about home care in the United States and a call to arms raising awareness of the need for better provision for elderly care. We spoke to Deirdre and producer Tony Heriza at the film’s premiere in Sheffield last year.

Where did the inspiration and impetus to make this film come from?

DF: There were a lot of roads leading to this film. I had been thinking a lot in my life, even as a child, about people who work in the home. It’s a crazy, almost class system in the United States that never really gets talked about, as opposed to other countries where it’s acknowledged. I had made a film about women growing older with vibrancy and sexuality, and my mother was a character in the film. She’s now almost 90, so me and my sister started to navigate this system and were very overwhelmed by it. Right at that moment I met someone who was organising a domestic worker rights movement, and when I realised there was an elder care faction – because that’s the fastest growing part of the domestic worker movement in the United States – I was like ‘somebody must be making a film about this because the population is going to explode’…and nobody was. So that’s when I jumped in and it was huge. That’s when Tony came on to produce, almost from the beginning.

There is an issue in the US which is ‘can we ask people to work for so little money?’. As one of the people says, caregiving is really the face of the Fight for Fifteen movement. It’s like ‘if we’re not going to pay THOSE people a living wage, do we have any respect?’. You’re still going to work but you’ll be impoverished. If our film does nothing but put it on the map – that caregiving is real work – we will have done a huge service to the conversation.

Deirdre, you have this interest in older people and especially older women. What is the reason behind this fascination?

DF: I think it came from when my sister was turning forty – I’m younger than her – and she was just so horrified and upset, and that’s when I started to really think about ageing. My sister was still, in my eyes, so young in every way. She looked young, she was at the beginning of her career. Then I started looking at society and saw that it really is true that the perception is that things are going down but the reality is that that’s not how people feel, that’s not what their lives look like and that’s not even what the documentation says about how happy people are. People are actually not really that happy in their twenties, even though in America we kind of idolise it. So initially it came with that feeling that things were getting better and better. It was a big thing for me to realise in this film that better and better happens to a point, and then you really have to accept that there is a point where that’s not going to be true. That’s what I have trouble dealing with. I think it’s just a hard part of life but in America it’s particularly like ‘no no no, OH MY GOD…’.

TH: It’s simply not on the map. We don’t want to talk about it or even think about it.

DF: There’re just going to be so many older people and we don’t have the resources and we’re going to bankrupt our system. We’ve backed ourselves into a wall where we’re just hoping to avert a crisis. They don’t like us to use the word crisis because we’re ahead of the crisis – that’s the good news, we can still fix it – but it will take a lot of concerted understanding that we need to address this. Whether that’ll happen…The power of denial is very strong!

Looking across your work, Deirdre, it seems like one of your interests is the idea of relationships that exist, or begin, in spite of our bodies giving up on us. I was wondering if you could talk about this, whether you agree…

DF: I don’t know that I would have ever thought of that as a link between the films. I think we have a certain sense of our body, and our bodies change. I know that’s really challenging for people because they feel so vulnerable. Our culture, American culture, is so much about the pioneer spirit and it’s very much not about vulnerability, it’s about being strong and ‘you can get it, you can pull yourself up by your bootstraps’. I think these relationships have to include vulnerability. Vulnerability is a great opening to intimacy, whether you’re having sex at 70 or you’re having a profound relationship with your child who’s your family caregiver, or your paid caregiver, there’s a real opening, a spiritual opening, but you have to accept vulnerability. It can’t just be because I’m young and sexy…

You made a fiction film which deals with mental health (Risk) and I saw that as part of the running thread as well – relationships where something is going wrong with the body but there’s still this continuing relationship. I thought this may be a preoccupation of yours…

DF: Oh good, I love that, you’re going to link all my work! I think the truth of the matter is that we aren’t the ideal. Even people who look like the ideal aren’t the ideal, they’re something else. You’re always trying to live up to that and the truth is that makes it a very isolating experience for people because they’re always asking ‘why am I not like what I look like?’. I think it would be wonderful if we could all admit that image is actually very restricting! There is something liberating, I think, about opening up these relationships and saying that we’re just vulnerable human beings struggling to figure out what it’s all about. On that continuum is going to be an aged moment which we are all going to have to get behind and accept.

The main woman in the film, Dee, she’s not well at all and she will probably die relatively soon. I saw her in the hospital while she was still conscious and I realised that I loved her. It was a very intense experience. It was really great for me because I suddenly understood how these caregivers feel. I know they love the people they care for. People say to me ‘it must have been horrible’ but it really wasn’t. There was a lot of love, there was a lot of connection. It was really very moving and profound a lot of the time. It was the system that pissed me off!

How did you find your subjects? Did you deliberately look for cases which contrasted urban and rural situations?

DF: Very much so. It was actually quite hard to find the rural story but we really wanted to make it clear to people that this was everywhere. Across class, across religion, across locations. We always knew that we wanted the film to have impact, to start a conversation. It was tough in editing, really hard, like ‘how do these things link up?’

TH: That balance of a compelling story and touching just enough on issues to make it useful. We’re talking to union organising partners, people working with ageing issues, so the film can be a really good jumping-off point for discussion but not make it into an educational film, that’s the tricky balance.

We’re hoping for three conversations to happen from the film. One is around the dinner table, the family conversation. What are we going to do? Then the second level is in the community – how can there be a social way of supporting each other? The third level is policy, government policy. If we can stimulate a little of each of those. People are having the private conversation but they’re not sharing it, so it’s like ‘it’s all on us’. We feel like now is a good time for the film, there’s activity happening at all those levels, it’s beginning.

How did Ai-jen Poo become involved? Obviously, it’s really interesting having her input in the narrative…

DF: She is the person, I think, who is at the forefront of thinking about these ideas in America. I think it’s safe to say that without her we wouldn’t even be where we are in terms of the conversation in this country. So when I was starting to think about making this film, everybody said to me ‘you should talk to Ai-jen Poo’. She was involved from the very beginning, but we didn’t think about putting her in the film until way later. We did a lot of audience screenings and people started saying ‘we want information’.

TH: We didn’t want an expert-driven film. Ai-jen Poo has her own personal story and at one point we tried to draw that out a little bit more because that has driven her work but in the end her role as a little Greek chorus I think really works.

Did you look into care homes as well?

DF: We do have an institutional bias in our country, where monies are funnelled much more towards nursing homes. I think the film always had this idea that it was about exploring the alternative. I have a really strong personal bias because I just can’t imagine my mother in a nursing home, myself in a nursing home…so I really wanted to explore what the options were. But some people have to go into nursing homes so we also didn’t want to damn them, we didn’t want people where that was their only choice to feel bad.

TH: For some people, a group situation actually is preferable.  So, there’s not a single solution but right now in the US, especially from Baby Boom forward, like 90% of people say that they want to live as long as possible at home. We’re trying to explore what that means. I think that the solutions for this ageing boom are going to be all kinds of things: at home, group homes, support in the community. We had to narrow in on one thing, and this idea that the boom in home care is going to be a tidal wave.

You talk in the film about the right to care. ‘Right’ is such a powerful, loaded word. In Britain, we’ve been facing attacks on our National Health Service, and in the US you’ve been fighting for universal healthcare. Have you looked at the international scene? Are there countries which you think ‘get’ eldercare better than others?

DF: I think the two are Japan and Germany. They’re ahead of us in terms of their elder populations, they’re older. It’s about 2030 when we [the USA] flip into that. I think it has to do with social insurance, understanding that there’s going to be work and that this work has to be accounted for. So paying family or having social insurance that you pay into as part of the lifecycle, acknowledging that it’s going to happen, figuring out and having solutions for that care to be there for you.

TH: They’re slightly different systems but both of them…part of it is the financing. Public support is available. In Japan it was controversial at first because it was seen as dishonourable to hire someone, but since they put the system in place there has been this real acceptance of it. The US will have to have some system like that, some public support. There’s no way that families can pay and there’s no longer the family structure just to have elders live in the home. It will come. Whether there’s a crisis that causes it…

DF: The question with the film was ‘should it say at the end that America is headed towards a crisis?’.

TH: We’d like to move people, not to make you feel overwhelmed and frozen with one more bad thing that we can’t deal with and more like ‘we have time’. Ai-jen always says there’s time because we can see this coming. We have time to figure out the complex set of solutions which can make this work better.

DF: But then if you ask Ai-jen what keeps her up at night she’ll say that it’ll get bottlenecked by our country, that we won’t ever be able to agree on a plan. ‘We don’t want to give money, we don’t want to be taxed’. Look at Trump. I mean, it’s pretty alarming. I was that a big thing is to put this onto the presidential agenda. Certainly, Bernie is the person who would be talking about it most, then Hillary, but Trump doesn’t want to talk about this. He’ll say ‘let’s get rid of the immigrants’. You CAN’T get rid of the immigrants! We should have the opposite! We need a system that’s opening up the door for immigrants because we need them to provide this service. We don’t have the womanpower to do it without immigrants! It’s pretty scary.

You’ve touched on another question! Any male care workers? Would you have been open to having male care workers featured in the film?

DF:   I would have definitely been open. I talked to a few male caregivers, and there are a few, but it’s still…I don’t want to give a percentage because I’ll get it wrong but it’s A LOT fewer.

TH: I’m guessing it’s 80% or higher women.

DF: Sometimes it’s really good that there are men because they’re obviously larger and stronger and stuff like that, although more and more technology could help with some of that stuff, there could be all sorts of ways to lift people. But look at how many pre-school teachers there are that are men, how many babysitters? I find it heart-warming when I see a man giving care because it’s not considered masculine, in a way, it’s very much women’s work.

Having made this film, is this now a life change for you?

DF: I wanted to make a film that could potentially change policy. I hope that it’s not my last film, but I do feel really committed. I’m also a professor so I don’t have all the time, but I really want to be there and at least want to have my finger on the pulse of how it moves and be part of the dialogue and thinking about the strategy of how it goes out.

TH: We’re part of two labs. One of them is the Fledgling Fund in the US where we’re part of a year-long documentary impact lab where we’ll work with about ten other filmmakers over the course of a year and figure out how to work the film to its maximum impact. So, we’re learning. It’s not a single thing, it’s a very complicated terrain.

DF: I think I was very political to begin with. It’s an interesting thing – I became a filmmaker because of Tony’s film. I saw his film about gentrification in Cincinnati, and then I went to Cincinnati. I took a year off from school to work on low income housing, and it never occurred to me to be a filmmaker. Then I met Tony and he said ‘why don’t you make films?’ and I thought ‘okay!’. I’ve known since the very beginning that films really do change people’s lives, because that film taught me about class. I had a very good education but sometimes films can just put the pieces together because the narrative is so strong and so clear: life is very confusing and it just kind of crystallises things. I think that we both share that commitment to politics.

As a final question, do you have any advice for budding filmmakers?

DF: The biggest is, I think, that it’s so hard to make a film and there are so many layers that you really have to find that story, that you just fall in love with. Whether it’s a fiction story or non-fiction, it’s a long-term commitment.

TH: One way of saying it is that it has to be harder not to make the film than to make film.