Beautifully shot and multilayered, the new documentary Mother centres on a care home in Thailand, which provides intensive one-on-one 24 hour care for 14 Western dementia patients. At the heart of the film is Pomm, who we see lovingly doting on Alzehimer’s sufferer Elisabeth. But Pomm’s reality is that at the same time she looks after her patient, she is always thinking of her three children, who live many hours away. I recently spoke over the phone with the film’s director Kirstof Bilsen, about the themes of the film, and how he came to make a film set so far from his native Belgium.
Carol Nahra: Can you tell me a bit about its origins?
Kristof Bilsen: I am always looking for stories that are micro but work on a macro level too. So far I focus on people stuck in a certain reality. In Elephant’s Dream it was people in a post colonial situation, and public sectors workers stuck in a job which didn’t exist. With this film it was to do with my mother; it was very personal. She was suffering a combination of dementia, though not literally Alzheimer’s, for quite a lot of time. We lost her this spring. She was going downhill for many years. Eventually we felt there was a point of no return coming: what would be the best for Mom? Would it be informal care at home? An old-people’s home, care centre? If so what would then be the consequences?
So yes, I threw myself into researching various approaches to elderly care and one of them was thinking “beyond” borders. In my research I found out about this place in Northern Thailand, where only 14 patients get 24/7 care by means of 3 caregivers per patient who do a rota. We initially went there for a two week research trip, where I made a seven minute short, which was really a portrait of place. But while researching and shooting that short I found and fell in love with Pomm. I mainly fell in love with her and Elisabeth because I mainly saw a grandmother and a child rather than a Thai woman and a patient, or a ‘guest’ as they call them. That for me was revelatory as I thought ‘that could be a story’. She could be a character. Without really knowing her back story, it was just the dynamic and bond that struck me as a good way into the story.
CN: Did you know going in that you would focus so much on Pomm and what’s it like to be a mother away from her children?
KB: What I prefer most in making documentary is to trust the process. A story leads you where you need to be. In the case of Pomm that was really key to the film. Pomm quite soon started talking about her children, started talking about what she had to cope with as a single mother. And sort of almost gently diverted me to this is actually the story that we are telling. To really be humble to the process.
CN: We also follow the story of Maya, who suffers early onset Alzheimer’s, and is being moved by her family to Thailand. How did you begin to incorporate Maya’s storyline?
The Alzheimer’s patients are at a certain stage quite down the line. You are limited to what you can film..How much can you empathise? The urge for me was to ideally follow a patient coming from Europe or specifically from Switzerland. It was serendipity because we were gently warned ‘well if want to film a patient, just be aware that it is a very stressful time’. It’s very problematic for a family to allow someone to film like that. They are stigmatised, get a lot of judgements from people in the West, you could say the Christian guilt thing – how do you dare to outsource someone all the way out to Thailand? And then suddenly there was this email coming from the man running the centre, who said ‘well actually you might be lucky, there is this family who will have their wife/mother – Maya – going there. And they are happy to meet you in theory’. So I went to Zurich and met them. Fortunately I had the 7 minute short I could show them, so they at least had a flavour of what I was up to. Plus I was very upfront about my own messy situation – we have our mother, and we are struggling and it’s huge taboo when it’s no longer home care. It was just being very up front and honest with them, and they were like let’s go on the journey together.
CN: How do you go about getting access to patients with dementia who can’t give informed consent?
KB: Well it was quite straightforward, being very transparent and common sense. That is my responsibility as a filmmaker in terms of representation. But then also for the organisation themselves, they had in the past a bit of media attention, specifically in Germany and Switzerland, and some radio pieces here and there, so they know what media can and cannot do. They were themselves quite confident in terms of the situation. But in terms of the patients it was always just a matter of being very clear to the family members – we are filming your beloved mother for example, in the case of Elisabeth – are you okay with us filming – and they would write informed consent.
CN: Did Maya notice your presence at all?
She did. But it was always a mystery how much. It’s interesting because what filming does and what editing does is you really empathise with them – with Maya in the film. Sometimes I feel that it might make them seem more conscious than they are, in the film, on the filmic frame, than in reality.
CN: Do you mean it makes it look like there is more cognitively going on than there is?
Yes, yes. Just because we do the drama shots – you see them leaving and the reactions of Maya. It’s all true but there is at the same time the deep mystery of how conscious are Alzheimer’s patients. How aware are they of the dynamics? I don’t mind that it adds to the empathy. We would also partake in giving care, that was part of the filming process.
CN: How long did it take you to film this?
KB: For me it’s really important that I take my time, that it’s a mixture of poetical and observational but also that the characters get the agency they deserve…So I think I really needed time to tell the story properly – you can’t do it in half a year. Filming technically started in fall 2016 and ended spring 2018. And then there was an editing process of four months. In total we did three trips. It’s not like there’s an incredibly amount of rushes – it felt quite sane. We shot about 50-60 hours, which allowed us to really be with them and be with Pomm, and be with her.
CN: What is your ideal care scenario?
KB: Ideally there really would be a world where there is space and time to give care. So if you give home care you would be supported by nurses that you know and that are affordable and you can really be a team. And you still keep a certain sense of privacy of your family, but you are also are a community. That is an ideal scenario – not an exhaustion route for the beloved partner or children to give care and not be able to talk about it.
CN: What are you hoping people will take away from the film?
KB: I would say a sense of empathy, open to discussion, to see that it’s not something that you need to hide away from – it’s just the continuum of life. We’re also expecting a little one, a little daughter in February. We are going to childcare places and I’m seeing children and toddlers. And the image of someone being so dependent is an image very familiar to me when I see people with dementia or Alzheimers, or more specfically my mother in the weeks before she passed away, that I still had the honour to feed her. For a lot of people that is unimaginable – feeding your parents? Now for me that taboo is gone – I am familiar with that concept. I would like for people to be much more open and kind to the continuum of life.