Our paper focuses on Sarah Polley’s film Away from Her as a commentary on places purposely constructed for care. We draw on cultural and architectural analysis to uncover the film’s reassertion and yet subtle critique of the troubling association of aging with decline, to which dementia provides a shortcut. We analyze the film’s architectural nod to themes of “home,” the importance of natural light and the depiction of circulation spaces as a means to further understand the association of old age with darkness and disorientation. The paper shows how the film’s projection of typologies of “home” is indicative of the continuities and ruptures experienced by residents with dementia and their family members. We demonstrate how Polley’s film uses real-life architecture as a set, such that her characters (who are not yet elderly but who are experiencing what the general public understands to be disorders of old age) navigate the apparently dark and confusing interiors of long-term care, bathed in profuse natural light. While the film is a drama about illness and love, the conflicts about where to live, how to care, and what comprises fidelity, the role of long-term care architecture in Away from Her shows how 21st-century lived experiences of dementia play out away from “home.”
Now, just as Mr. Farquhar’s house was gone, replaced by a gimcrack sort of castle that was the weekend home of some people from Toronto, the old Meadowlake was gone, though it had dated only from the fifties. The new building was a spacious, vaulted place, whose air was faintly, pleasantly pine-scented. Profuse and genuine greenery sprouted out of giant crocks in the hallways. 1Alice Munro, “The Bear Came Over the Mountain”
Alice Munro’s acclaimed short story “The Bear Came over the Mountain” makes fleeting architectural references that shape the life story of the central character, Fiona Andersson, who is diagnosed with “early onset” Alzheimer’s disease. In adapting Munro’s story for an award-winning 2006 film Away from Her, director Sarah Polley chose Freeport Health Centre in Kitchener, Ontario, designed in 1989 by the Toronto branch of NORR architects, to stand in for Andersson’s final residence, Meadowlake Retirement Facility. We explore the role of architecture as constructed in the facility itself and in Polley’s film, focusing on how each articulates, counters and —paradoxically—also reinforces fears of dementia. We draw on cultural and architectural analysis to uncover the film’s reassertion and yet subtle critique of the troubling association of old age automatically with decline, to which dementia provides a shortcut. To do so, we focus on how the film projects typologies of “home,” indicating the continuities and ruptures experienced by residents with dementia and their family members.
We use the framework of critical gerontology for our analysis of the portrayal of long-term care architecture in Away from Her, particularly its focus on cultural meaning as a “symbolic/social/ideological/construct” 2Gullette 104. While dementia and old age are by no means synonymous, we draw here on a cultural slippage between them. Dementia is not the sole province of older adults, but culturally it is associated with old age. Thus, even the portrayal of Fiona’s early onset Alzheimer’s disease in Away from Her participates in a cultural discourse about aging. As Sally Chivers has argued, dementia functions as a sort of shorthand for old age in cultural representations, and especially for the parts of growing old that the general public most fears: losing control of the mental and physical self 3Silvering Screen. Cultural gerontologist Hannah Zeilig argues, “Understanding the internal worlds of people as they age and as these relate to the material, lived conditions of older people is an area of intense interest for critical gerontologists” 4“Critical Use” 20. Like sociologist Stephen Katz, we believe that narrative is an excellent vehicle for teasing out connections “because it anchors the inside of aging, bringing together self and society and animating our biographies as we borrow, adapt, interpret, and reinvent the languages, symbols, and meanings around us” 5np. Further, Zeilig points to a common metaphoric association of darkness and shadows with both dementia and Alzheimer’s disease, stating that the darkness is “often contrasted with light, the light of possible medical advance” 6“Dementia As a Cultural Metaphor” 4.
Long-Term Care as a Home
We show here how Away from Her’s emphasis on natural light and depiction of circulation spaces illustrates attempts to cover up generalizations such as “old” and “sick.” The architecture gestures towards a general notion of “home,” while avoiding the particularities of the residents’ former homes. Our examination of the film’s depiction of Meadowlake and the real-life Freeport Centre suggests that architectural devices, particularly references to home, occur neither in isolation nor as a fabricated fiction. Rather, architects frequently employ them in the production of social and cultural values and norms associated with healthcare and aging. That is, an emphasis on daylighting and wayfinding over, for example, the role of artwork and personal possessions, reveals an assumption that adults moving into care need to be reassured that late life is not necessarily a descent into darkness and disorientation, more than they need to be reassured that they will be able to maintain personal aesthetic control over their environments. Environmental Gerontologist Habib Chaudhurypoints out that, “Facilities designed on the medical model of care can promote the adoption of generalized social roles, such as ‘old’ and ‘sick,’ and deprive individuals of their familiar and meaningful environmental past” (9). Wayfinding and daylighting, closely associated with hospital design, provide a link to such stereotyped identities. Other architectural features, such as mimicking related or nearby buildings, can better evoke the familiar, place and historically based, meaning of home.
After discussing three different contexts of home within the film, we examine its engagement with the concepts of natural light and circulation in long-term care architecture in order to illuminate how spaces constructed for care both challenge and reinforce relationships among aging, illness, care, isolation, and immobility. The drive for light and clear orientation presupposes two important assumptions about old age: firstly, that it is a dark, introverted, and isolated life stage and, secondly, that mobility and the ability to navigate will be severely diminished as we age. The absence of, for example, a drive for personal possessions and individualized artwork presupposes another assumption that as people age, their need for identification wavers. While natural light and circulation are desirable in long-term care design, the way in which Away from Her exaggerates their use at Meadowlake reveals a set of anxieties about what they replace from residents’ former lives.
In Away from Her, architectural references to domestic life combined with hotel architecture reveal tensions that reflect the crisis around which narrative films about old age typically revolve: namely, where should the frail old live? We focus especially on the ways in which Away from Her contrasts a set of home spaces while commenting on the hospital- and hotel-like nature of long-term care. The prevalence of “homelike” in describing long-term care is plagued with historic associations; as historian James Struthers’s research on Ontario home care shows, these spaces emerged in reaction to the smaller, modern homes of postwar families, and so truly were seen as homes which provided familial comfort 7341–342. Gerontologist Graham Rowles and Chaudhury make clear that the concept of “home” is rich in ambiguity and ambivalence, meaning different things according to context and within various disciplines, and to individuals. They note that it gains its potential because people not only conceive of but also experience home which “is associated with defining, maintaining, and recreating self-identity” 816. Thus home is both an idea to which people attach personal significance, particularly in terms of a sense of belonging and wellbeing, as well as a physical site that people navigate in a phenomenological sense. This multiplicity makes all the more interesting the ways in which Away from Her uses concepts of “home” and “homelikeness” in its plot and setting, showing how those ideas are inadequate disguises for the above named assumptions about old age and the necessarily institutional nature of a long-term care setting. House designers also employ techniques such as clear circulation paths and daylighting, within reason. Wayfinding, however, is mostly unnecessary in residential settings and daylighting is much easier in a structure with a smaller footprint. Their emphasis within Away from Her illustrates something most of us take for granted: that nearly all long-term care settings include these special provisions. Courtyards, in particular, are one of the signature features of long-term care architecture, allowing us to “read” the building’s use from afar 9the way a steeple might function in a church.
Away from “Home”
Away from Her offers a love story combined with an Alzheimer’s narrative. The film’s reviews feature these two genres jousting for prominence: some critics read the film as a heart wrenching romance interrupted by illness and others as illness narrative enhanced by a tale of a lover’s devotion. Cultural critic Anne Davis Basting explains that elements of Away from Her “[capture] a significant shift in mainstream stories of dementia.” Specifically, she argues that “rather than focus on tragic decline, Away from Her looks for moments of grace, eschewing the linear plot line that seeks climax and resolution”1048. In their search for grace, Julie Christie and Gordon Pinsent play Fiona and Grant Andersson, a couple grappling with Fiona’s diagnosis while they continue to come to terms with Grant’s past philandering. When Fiona concedes that there is no place that will suit them as a couple, she adds, “I think all we can aspire to in this situation is a little bit of grace.” This plot only retrospectively portrays what is so often the climax of the dementia story—a decision about where to live. The structure leaves considerable narrative room to explore care spaces, care choices, and their ramifications. After Fiona gracefully decides that she ought to enter institutional care alone, Grant must demonstrate his dogged love for her, and he does so navigating the corridors of Meadowlake for most of the film.
Away from Her plays up a seemingly outdated policy and illustrates how quickly Fiona forgets her home space in order to amplify the transition from family home to institutional home. Anthropologist Robert Rubinstein and gerontologist Kate de Medeiros point to the lack of scholarly work on the effect the transition from home to long-term care has on late life selfhood and identity 1158. Away from Her plays with this topic with regard to the relationships long-term care residents form after they move. Once Fiona decides to move into institutional care, Grant visits Meadowlake to reassure himself that it’s a suitable new residence for Fiona. He learns that the institution enforces a policy that new residents cannot receive visitors for their first thirty days of living there. As supervisor Madeleine Montpellier 12Wendy Crewson explains to Grant:
Before we had the rule in place, they’d often forget over and over again why they were being left here. Whereas we find, if they have a month to adjust, they end up happy as clams. Meadowlake’s their home then. After that it’s perfectly fine for them to take a little visit home every now and then. 13emphasis added
It is telling that, in Madeleine’s explanation, both Meadowlake and where residents had lived before the move are described as “home.”
Rowles and Chaudhury explain this tension between institution and home as a dialectic. As they describe it, “home” is defined in relation to places that are “not home.” They question how this adjustment works for residents and explain that “residential care environments…strive to create a homelike physical and social environment within an organization/institutional framework” 1415. Grant, having failed 15once he is allowed to visit to ignite Fiona’s past interest in her ancestral home of Iceland, convinces her to visit their Ontario home in the guise of a field trip. After staring in awe at her formerly familiar surroundings, she says “they’ve kept it so like it was” 16emphasis added. Fiona continues after Grant’s prompt: “the people who live here.” They walk outside where after her memory fails her she asks to go back “home,” meaning Meadowlake. Thus Polley sets up Fiona as a character who neatly demonstrates the effectiveness of Montpellier’s thirty day moratorium on visits from the institution’s perspective and its harm from the perspective of potential visitors. The fictional policy, then, amplifies the film’s focus on Meadowlake Retirement Facility as a chosen home.
In her adaptation, Polley sets up a revealing interplay among disparate home spaces: the cottage Fiona has left, another resident’s house, and Meadowlake. During Fiona’s first month at her new “home,” she seems to have forgotten Grant and fallen for fellow temporary resident, nonverbal but expressive Aubrey Burke 17Michael Murphy. When Aubrey leaves Meadowlake after his wife, Marian 18Olympia Dukakis, has had what respite she can afford from the rigors of providing her husband’s care, disconsolate Fiona so moves Grant that he seeks out the other couple 19the Burkes in their tract home to beg Marian to allow Aubrey to return to Meadowlake. The film engages three key domestic settings to mark different mindsets of the characters and to reinforce the gravity of the decisions facing all of them. Of home, literary scholar James Krasner says, “The physical organization of the home becomes a representation not only of the owner’s identity but also of his or her life story” 20213. Aubrey’s and Fiona’s houses are quite different, yet both characters make Meadowlake their home. The contrast indicates a perennial challenge to long-term care designers: how to capture and conjure up a universal image of home to residents of various backgrounds with different life stories. Indeed, architecture—like foodways, furniture, music, and holiday traditions—plays a central role in the differentiation of long-term care settings for cultural groups such as Italian or Jewish populations, and more recently for newly visible residents such as aging same-sex couples who wish to remain living together.
Grant and Fiona’s rural cottage offers a domestic space in which the couple has grown older and more comfortable together (fig.1). Described in the script notes as “warmly lit,” “old and large but not ostentatious,” the cozy, lakeside cottage has picturesque, asymmetrical massing and an uneven mix of fieldstone and wood cladding 216. A massive steeply pitched roof emphasizes the home’s protective function. Tiny dormer windows in the midst of the roof allow film viewers to imagine Grant and Fiona’s romantic attic bedroom characterized by slanted walls and unexpected shapes. Three chimneys, including a massive central one, mark the locations of their interior fireplaces. The spaces on the ground floor flow into each other as scenes markedly juxtapose the characters viewing one another from adjacent rooms. For example, the kitchen is visible from the dining room. The cottage is older, rustic, and its interior is untidily draped in earth-tone textiles. Their home is a poignant example of a building that tells a story, as Fiona inherited her parents’ house, which then served as a retreat when Grant had to leave his university job—where he had affairs with students—to preserve his marriage.
Fiona and Grant live in a rural setting, whereas Marian and Aubrey’s Colonial 1960s two-story home—pitched roof, grey non-structural brick, white aluminum siding, peacock blue shutters and two-car garage—is set in a neat suburban setting and this tidiness extends into every aspect of their situation (fig.2). The house and its setting reflect the ubiquitous, mass-produced, predictable site and cookie-cutter architecture of postwar housing, where conformity was all-important. The film depicts the nicely manicured lawn and shrubs as becoming unkempt since Marian is struggling financially.
Both homes imbue the characters with their internal worlds. Many touchstones demonstrate Fiona’s decline. For example, the cottage kitchen holds a dated fridge in which Fiona mistakenly places the frying pan while the couple hand-dries the dishes together after a meal. The next time we see their kitchen it is cluttered with post-it notes as triggers to abet Fiona’s fading memory. By contrast, Marian and Aubrey’s postwar suburban home includes a bright kitchen with the newest appliances, each in its place; this space offers Marian slight escape from her care duties surrounding Aubrey, who is fixated on the sports channel in the adjacent room.
The Burkes’ home space mediates between the Anderssons’ cozy cottage and Meadowlake in that the suburban home is demonstratively neat and organized: “the house of a truly practical person. Everything is polished and organized, complete with a plastic runner down the hall to protect the carpet” (Polley “Script Notes” 25). The domicile portrays a clean home with carefully protected wall-to-wall carpeting and all the latest gadgets purchased by Marian and Aubrey’s absent son: “coffeemaker, food processor, knife sharpener, and some things Grant didn’t know the names or uses of” (Munro “Fiction”). By contrast to the populated kitchen, the house’s austere concrete veranda and lifeless interior presage the ways in which Meadowlake, with its accessible corridors and attractive common areas, shares the superficially domestic qualities of a 21st-century, middle-class home.
The long-term care facility Meadowlake represents both a respite and an exile from the more conventional house structures of the romantic cottage and the standardized suburban home. Because of its obligatory communality, Meadowlake has several archetypal spaces, such as the corridors, the courtyards, the communal dining rooms, the television rooms, the private patient rooms, and the locked second floor for advanced cases. Note the absence of a kitchen where most scenes take place in the homes of both the Burkes and Anderssons. With the exception of the patient rooms, these spaces demonstrate a passage from outside freedom / potential danger to internal restriction / safety.
Meadowlake’s architecture differs from the Andersson’s cozy, lakeside home in every possible way. While their own home is intimate, unique, rustic, and full of family memories, Meadowlake is large 224 stories, constructed of hard-edged red brick, and sanitized of any personality. The script describes Meadowlake as a “clean, bright facility,” and emphasizes these features during the introductory tour of the facility 2327.Unlike the Andersson’s home, Meadowlake’s interior is sparsely decorated with the same basic furniture in each room. Instead of the neutral textiles prevalent at the Andersson’s, Meadowlake has an institutional color scheme of pink and green.
In reality Kitchener’s Freeport Health Centre is an award-winning reuse of a former tuberculosis sanatorium as a chronic-care hospital. Its barrier-free plan garnered it a prize, but its overall planning concept of simulating a village, complete with a courtyard cum town square, distinguished it from many of its predecessors in long-term care architecture 24Walterfedy.Freeport is a red brick building with extruded gables broken from the primary mass with teal-framed storefront windows. The building relays its functions exuding the contrast between public and private, or the public rooms and patient rooms.
Since 1999, many institutions emulate the family home in their RHA 25Resident Home Areas as prescribed by Ontario’s Long-Term Care Home Design Manual 26Ministry of Health and Long-term Care. These “smaller, self-contained units within the long-term care home…give residents more intimate and familiar living spaces,” claim the report’s authors 272. Freeport, as a hospital built a decade before this mandate for long-term care, clusters resident rooms around public spaces in an attempt to diminish the building’s large scale. Significant for our exploration of architecture is the way its designers included an explicit nod to its new function as a “residence” in the multiple gable roofs, protruding bays, and apartment-house style entry. Note, too, that the number of stories in the building’s elevation is ambiguous (fig. 4). All these architectural features conjure up a caricatured, simplified, postmodern understanding of the history of home that Polley includes in her film as Meadowlake, perhaps as an attempt to soften the image of the 350-bed, institutional facility and to persuade Grant, Fiona, and thousands of other North Americans like them to see it as a real extension of the family home.
The tension between institutional and home architecture is made visible to film viewers through the differences between the characters of Meadowlake’s patronizing administrator Madeleine and the empathetic nurse Kristy 28Kristen Thomson, whose pink scrubs match Meadowlake’s walls. During Grant’s tour of Fiona’s potential new home, Madeleine, with her “pasted-on smile,” offers viewers a focus for their potential frustrations about the corporatization of the care space. By situating the “institutional speak” in the supervisor character, the film allows other care workers, especially nurse Kristy, to convey a more welcoming homelike atmosphere. In contrast to Madeleine’s scripted facility tour, Kristy is portrayed as thoughtfully guiding Grant through the lived experience of Meadowlake. Madeleine claims that Meadowlake’s thirty day separation policy reduces confusion for new residents, but Kristy declares that the policy in fact exists to “[make] it easier on the staff.” Moreover, the obvious strain between Kristy and Madeleine reflects the tension between what viewers might desire of paid institutional care—the individual attentions of a caring nurse who reads aloud to patients and makes them feel “at home”—and what viewers fear most of the need to “resort” to institutional care—a sterile rigid environment, presented as homey but efficient, as exemplified by a characterless woman in a suit.
Historian Andrew Sandoval-Strausz argues that homes indicate wider social beliefs tied to individual mores: “In most societies, people’s relationship with their dwellings is more constant and permanent than with any other part of the built environment. As a result, homes are much more than just places of residence: they become expressions of self and community, repositories of individual identities and shared values” [ref[264[/ref]. Krasner explains, “The elderly home is more like a fictional world than most spaces, because every path and every object is likely to be ‘storied’” (218). Away from Herpresents Meadowlake as an institutional facsimile of a home that imposes artificial identities, which rely not on the resident’s own recollections or stories, but on collective memories or on ideas of what those memories and stories ought to be. Thus, in Figure 5, Fiona’s room is marked by her name and an association with corn, an aesthetic that has nothing to do with her past, but represents her name to the staff and gives an appearance of a rural past to visitors passing in the hallway. Such touches display the “homelikeness” of the residences as well as the limited connections the individual residents have to their private spaces. However, since the imagery is so unlike what residents would have needed or probably even wanted in their previous homes, they underscore the transitory nature of the new locale and the need for temporary nameplates within a de-personalized location. Similarly, whereas at “home” in her cottage, Fiona is typically draped in sweaters just as the cottage is “draped with earth tones and textures,” at Meadowlake, Grant is appalled to find her wearing an orange cardigan that is not hers, that is the same shade as the institution’s brick exterior and that is decidedly not her past style of clothing.
Long-Term Care as Temporary
As much as the film portrays Meadowlake as a new, neat version of a home, it also characterizes the facility as a temporary place, like a hotel. This impermanence may make the transition to care easier for many residents; however, the very name long-term care challenges that notion of ephemerality. Indeed, some residents, such as Fiona, have chosen to move into care for the duration, whereas others, such as Aubrey, stay at Meadowlake for the short term, at least initially. Thus, these divergent opinions on the temporality of long-term care homes allow potential residents and their loved ones some variability in their acceptance of change. It is always understood, however, that even those residents who are “permanent” will only last so long. In Ontario, the average length of stay is three years; after that time forty-two percent move into hospitals and thirty-two percent die 29Alder.
A “hotel-like” atmosphere also shapes the expectations of would-be residents. Architect Elaine Caouette points out that “the most preferred building type, representative of an ideal nursing home, in [her] study, was in fact a real hotel” 30273. Prior to leaving the cottage, Fiona speculates that during her stay at Meadowlake, she will be “dressed up all the time. Or semi-dressed up. It’ll be sort of like in a hotel.” Despite its explicit gestures to the tradition of domestic design, Meadowlake’s architecture points to the suburban or roadside hotel in its scale, massing, kitschy pitched roofs and automobile-dependent entry sequence. Familiar roadside chain hotels like the Hampton Inn, seen across the North American landscape, share with long-term care facilities a strict division of private and public spaces, and a system of double-loaded corridors with a repetitive or modular room design.
However, for Fiona the institution will function as much like a hospital as a vacation spot. She is quickly marked as one of the residents who will only briefly belong on the first floor, where social activities and residential spaces are geared to the older adult residents. She soon moves up to the second floor, “the extended care wing” with “a lock down system” where, Grant notices, the radio appears to play solely for the careworkers’ enjoyment and where residents transform into patients. Pallasmaa relates “descending a stairway to the main floor in films … to entry into the public sphere and self-presentation” 31“Stairways of the Mind” 13. In this narrative, the opposite movement occurs — an ascension by elevator marks the removal of the person from the public sphere and everyday life. Such scenes provide critical commentary on this typical movement within long-term care facilities, whereby the medical conditions of residents determine their location, exactly like a contemporary hospital. Spatial location, that is, serves as a barometer of mental and physical wellness.
Daylight and Transparency to Compensate for a Confused Mind
Lighting provides a point of both continuity and contrast among the home spaces in the film, evident in the differences among the “pink sunset light” that Fiona enjoys outside her cottage, Meadowlake’s choreographed brightness in shared spaces and the controlled lighting of what will become her new institutional, urban home 32Polley “Script notes” 23A. Both the film and the facility place a premium on the importance of natural light inside the building.
Because the one-dimensional supervisor Madeleine is the character that draws Grant’s 33and viewers’ attention explicitly to the corridor’s brightness, that light-filled space remains suspicious and never free from its associations with institutional space and bureaucratic control. Significantly, many scenes featuring the corridor involve Madeleine, and most scenes featuring Madeleine involve the corridor. A particularly poignant moment of the film is when Madeleine leads Grant “down a long bright hallway, blasting with light.” She emphasizes: “As you can see, we get a lot of light.” Grant responds, sardonically: “Yes. I see that.” To emphasize this fact, the cinematographer over-exposes the scenes involving the hallway, referred to by the architects as verandahs 34“Freeport Hospital Health Care Village”, so that the image is not only brighter, but the brightness obscures the perception of the exterior context, thus leaving the patients mobile, but without clear destination. Madeleine boasts about the institution’s quality of light almost as a consolation prize to those who enter, as if the bright light might compensate for the free movement outside the building that is sacrificed upon entry. She points to an architectural tool— abundant daylighting —that she assumes will be most important to Grant, perhaps to distract him from the new locale’s other shortcomings.
Madeleine’s pushy references to natural light and to the physical layout of Meadowlake, then, mask the insidious assumptions that Fiona should be content with a hallway of light, after years of outdoor recreation such as cross-country skiing. To heighten the connection, the sound of Grant reading from medical descriptions of Alzheimer’s disease serves as background to an image of him skiing alone outside their cottage. As his voice describes dissolving brain synapses “like a series of circuit breakers in a large house flipping off one by one,” he turns to see the lights in the cottage going out, one by one. The implication is that the natural light in Meadowlake will compensate for the lights “going out” in Fiona’s brain.
Like explicit references to light flooding the corridor, interior windows in the film propel Grant’s distrust of Madeleine. The windows allow her to carefully oversee patients and visitors’ movements and, as is shown in Figure 6, Grant keeps walking as she calls his name from her office. The space presents image of a “transparent” administration that carefully oversees Grant’s visits. This may be particularly important in Canadian institutions where administrative transparency is broached through increasing regulation. Indeed there are some 333 different standards in Ontario alone that long-term care residential settings are supposed to meet 35Long-Term Care Homes Act, 2007 – O. Reg. 79/10. Banks, hospitals, courthouses, and many other building typologies rely on this same effect. If we can “see” what transpires in a space, we supposedly implicitly trust its occupant. While Madeleine may appear to offer a transparent view of the management and operations of Meadowlake, a residence that suits Fiona quite well, Grant plays the role of the abandoned spouse who does not like what he sees and dislikes the rote nature of the institution’s policies, symbolized by its abundant illumination.
Wayfinding Spaces as Places for Interactions
Architects maximize daylighting in long-term care facilities with interior glazing to distribute natural light. By organizing the building around a large courtyard, designers can provide more interior spaces with windows and larger spaces, such as dining halls, with windows on several sides. Such courtyards are completely enclosed spaces open to the sky and, in general, function as excellent orienting devices; they are also a common way that architects break down the scale of massive buildings. And like the view from the all-important windows mentioned already, a courtyard offers a tiny piece of the outside world to those stuck inside. The site plan 36fig. 7 of the real Freeport Health Centre shows the two 1980s patient pavilions 37numbered 2 and 3 in fig. 7 and auditorium 38numbered 5 that were added to the original hospital buildings 39numbered 1 and 4 intended for tuberculosis patients and administration, thus creating a large courtyard.
Long-term care courtyards in the film offer a space of escape to Nurse Kristy. While she converses with Grant while enjoying a cigarette in this pseudo-outside space, Grant finally faces his fear that Fiona is ready for the dreaded second floor, a place reserved for serious cases who have little hope of escape from the institutional realm, or, as Kristy puts it, “people who have really lost it.” A stack of white patio chairs, stored but still outside in winter, reinforces that this is an outdoor collective leisure space, as well as the closest outdoor spot for workers to use on break. The ensuing exchange is the film’s only scene in which Grant is openly admonished for his sanctimonious, too-late devotion to the wife he had betrayed sexually. Kristy confronts him, throwing his own words about Fiona “punishing” him back in his face. Freed to some extent from the institutional moorings by her courtyard setting, Kristy strays from her role as Grant’s supportive listener to act momentarily as Fiona’s advocate. A high angle shot from the perspective of Fiona who is standing indoors peering out a window ends the scene, reinforcing that this view is now her sole experience of the outdoors. The contrast reinforces the false hospitality of the interior Meadowlake world. These spaces function as a simulacrum, with the falseness implied by that term, of the outside world, the world that residents have left behind, or in Fiona’s case lost, as Kristy has suggested.
Like the courtyard, the hallways and common spaces offer patients a glimpse of the outside and a modest place for ambulation. Many times in Away from Her, patient interactions occur in circulation spaces and elevator lobbies complete with their “profuse and genuine greenery” 40Munro “Fiction”. Freeport’s architects, as we see from the plan in Figure 8, minimized circulation, clustering rooms to provide a variety of shapes, views and perhaps more intimate relationships among users. The film emphasizes this by having the camera track forward following Grant as he walks through the hallways, amplifying his progress, but track backwards while Fiona walks forwards, making her appear to be making no progress through her new landscape.
When Krasner illuminates the metaphorical patterns 41employed by gerontologists that relate environment to identity, he emphasizes the metaphor of “easy motion through a landscape” 42211. Similarly at Meadowlake, tiny patient rooms mean the only chance for real movement and socialization is in hallways, staircases or the all-important dining room/lounge, where games and television help to pass the hours, with or without visitors. Environmental scholar Leonie Kellaher speaks of this issue in residential care homes, writing that “the space which accommodates the person and the essentials is generally too confined for the resident to tolerate for extended periods and the individual is thus drawn into the public arena—sometimes unwillingly” 43224. Polley adds to Munro’s story a retired hockey play-by-play commentator, Frank, who brings comic relief, helps to exteriorize Grant’s emotions, and draws attention to the circulation and lack of circulation of residents. The first thing viewers learn about Frank, besides that he offers all present a play-by-play ongoing commentary on the workings of Meadowlake, is that he already lives on the second floor. He points out in his unmistakable hockey-announcer tone, “we’re going back up, back up to the second floor.” His last appearance repeats this reference but with greater weight for Grant who is facing the realization that Fiona is going to have to ascend. Frank passes Grant declaring, “and we’re back in Meadowlake, going back to the second floor, and passing a man with his heart broken on the left, broken in a thousand pieces.” Even this patient, Frank, who has “lost it,” perceives the emotional significance of enhanced restriction to Fiona’s circulation. Polley situates his interaction with Grant—an unintentionally invasive public commentary on Grant’s obvious interior pain—in a pivotal circulation space 44both hallway and elevator lobby emphasizing the forced sociality of Fiona’s new home.
In Away from Her the games table marks Fiona’s betrayal or forgetfulness. Her devotion to Aubrey’s card playing makes her unavailable to Grant who lingers sadly, often holding a bouquet of flowers. While the dining room, where the game is played, marks a social space in Meadowlake, Grant does not get to socialize with Fiona there. Instead, he is off to the side, receiving guidance from Kristy or commiserating with put-out teenage visitors who are even more bored than he is. The layout’s grating insistence on the importance and existence of social worlds for Meadowlake’s residents illuminates Fiona’s abandonment of Grant. It is in a brightly lit corridor space that he picks up a paper she has dropped, and, while returning it, he discovers it to be a portrait of Fiona, remarkably well drawn by Aubrey, who at this point is a rival for Fiona’s affection. Grant is forced to sorrowfully accept that her social existence, even without him, is better than its feared opposite: the isolation that follows those who are unable to circulate, of the residents who cannot participate in the common rooms, and who are on the second floor. The scene in Figure 9 brings this haltingly to viewers’ consciousness as Fiona leaves Aubrey at the gaming table to speak to Grant and Aubrey is left unable to play, thus demonstrating their co-dependence.
Fiona confronts a situation much feared at this contemporary demographic moment: that is, she faces health conditions that will require more care than she can expect to receive at home, and she must decide where to live. In Fiona’s own words, her mind appears to be “going” and, as though mirroring that disappearance, familiar buildings are transformed from a “drafty brick house” to a “gimcrack sort of castle,” such as that of her former neighbor 46Alice Munro “Fiction,” also quoted in epigraph. The logistics of film 47i.e. shooting on location require Polley to elaborate on Munro’s description of architectural features, making them central to the story of aging and illness. Our focus on the film thus offers a way to interrogate how Polley’s filmic images of home and homelike spaces for dementia care transform Munro’s story into a vivid commentary on current fears about late life as automatically associated with decline. We have used the example of Away from Her to show how a cultural studies scholar and architectural historian, working together, can contribute to understanding how a film representation of architectural space can reveal popular assumptions about long-term residential care.
The provision of abundant daylighting and clear wayfinding is material evidence of a pervasive fear that old age will bring reduced mobility or trouble with orientation; we are not suggesting that such fear is misguided, only that a study linking film and architecture can show how space functions as a gauge of such fears. Indeed, it is Fiona’s potential move upstairs, and not her alliance with Aubrey, that breaks Grant’s heart into a thousand pieces. Many scholars believe that architecture “reflects” some sort of social and cultural reality; our case study of long-term care in film is a way of complicating that understanding by seeing architecture not only as passive reflection, but as actively engaged in the communication of social and cultural norms/ideas.
References to domestic and hotel architecture exhibit the crisis around which narrative films about old age typically revolve, namely anguish about where the “frail” character should live when chronic care becomes necessary. Krasner concludes that “to understand the determination of the elderly to remain at home as long as possible, and thus judge the best way to ease their transition out of it, we must recognize the importance of materiality to home-based metaphors of identity” 48228. Indeed, we have shown how Polley’s film uses real-life architecture as a set and adds narrative elements that exaggerate components of that architecture in a way that illustrates the continuities and discontinuity of concepts of home for residents who move into long-term residential care. Instead of navigating the dark and confusing interiors of long-term care, Polley’s characters 49who are not yet elderly but who are experiencing what the general public understands to be disorders of old age are bathed in profuse natural light that illuminates the loss of what they have left behind. While the film is a drama about illness and love, the conflicts about where to live, how to care, and what comprises fidelity, the role of long-term care architecture in Away from Her shows how contemporary lived experiences of dementia play out away from “home.”
1 This research was supported by the Social Sciences and Humanities Research Council of Canada as part of their Major Collaborative Research Initiative. Pat Armstrong, York University, Principal Investigator [file#412- 2010-1004]. We are grateful to McGill University architecture students Frederika Eilers and Eve Lachapelle for research towards this paper and Trent University Canadian Studies student Anne Showalter for her feedback. We also thank Frank Panici, NORR Ltd.
The story was first published in The New Yorker and subsequently in Alice Munro, “The Bear Came Over the Mountain,” in Hateship, Friendship, Courtship, Loveship, Marriage: Stories.
 For example, Cultural Landscapes as popularized by geographer Carl Sauer holds that “Culture is the agent, the natural area is the medium, the cultural landscape is the result” 50qtd. in Wilson and Groth 5. Thus, culture plays an active role in the construction and formation of the built environment. Note also Lamster’s claim that “film has had a profound effect on both the way architects envision their work and the way the public consumes architecture” 512.
For examples of these reviews, see Sean Axmaker, “Poignant Away Paints a Painful Portrait of Loss,” Seattle Post-Intelligencer, 10 May 2007; Sean Burns, “Now Comes the Night,” Philadelphia Weekly, 16 May 2007; Geoff Pevere, “Away from Her: A Marriage Adrift,” Toronto Star, 4 May 2007.
 For mainstream examples of dementia plots that focus on the difficult decision to move the person with dementia into care see Iris 522001, A Song for Martin 532001, and The Savages 542007.
 In fact, there has been much research on the connection between homelikeness in architecture and relief of dementia symptoms 55Zeisel and Tyson 439.
 In Munro’s story, the neighborhood is described thus: “The houses all looked to have been built around the same time, perhaps thirty or forty years ago. The street was wide and curving and there were no sidewalks. The front walk was paved with flagstones and bordered by hyacinths that stood as stiff as china flowers, alternately pink and blue” 56“Fiction”.
 Mark Franklin, architect and critic, describes a related practice at Baycrest in Toronto. He explains that at Baycrest a “glass cherry display case” outside each apartment “acts as a formal repository…Whether the display of these objects is the result of a distillation of a lifetime of personal effects or an assertion of ownership, the rooms and their display cases are charming, their emotive and symbolic power touching” 5732. Previously, Adams and Chivers reported that while these memory boxes intend to differentiate residents, observations in facilities uncover that the boxes serve to homogenize identities. 5889
While we have not conducted formal interviews for this phase of the research, one of the authors had occasion to speak to Polley about this detail of the patronizing administrator’s focus on natural light. She told one of the authors that she included it based on a number of tours she went on of Ontario facilities on behalf of her grandmother, which included this bright insistence as a way to cover up the doom and gloom inside.
 Freeport Health Centre and its portrayal as Meadowlake is not unusual for its courtyard hallmark, as is evident from a perusal of current long-term care architecture where the courtyard design is taken to an extreme. For example, the massive interior atrium in Toronto’s award winning Baycrest Apotex Centre, designed in 2000 by local architects Diamond + Schmitt as a long-term care addition to the existing hospital, features real trees, overhanging balconies, even the use of exterior cladding inside the building to simulate an exterior courtyard. This atrium engages an analogy of a luxury hotel; unlike Meadowlake, there is no confusion of a moderately priced, road-side hotel like the Hampton Inn. As well as looking like a luxury hotel, the Apotex Centre could also be mistaken for a shopping mall. Baycrest’s atrium is not part of a mall or luxury hotel, but rather it accommodates 472 long-term care patients 59with 100 bed available for patients with cognitive disorders.
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About the Authors
Sally Chivers is Professor of English Literature and Founding Executive Member of the Trent Centre for Aging and Society at Trent University. She is the author of From Old Woman to Older Women: Contemporary Culture and Women’s Narratives and The Silvering Screen: Old Age and Disability in Cinema, as well as journal articles and book chapters on representations of aging and disability in Canada and beyond. She is also the co-editor of The Problem Body: Projecting Disability on Film.
Annmarie Adams is Director and William C. Macdonald Professor at the School of Architecture, McGill University, Montreal. She is the author of Architecture in the Family Way: Doctors, Houses, and Women, 1870-1900 (McGill-Queens University Press, 1996), Medicine by Design: The Architect and the Modern Hospital, 1893-1943 (University of Minnesota Press, 2008) and co-author of Designing Women: Gender and the Architectural Profession (University of Toronto Press, 2000).
Notes [ + ]
|1.||↑||Alice Munro, “The Bear Came Over the Mountain”|
|4.||↑||“Critical Use” 20|
|6.||↑||“Dementia As a Cultural Metaphor” 4|
|9.||↑||the way a steeple might function in a church|
|13, 16.||↑||emphasis added|
|15.||↑||once he is allowed to visit|
|25.||↑||Resident Home Areas|
|26.||↑||Ministry of Health and Long-term Care|
|31.||↑||“Stairways of the Mind” 13|
|32.||↑||Polley “Script notes” 23A|
|34.||↑||“Freeport Hospital Health Care Village”|
|35.||↑||Long-Term Care Homes Act, 2007 – O. Reg. 79/10|
|37.||↑||numbered 2 and 3 in fig. 7|
|39.||↑||numbered 1 and 4|
|41.||↑||employed by gerontologists|
|44.||↑||both hallway and elevator lobby|
|45.||↑||from the film Away from Her|
|46.||↑||Alice Munro “Fiction,” also quoted in epigraph|
|47.||↑||i.e. shooting on location|
|49.||↑||who are not yet elderly but who are experiencing what the general public understands to be disorders of old age|
|50.||↑||qtd. in Wilson and Groth 5|
|55.||↑||Zeisel and Tyson 439|
|59.||↑||with 100 bed available for patients with cognitive disorders|