Remembering Philip Seymour Hoffman, long-term care firebrand

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Tim Mullaney
Tim Mullaney

When Philip Seymour Hoffman died on Feb. 2, the world lost one of its great actors — and one of the most persuasive voices to speak out about the pitfalls of the changing long-term care system in the United States.

OK, Hoffman himself wasn't a critic of the nation's long-term care system, but in the role of Jon Savage, he delivered a blistering and relevant diatribe against a certain type of provider.

In “The Savages,” released in 2007, Hoffman and Laura Linney played siblings, Jon and Wendy, who have to place their father in long-term care. When Jon finds Valley View, a skilled nursing facility near his home in Buffalo, Wendy balks.

“I thought we were going to try assisted living,” she says.

“They're not going to take him in assisted living, let's be real,” Jon replies. “He's got dementia.”

Jon's haste to get his father into an open bed is motivated at least in part by his own cynicism. “Believe me,” he tells Wendy, “once you get inside, these places are all the same.”

Wendy doesn't share her brother's blasé approach and frankly expresses her concern with the institutional atmosphere at Valley View, featuring cramped semi-private rooms and a traditional, hospital-style layout. She becomes enamored with Green Hill Manor, an upscale senior living provider that markets itself in glossy pamphlets as “distinctive,” “innovative” and “stimulating.” She secures an interview, but undermines her father's chances of admission by trying to feed him answers to an administrator's questions.

After the botched interview, Jon confronts Wendy in the Green Hill parking lot. After reminding her again that their father has dementia, he says that their father isn't the one who has “a problem with Valley View.” Wendy is the one who doesn't like the more institutional facility, and her guilt is what places like Green Hill “prey upon,” he says.

“The landscaping? The neighborhoods of care? They're not for the residents, they're for the relatives,” he says. “People like you and me who don't want to admit what's really going on. People are dying, Wendy. Right inside that beautiful building, right now, it's a horror show. And all this wellness propaganda, and the landscaping, it's just there to obscure the miserable fact that people die.”

Watching this scene in 2007, I sensed that Jon was being too jaded for his own good — or his father's — and yet I also caught a whiff of truth in what he was saying. The scene stayed vivid in my memory thanks to that complexity, expressed through Hoffman's nuanced performance.

Now, seven years later, I found that this scene has taken on even more complexity — so much so, it was painful to watch. Given the horrible circumstances of his own death, it's difficult to hear Hoffman talking about this subject. But his speech also sounded disturbingly less cynical to me now than it did when I first saw this movie. Whereas I used to think that Jon was using his father's dementia basically as an excuse to dismiss Green Hill, I now wondered if he was doing his father a big favor by keeping him out of a setting that would be eager to have him — but would not be equipped to care for him.

In fact, Hoffman seemed at times practically to be channeling Larry Minnix's impassioned response to last year's Frontline expose on assisted living:

“Many of us have complained that assisted living is admitting and keeping residents that they can't care for,” the LeadingAge president and CEO wrote. “These facilities play on the public psychology that families will gravitate to the nice wall sconces, winding staircases, secure gardens, and public-relations trained admissions staff who know that, as one investor-owned chain marketing person told a friend of mine, ‘if you get them to cry, you know they will buy.'”

Over the course of his career, Hoffman got me to buy his performances again and again, not only by making me cry, but by making me laugh, cringe, gasp and think hard about difficult subjects — long-term care among them. He might now be gone, but his body of work still can be revisited, and still can elicit that whole range of responses. But you don't have to take my word for it. Just press play on “The Savages.”

Tim Mullaney is a Staff Writer at McKnight's. Follow him @TimMullaneyLTC.


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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.