Review of ‘I’m Not From Here (Yo No Soy de Aquί)’ Directed by Maite Alberdi and Giedre Zickte, Chile, 2016
Film Review by Robert Abrams, M.D., Professor Emeritus of Psychiatry, Weill Cornell Medicine, New York

I’m Not From Here is an arresting short film directed by the Chilean team of Maite Alberdi and Giedre Zicte. Despite its slow pace, perhaps reflecting the tempo of aging, this film is full of substance and heart.

Set in a Chilean care home, the film pointedly asks whether cognitively impaired individuals should be urged to acknowledge their actual lived realities, or left to interpret the world as they perceive it.  This is a question confronted by staff in care homes everywhere, places in which the phrase “I’m not from here” may be one of the most frequent plaintive expressions to be heard.

How to respond to “I’m not from here” and similar revisions of reality in a compassionate way is addressed in the film’s portrayal of its central character. The importance of community in care homes is also noted. Inasmuch as care homes are communities, they can provide peer-to-peer psychological support, the therapeutic potential of which is frequently unrecognized.

In the film’s opening scene, Mrs. Josebe, an older widowed woman of firm, decisive character, outlines the story of her life to a fellow resident in a reasonably cogent sequence.  Using faded photos and old yellowing documents, she begins by describing her joyful, easy-going youth in a Spanish Basque town, followed by a move to Chile, where she married and raised her own family.

Teasingly, she asks her listener how old he thinks she might be.  He hesitates, knowing that such inquiries are intended to elicit a flattering response. Gradually it becomes apparent that Mrs. Josebe does not actually know her own age, and although she provides the year of her birth, she also does not know the present date.

From this point her cognitive decline becomes increasingly evident. “At home do they know I’m here?” she asks one of the workers. By now she is convinced that she is just a “visitor” to Chile and to this care home, thereby coupling her growing memory impairment with psychological defenses. Her forgetfulness about her age allows her to think of herself as younger than those around her, and she recoils from the other residents’ vulnerabilities without realizing that they are historically her own.

When she telephones her daughter, Mrs. Josebe is told that she must understand that she has been at the home for nearly a year, not, as she believes, for a single day. Although her daughter’s tone had not been harsh, after that call Mrs. Josebe becomes distraught and further disoriented.

But by the end she is seated outside on a fine day, chatting happily with one of the residents. She adheres to the belief that she still lives in her childhood village in Spain and is just passing through Chile. Nevertheless, Mrs. Josebe is, de facto, a member of the care home community, even if the pleasure she can derive from life there is predicated on her belief that she is a temporary visitor.

It can be observed that all of Mrs. Josebe’s impactful encounters, hostile or friendly, take place in a communal context. She has been defining her identity and character—proudly Basque, independent, sharp-spoken, no-nonsense—both with and against her fellow residents. One can speculate how poorly she would fare living mostly alone or with a daughter who, however well-meaning, would tell her repeatedly that she is confused and must strive to appreciate the true nature of her circumstances.

This film advances the view that asking at least some individuals with dementia to accept the truth of their conditions could well be futile and result in avoidable suffering. After recovering from the disturbing conversation with her daughter, Mrs. Josebe is seen to be living comfortably and unchallenged within her own understanding of reality. She might now be able to engage with others and avoid the loneliness that had been predicted for her earlier in the film.

There are several caveats: First, resolutions like this one may not be permanent, consistent with the dynamic nature of dementia and its progressive decline. Then, some dementia-related delusions are associated with significant behavioral disturbance and may require different approaches.

Still, this film offers prescient lessons about the psychological well-being of individuals with dementia. The significance of community and the value of resident-to-resident interactions for mutual support are demonstrated; but the greater emphasis is placed on questioning the purpose of reflexively correcting cognitively impaired residents’ interpretations of the world and their positions in it. After all, in the most expansive view of reality, isn’t truth largely subjective, and are we not all transients in life?

Further Reading

The Eternal Memory was shortlisted in 2024 for the Oscars, in the best documentary feature film category. Read Khalid Ali’s interview with Maite Alberdi about The Eternal Memory, conducted in October 2023 at the London Film Festival.

Khalid Ali also reviewed her 2020 film, The Mole Agent, which was Chile’s submission to the Oscars. It was shortlisted for best international film. Read Ali’s review on the Medical Humanities blog.