We Made a Film About Quality Elder Care. Cutting Medicaid Would Take That Away

By Kathleen Chalfant Ryan Bort

We Made a Film About Quality Elder Care. Cutting Medicaid Would Take That Away

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Kathleen Chalfant, Sarah Friedland

July 2, 2025

Ruth (Kathleen Chalfant) and care worker Vanessa (Carolyn Michelle) enjoy a lighthearted moment in the dining room at Bella Vista.

Music Box Films

About midway through our film Familiar Touch, Ruth (played by me, Kathleen), bursts into the kitchen of the memory care facility she’s just moved into. A professional cook, she believes she’s there for a day on the job. Knife in hand, she confidently takes over the prep station,

showing the staff “how it’s done.”

What’s remarkable is not Ruth’s confusion, but the way her caregivers respond: They meet her where she is, letting her contribute in the role she knows best. They don’t correct her or take the knife away; they honor the identity and purpose she’s spent a lifetime building.

That’s what good care looks like.

I (Sarah) saw this firsthand when I worked as a memory caregiver, supporting New York artists and creatives living with dementia and memory loss. My role wasn’t just to help them get through the day, but to stay connected to their autonomy and sense of self. For one client, that meant choosing her outfit each morning. For another, it was picking out the right cut of meat from the butcher. In these small, daily acts of agency, people held on to who they were — even as their care needs shifted.

Receiving care doesn’t diminish us. In fact, care is what makes life possible. It’s a reciprocal relationship built on trust and intimacy, not a loss of dignity.

We made a film about a woman who, because of privilege, has access to the care she needs to age with grace. But the reality for millions of Americans is starkly different.

Republicans in Congress have passed a budget with the largest cuts to Medicaid in history — a program that provides essential care for 17 million older adults and people with disabilities. More than 60 percent of nursing home residents rely on Medicaid, including many with Alzheimer’s and dementia. Cuts of this magnitude would devastate families already struggling to provide care.

And with Congress returning in July to finalize budget negotiations, the stakes couldn’t be higher. What happens in the coming weeks will determine whether we continue to invest in care or rip it away from the people who need it most.

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This isn’t just a policy fight. It’s personal, political, and deeply gendered.

Let us be clear: This is a feminist issue.

Women make up the vast majority of both paid care workers and unpaid family caregivers. They are the ones most often called to step in when our care systems fail — sacrificing careers, income, and well-being to fill the gaps. At the same time, paid care workers — again, mostly women, and predominantly women of color — are too often undervalued and underpaid, their work dismissed precisely because it is “women’s work.” And those who need care often face impossible odds. The average woman, especially Black, brown, and immigrant women, are forced to navigate a maze of red tape, long waitlists, and high out-of-pocket expenses.

We made Familiar Touch in collaboration with the residents and care workers at Villa Gardens, a real continuing care retirement community in California. Over weeks of both a workshop and feature filming, we got to know dozens of people on both sides of a caregiving relationship: care recipients, but also care workers. We witnessed up close the talent, skill, and deep humanity that they bring to their jobs. Medicaid funding is crucial to sustaining the essential work — and wages — of care.

Yes, Medicaid can and should be strengthened. But reforms should honor care, not dismantle it. Raising wages for care workers, expanding access, and ensuring dignity in aging are not luxuries — they are necessities.

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I (Kathleen) am 80 years old. My husband, Henry, is 85. We are fortunate to live independently for now, but we know that could change at any moment. Playing Ruth offered a window to a possible future and instilled how the right care can help maintain dignity in our most vulnerable moments. Many of my friends already rely on care workers and the safety net Medicaid provides. For them, and for all of us, this fight is deeply personal.

I (Sarah), in my thirties, am often asked if my work with older adults has made me fear aging. It hasn’t. What I fear is something else entirely: a culture that tells us older adults no longer matter, that abandons care workers by giving them poverty wages, that proposes balancing budgets by stripping care from those who need it most.

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The refusal to care for America’s aging population is not just cruel — it is ageist, sexist, and should scare us all more than wrinkles or moments of forgetfulness.

We must fight for Medicaid. We must fight for care so that dignity in aging is not reserved for the privileged few, but a right we all carry with us, all the way to the end.

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