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Alive with Alzheimer's is a
collection of photographs in black and white by sociologist Cathy Stein Greenblat
of residents, their caregivers and some friends and family at Silverado Senior
Living in Escondido, California. Silverado is a specialized residential care
facility for people with Alzheimer's and other forms of dementia, and there are
now many such facilities around the country. Greenblat was especially
impressed with Silverado because of their attitude towards their residents and
their ability to improve their quality of life. Her photographs attempt to
capture some of this. They also provide more positive images of people with
Alzheimer's, helping to counteract the hopelessness that often accompanies a
diagnosis of a neuro-degenerative disease.
An introductory chapter explains Greenblat's
personal interest in Alzheimer's -- some of her family members have had the
disorder. She says that people with Alzheimer's are capable of living and
loving, and they need loving attention. Other chapters have explanatory text
accompanying the photographs, often with extended quotations from some of the
people photographed and there is an Afterword by Enid Rockwell, MD, which sets
out some of the basic medical information about the disease. It is a short book
at just 116 pages, many of which have little or not text. Nevertheless, it is
powerful and instructive.
The profound and progressive
cognitive deficits that come with Alzheimer's are frightening both for the
person with the disease and for family members, who see their loved one
disappearing as they watch. Memory-loss is a universal symptom, and people
with the disease eventually stop recognizing their family members, or they
revert to an earlier time in their memories, when their children were young and
their spouses were still alive. People lose their other cognitive skills too,
and in some respects become like young children. A considerable proportion of
people with the disease experience delusions, and may hear voices.
Greenblat's emphasizes that
Silverado is special because it helps its residents retain their humanity
rather than dope them up with lots of medication and stick them in front of a
television. She shows residents enjoying themselves on a day trip at the horse
races, at the residence with their family members, interacting with pets and
children, playing games, and enjoying music. There is no denying that the
residents shown are in advanced stages of their disease, yet they are often
still capable of happiness and joy. While it can be very painful for family
members to see their loved ones gradually retreating from the world, it is a
comfort to see them still having some life.
While Alive with Alzheimer's
is inspiring, it is will not alleviate all fear of Alzheimer's. Facilities
like Silverado are probably unusual and difficult to find. Furthermore, even
when living as fully as possible with advanced Alzheimer's, one may question
whether one would want to live like that. The suffering and loss that comes
with degenerative diseases is terrible, and many people hope that they die
suddenly, in their sleep, while still retaining most of their physical and
emotional capacities. Seeing the disorder raises difficult questions about
when life is worth living, and when life is worth ending. For those of us who
still are still basically healthy, it is hard to contemplate such a decline. Greenblat's
book does not make it much easier to think about the losses that come with
Alzheimer's, but it does point to some ways in which living with those deficits
may still be better than death.
© 2006 Christian Perring. All
Perring, Ph.D., is Academic Chair of the Arts & Humanities
Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also
editor of Metapsychology Online Review. His main research is on
philosophical issues in medicine, psychiatry and psychology.
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