Abendlied. By Birthe Piontek.

I worked on the series for about seven years – from 2011 until 2018. In the first two years, I wasn’t sure what I was doing; little was I aware that the project might end up in a book. I just had the urge to express what I saw and felt when I visited my family in Germany. It was the time where my mother showed the first signs of Dementia; however, we weren’t sure about that back then, or better: we were in denial. 

But something was shifting; she was slowly slipping away, and so was the house I grew up in. After two years of working on the project, I found that I had started to develop a visual language for what was going on, and I also knew what I wanted to say. However, like with any project, it takes a lot of trial and error and a lot of time to refine ideas and images. It was especially challenging as I wasn’t physically present on an ongoing basis and only had a few weeks each year to work on it. But in many ways, the breaks were also useful to digest what I worked on and let ideas simmer.

(...) For a long time, while working on the series, I was afraid that this might not be the case, that the images would be “too personal” and the viewer wouldn’t be able to access it. I think, as much as this project is a personal one, it is also very universal. In many ways, the materials I’m working with are universal, too, even though they might have a specific meaning for my family. But the viewer knows what these materials are. One knows about the symbolic meaning of collected teeth, hair, or precious porcelain. We all have versions of these mementos in our homes. And, at some point in our lives, we all encounter losses and the accompanying grief. We understand the power and workings of change and we understand when something comes to an end. Maybe, it’s not so much the materials, but the universality of these experiences that make it possible for the viewer to enter the work – and feel it.

Birthe Piontek

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photographs by Birthe Piontek via and via and via and via and via

Diagnosing Alzheimer's Disease: Black vs White Patients

In the U.S., Black Americans are about 1.5 to 2 times more likely to develop Alzheimer's or related dementias than whites are. Nevertheless, fewer Black than white Americans are diagnosed with Alzheimer's or related dementias. In a study carried out by Lennon et al. (2022), 15 years (ranging from 2005 to 2020) of data on 5.700 Black and 31.225 white participants were tracked. While 36.1% of white participants were diagnosed with Alzheimer's, only 26.8% of Black participants received the diagnosis. Relative to white participants, Black participants had 35% lower odds of having the diagnosis at the initial visit (via).

Black study participants showed higher rates concerning cognitive impairment (particularly processing speed, language, executive function) than white participants, higher rates of hypertension and diabetes - in other words, more potential risk factors for Alzheimer's. In addition, they were twice as likely to experience delusions and hallucinations and generally more likely to show symptoms such as abnormal sleep, appetite or eating changes, irritability, agitation or aggression.

According to the research team, the results are further evidence that - compared to white patients - Black patients usually need more severe clinical presentations to receive a diagnosis of dementia from physicians. The results are backed by the tendency found in numerous studies showing that Black individuals are only diagnosed with Alzheimer's or related dementias when the disease process is more advanced.

Apart from the differences in diagnostic thresholds applied by providers, the scientists believe that these trends are partly due to social attitudes within Black communities in which memory problems are viewed as a normal part of ageing and medical treatment is only sought when neuropsychiatric symptoms (hallucinations, delusions, personality changes) are encountered. 

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- Lennon, J. C., Aita, S. L., Del Bene, V. A., Rhoads, T., Resch, Z. J., Eloi, J. M. Walker, K. A. (2022). Black and White individuals differ in dementia prevalence, risk factors, and symptomatic presentation. Alzheimer's & Dementia, The Journal of the Alzheimer's Association, 18(8), 1461-1471.
- photograph by Gordon Parks via

"a big advantage for women." Monica Vitti (1971)

"What do you think about divorce?"
"It is one of the most sacred things, a big advantage for women."



"And about unmarried women who want to have or do have a child?"
"I completely approve of women who are mothers without being married." 
Rome, 21 November 1971



Monica Vitti is one of the most popular Italian actresses; she received a great many awards. Alzheimer's Disease "removed her from the public gaze" in the 1990s (via).



- Costantini, C. (1997). Le Regine del Cinema. Roma: Gremese Editore; page 185
- photographs via and via and via

Time to forget

"It's time to forget
To forget about your age
Forget about your race
Your social standing
Your ideological view...
Forget about everything that keeps us apart"



September is World Alzheimer's Month, November is National Alzheimer's Disease Awareness Month in the U.S., and June is Alzheimer' & Brain Awareness Month. These initiatives all aim at raising awareness and changing the circumstances of those directly and indirectly affected. According to the World Health Organisation, members of civil society "can play a key role in improving the lives of people with dementia, their carers and families" by enhancing dementia research, by supporting people with dementia, their carers and families, by fostering improvement in health and social care delivery, by raising public awareness, and by influencing government policy-making. More: LINK

Mémo

Louis has a protective daughter, Alzheimer's and a strong will to carry on despite the difficulties. This beautiful animated short film was produced by the award winning animation school Gobelins.



Today is World Alzheimer's Day, a day that is dedicated to raising awareness about persons with Alzheimer's and its impact on their families. Alzheimer's is a family disease as family members often develop chronic stress when they helplessly watch their parent's, partner's, sibling's, ... cognitive decline and see how the symptoms worsen (via).



image via

The Truman Show, Music & Dementia Village

"For those who have forgotten who they are. For those who no longer count time. For those to whom love and care is all that matters. Dementia Village Architects creates custom living environments for elderly people with dementia. No big anonymous buildings, but instead manageable and pleasant residential areas. Where it is comfortable for everyone to live. Where residents feel safe at home. Where they enjoy living out their final days, connected with family, caregivers and healthcare providers. Where they can enjoy the precious life they were used to and still want to lead." 
Dementia Village Architects



In December 2009, a village was founded in the Netherlands, one for people with Alzheimer's Disease. Hogeweyk in the municipality of Weesp, on the outskirts of Amsterdam, has a town square, supermarket, theatre, pub, hairdressing salon, garden, post office, restaurant (via), green areas, i.e. parks and gardens designed by the landscape architect Niek Roozen, 160 inhabitants and 250 geriatric nurses and specialists whose 24-hours-a-day occupations range from cashier to grocery-store attendees and post-office clerks. The residents live in "lifestyle groups", in groups of six to seven persons who share similar interests and backgrounds (via). They live in houses together with one or two caretakers. The decor, design and furniture of each house is based on the design of furniture at the time the residents' short-term memories decreased. Homes resemble the 1950s, the 1970s, or the 2000s - a narrative reality with many recognisable stimuli.
Cameras monitor the residents, caretakers in street clothes take care of the residents. Family and friends are encouraged to visit as often as they can. According to reports, the residents need fewer medications, eat better, live longer and appear more joyful than those living in elderly-care facilities. And, they are more active as they spend comparatively much time outside. By contrast, nursing-home residents go outside for just 96 seconds a day. Hogeweyk residents engage in a community instead of feeling isolated; isolation makes the disease worse. Living in the village does not cure but it creates an environment "around life rather than death" (via).




"Into Oblivion" is a project of Maja Daniels, who photographed life within a geriatric hospital for three years. Based on the "principle of precaution", the so-called Protected Unit is "home to residents with Alzheimer’s disease. Due to tendencies to wander about and potentially get lost, they are confined within the ward. A locked door separates the occupants from the rest of the hospital." Within the secured area, residents can circulate freely "but due to a lack of activities and a limited presence of carers in the ward, the locked door becomes the centre of attention for the elders who question the obstruction and attempt to force it open. The daily struggle with the door, damaged due to repeated attempts to pick the lock, can last for hours."

This series documents not only the day-to-day challenges in an often ignored sector, but also the wider implications of the growing populations of elderly in modern society as an increasing life span has coincided with the breakdown of the family unit.
These aspects have caused a growing disregard for the elderly, swept aside by a commercially driven, youth-obsessed culture. As growing old and being dependent is more taboo than ever, the geriatric institution hides our elders away, safely out of sight. Maja Daniels

::: "Alive Inside", beautiful, beautiful, beautiful trailer: watch

"Dan Cohen, founder of the nonprofit organization Music & Memory, fights against a broken healthcare system to demonstrate music's ability to combat memory loss and restore a deep sense of self to those suffering from it." The full movie (1:17:51): watch

images via