click! Photography Changes Everything

Jeff Sandoz, psychologist, describes how a doctor, self-diagnosed with Alzheimer’s disease, devised a clever photographic system to help him in his daily life.

Alzheimer’s disease has been called the “Thief of Memory,” and if that’s the case, then how does one catch a thief? Surveillance cameras can provide some assistance in the case of physical property being stolen, but can photography help guard against or minimize the loss of a more valuable commodity; human memories? In my work, one case of how people cope with the disease provides an interesting example.

Dr. H. was a retired physician and octogenarian who—as his daily functioning began to deteriorate following a stroke—recognized the memory-related symptoms of Alzheimer's disease and made a self-diagnosis. When his own family physician confirmed what he suspected, and it became clear that he could no longer live on his own, Dr. H.’s children moved him to a nursing home, where he lived for the final year of his life.

Once he was settled in, Dr. H.—who his children described as being fiercely independent—continued to read medical journals in order to better educate himself about Alzheimer's disease, and developed techniques that enabled him to maintain a functional memory until the final three months of his life. He carried a pencil and paper in his shirt pockets at all times and continually wrote down notes. He made daily entries in a journal, listing what he had eaten, what he liked or disliked at each meal, the activities he participated in, and the names of people who telephoned or came to visit him. Dr. H. reviewed his written comments daily.

In addition, Dr. H. made and used photographs as memory retention devices. On the wall above the roll-top desk in his room hung a series of framed photographs representing members of his extended family members across four generations. Each photograph was labeled with the name of the person or persons depicted, describing their specific relationship to him. Every day, he reviewed pictures of family, friends, and fellow residents in the nursing home. Sometimes, if he had things that he wanted to say or communicate with them, he would note that on the backs of the photographs, as a reminder. When visitors dropped by, Dr. H. would often tell them stories about his relatives in the labeled pictures on display.

Dr. H. also kept a camera, rolls of film, and a photographic album in his roll-top desk. He was observed taking pictures of others frequently. After the pictures were developed, he would label each one with the subject's name and indicate that person's relationship to him. Just as he did with his written materials, Dr. H. reviewed the photographs and names underneath them daily. His photographs of nursing home residents were put into his photo album and became part of an annotated floor plan of the facility Dr. H. used to navigate his way around. During the day, if he saw someone whom he did not recall, he would refer to his album in order to refresh his memory. If he had no photographs of that person, he would take one and label it for future reference. Whenever necessary, he changed information on the photographs to reflect residents’ current status.

As a trained medical professional who had devoted his life to the care of others, Dr. H.’s interactions with other people in the nursing home included encouraging and assisting them in their attempts to retain memories. He would often talk with his peers with regard to common interests and ask them how they remembered certain things. On numerous occasions, he was observed sharing his memory retention devices with other nursing home residents, which enabled some of them to improve or maintain certain levels of functioning in their daily activities. At those times Dr. H. appeared to receive great delight in sharing the photographic and writing techniques that became instrumental in prolonging and preserving the continuity of memory, for himself and in others.