In 1996, I began to photograph the faces of people suffering from Alzheimer’s disease in Wittenberg, a hospital for elderly people in Amsterdam. At this same nursing home, I had my first experience in healthcare while working as a nursing assistant for an employment agency, and photography played an important role in my meetings with people who had Alzheimer’s disease. Photography also enabled me to explore a reality of dementia that differed from the norm.

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The common perception is often that those with dementia do not have a dignified life. They’re often thought of as dirty old men and women, lonely and abandoned, wasting away in nursing homes. Photographs have shown us images of people with dementia wearing baby bibs, slobbering from the mouth, with the remains of a dinner on their clothes. The resulting and prevailing public thought? That’s no life!

I wanted to take a different approach. My wonderment about Alzheimer’s disease aroused my interest in the lives of people with dementia, and my interest in human existence and its history led me to focus on the face. In my portraits, I turned my attention on the traces of the self that remain there.

Throughout this project, I have seen lots of happy, grouchy, sleeping, anxious, sad, angry, dear, bored, smiling, and crying faces.

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These faces are not so different from the faces I see on a tram ride through the city or on a walk through the Albert Cuyp Market–when people forget to keep their faces straight.

Human existence becomes movingly clear when dementia has broken the mask of our personalities. Vulnerable and naked, our humanity is apparent in the face. Throughout this project, I’ve asked myself: What is left of human existence after Alzheimer’s disease destroys the self?

While photographing, I scanned the faces for signs of an inner life, and in my portraits I tried to illuminate the life I saw.

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Alzheimer’s disease shows us human existence without any decoration–heartbreakingly bright, fragile, and delicate in all its details. More similarities than differences exist in our lives than one might think. We’re all familiar with sadness, joy, fear, despair, depression, and cheerfulness.

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And people with Alzheimer’s feel these emotions in the same way that we do. Unfortunately, emotions confuse them — and us, too.

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People with dementia wander around in time. They are nomads in their own history and future. Time has no beginning or end. Thrown back on themselves, their lives are totally out of control.

Dementia can alter a carefully constructed personality into a human wreck. The disintegration of the inner life hits the heart of human existence. Our whole lives and hearts are devoted to developing our personalities. A confrontation with people who suffer from dementia can be frightening because their existence raises questions about our own lives. They show us that life can evolve in a different way, and their fate makes us sensitive to alternate possibilities.

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When things weren’t running smoothly as I pursued this photography project, I comforted myself in my relationships with the nursing home residents.

One of my favorites was Ms. de Graaff. She was always in a cheerful mood, and in conversation with her, my frustrations would go up in smoke.

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In these two portraits of her, the first shows her with her dentures and glasses, the second without. She had lost them.

Her face has dramatically changed in the time between. But she had not lost her cheerfulness, liveliness and her characteristic way of handling misfortune and grief.

What is deep inside her stays forever. What is not dissolves in a life that has been forgotten.

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At the beginning of a shoot, I let a man have a Polaroid photo of himself. He stares at his own portrait. Then he looks up and asks me annoyed:

“Who is this man? What do I have to do with that man?”

Before I come up with an answer, he throws the picture on the floor.

He looks at me and asks: “Do you have a smoke?” I give him a cigarette. He smokes it, and we start the shoot.

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I spent much of my time in the nursing home looking for suitable candidates. I sat at a table in the living room, drank a cup of coffee, and chatted with the residents. Meanwhile, I studied them and searched for characteristic postures and facial expressions.

I had a separate room in the nursing home that I could use as a studio in order to work in peace. While I photographed, the residents would sit in front of me in an armchair, a chair at a table, or in their own wheelchair. And I would sometimes get the same postures in the studio that I had seen in the living room. I could also wait for that specific moment portrait photographers wait for: the special moment in time in which posture and facial expression come together in a meaningful portrait.

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That often meant a very long wait.

I usually needed more than one hour to complete each shooting. My directions proved to be useless and pointless, as those I photographed often lived behind a wall of misunderstanding. With the camera ready, I waited for the moment.

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There is a woman. She is sitting before me with hunched shoulders deep in her own world. She is little. On her lap, she holds a purse. She firmly holds the handles in her hands. Suddenly, she comes upright and opens her handbag. A hand moves into her bag. A package emerges wrapped in blotting paper. Very cautious and careful, she opens the package. As if it is precious and fragile. A photo emerges out of the paper, and she shows it to me. It is a picture from the early 20th century. It shows a middle-aged woman in the brown colors of an ancient photo process. She is young and in the prime of her life. Cracks on the surface of the photo cross her face.

“That’s my mother,” she says. “Isn’t she beautiful?”

After a short while of showing the portrait, she carefully wraps the picture with the paper and locks it in her bag. Her hands take the handles tightly, and her body gets into the familiar posture. The shooting begins, the flash illuminating her proud and happy face.

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One day, I see a woman holding a frame in her hands. When I sit beside her, I see a picture of a baby in the frame.

“Is that your grandchild?” I ask her.

She smiles. Pride appears on her face. When I look more closely, I see written under the picture “for children from 9 months.” I understand that the portrait is an advertisement image for baby food. But what makes the image so special that it is in a frame? And why does she hold it so proudly in her hands?

“Has your grandchild been a model for a baby food advertisement?” I ask her.

She looks at me, confused, not understanding my question. A nurse who is busy with the dishes intervenes and gesticulates in my direction.

“It has your eyes,” I say to the woman.

She takes the frame and firmly presses a kiss on the glass.

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ALEX TEN NAPEL lives and works in Amsterdam. He studied at the School for Photography in The Hague. His work has been exhibited—in solo and group shows—at the Epson Photo Festival, Paris Photo (France), Pobeda Gallery (Russia), Cook Fine Art (New York), Galeria Omar Alonso (Mexico) Foto Art Festival (Poland), Miami Photo, International Festival of Photography (Lodz), and KievFotoCom (Kiev). His work has also been published in Le Monde Magazine, ZOOM, Nowy Biuletyn, Fotograficzny, ŚwiatObrazu and Foto&Video.

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