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Saturday, April 23, 2011

Advocating for the Helpless

Highlighting the humanity and individuality of our elders

Abraham Nievod, Ph.D, J.D. is attempting to change people's understanding of the elderly with his documentary photography project titled, Portraits of Aging and Dementia.  His awareness of this issue developed as a result of his work as a neurologist and doing evaluations of competency for the elderly and the mentally disabled for the courts and for other therapists.  Many times the legal issues are decided for the elderly by people who've never seen them, never met them.  When he realized this, he began going to the elderly person (usually housed in some sort of assisted living situation), photographing them and including the picture with his report.  (One judge commented that it was the first time he had ever seen anyone for whom he had made a competency decision!)

This picture including effort grew into the portrait project.  As he went to seek out these individuals, he observed how they were living in such an isolated, circumscribed world with very limited horizons.  He decided that he wanted to show the elders in an individualized, personal way.  He told parts of a few of their stories:  One person was one of the first women Marines. One man was sold as a child; 40 years later, his brother became a government official, tracked him down and introduced him to his mother and father for the first time.  One man he photographed standing in front of a painting that he had done in earlier years as an artist.  Dr. Nievod is trying to counterbalance the tendency for people to begin treating them differently once a person gets labeled as incompetent.  (An unfortunate fact, according to Dr. Nievod is that sometimes the judgment that someone is incompetent to deal with their own business matters is based on a 10 minute test, the MMSE-mini mental status examination score).

A basic description of dementia is memory impairment and disturbances in executive function*, however, there are now thirteen different kinds of dementia identified.  Also, anxiety and other mood disorders can effect executive function.

There is usually a difference between the assessment of a 32 year old accident victim and an 88 year old accident victim.  It is this unfairness that is highlighted by the project.

The elderly must be protected from being taken advantage of.  Elder abuse is something to be aware exists.  It is important to remember that even though a person is older, slower, less sharp, not as strong as a younger person, that they are still a unique individual, may still be quite capable of making choices and decisions for themselves and, should be treated with the regard expected for any adult.

For the California laws pertaining to this topic, see Probate Code Section 810-813.

*Executive function refers to such abilities as using abstract concepts, to reason, to plan, organize, and carry out actions in one's own rational self-interest, ability to use logic.


  1. Excellent article by Abraham Nievod, Ph.D, J.D., not all elderly people suffer from dementia however.

  2. Yes, of course that is true. All the more reason that the criteria for determining incompetency should be more stringent.