New Jersey sociologist Cathy Stein Greenblat didn't know what to expect when she visited Escondido's Silverado Senior Living.

"I was just scared," said Greenblat, who went there to photograph patients for a book project. "I thought frankly, 'I'll go there, but I'm not sure I'll be able to do this.'"

Greenblat, a professor emerita at Rutgers University in New Jersey, saw her grandfather slowly slip away as he succumbed to Alzheimer's disease. In his last two years he lived in an institution and didn't believe Greenblat was his granddaughter, because he only remembered her as a little girl.

After his death, Greenblat's grandmother developed Alzheimer's and spent the last 10 years of her life in a nursing home, unable even to speak for her final four years.

Those memories steeled Greenblat for what she might find when she decided to photograph elderly people. Greenblat had chosen her subject after studying under renowned photographer Mary Ellen Markand traveling to Mexico on a photo expedition.

More than just another opportunity to shoot real people in a candid environment, Greenblat saw the project as a way to confront her own anxieties about Alzheimer's and the places that care for the afflicted.

What she found would change her view of the disease. While Alzheimer's indeed is heart-breaking, Greenblat said she learned that people with the disease still can have fulfilling lives.

"I believe that it is sad to die, and I believe that it is a tragedy to die without being treated as 'alive' to the very end," she wrote in "Alive With Alzheimer's" ($27.50, The University of Chicago Press).

Greenblat happened to be in San Diego County because she and her husband had sold their New York apartment and had an opportunity to live somewhere else during summer 2001. They stayed with friends, and while he finished writing a book, she looked for a place to photograph seniors. A friend recommended Silverado, and she approached the administrators.

"They said, 'What's the story you want to tell?'" Greenblat said. "I said, 'I have no idea. I don't have a preset story. I'm not trying to do something negative about you, but I can't tell you what it will be about."

Greenblat soon discovered that although residents at Silverado were in various stages of Alzheimer's, they still could have dignified and decent lives. They were not incoherent and lost in their own worlds, but rather real people who responded to activities and interaction with others.

"I guess I had bought into this idea that they were half-dead and not really capable of the kind of response and emotional range and enjoyment I saw," she said. "And the other side of it is, I've never seen caregivers who were so understanding of this disease."

Greenblat found that Silverado's approach was supported by other professionals.

In "Alive With Alzheimer's", Greenblat quoted from the book "Life Worth Living" by Dr. William Thomas, who wrote that most resources at care facilities go for the treatment and diagnosis of Alzheimer's, but not for attention to patients' individual needs.

"Loneliness, helplessness and boredom steadily decay our nursing home residents' spirit," Thomas wrote.

In contrast, Greenblat noted Silverado emphasized quality of life and social stimulation over medication. It also has a staff that honors the "personhood" of each resident and uses touch and music as therapy.

Thirty photos in the book feature Heather Davidson, a music therapist who regularly visits Silverado with her guitar.

"Many residents who didn't speak clearly and logically could remember and sing all the words to such songs as 'Daisy, Daisy,' 'Oh! Susanna,' 'Home on the Range,'" Greenblat wrote about residents who lit up as soon as they saw Davidson.

One resident named Edith is shown in one photo on her back in bed with a cat, Cricket, lying on top of her. Edith had been heavily medicated for two years and was often bedridden in her early days at Silverado, Greenblat wrote. A month after the photo was taken, Edith is shown enjoying a day at the Del Mar racetrack with her daughter.

Greenblat's photos show residents sometimes looking lost, sometimes looking happy, sometimes doing things for themselves and sometimes being fed by a loved one.

Referring to all her book's subjects by their first name only, Greenblat wrote about a woman named Carole feeding her mother ice cream. Carole said, "I know these will be the last photographs we will have of my mother. She hasn't eaten for three days, and I know this is the end."

Greenblat spent six weeks photographing residents at Silverado, spending five or six hours there at each visit.

"They would absolutely recognize me," she said about the residents. "They were used to me having the camera around. I just became like a fly on the wall."

Greenblat said she hopes her book will shine light on how Alzheimer's patients still can have a dignified life. She already has been told that it should be translated into other languages so even more people can learn from it.

She also said she believes many centers don't offer as many activities to Alzheimer's patients because they wrongly assume the patients will not respond. But the centers are wrong about the patients, Greenblat said:

"They're still so much alive."

Contact staff writer Gary Warth at gwarth@nctimes.com or (760) 740-5410.