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TX: 11.11.05 - Dementia: Joan Bakewell Column
 
PRESENTERS: LIZ BARCLAY AND WINIFRED ROBINSON
THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS COMPLETE ACCURACY.

READING
Dementia is degenerative, although the speed of decline varies. In the later stages memory loss is likely to be severe. A person may cease to recognise family and friends or even their own reflection. They may gradually lose their speech and their ability to perform everyday tasks unaided. They may also exhibit challenging or unusual behaviour, such as verbal or physical aggression, agitation, making repetitive movements and hallucinations.

BARCLAY
If you watch Coronation Street or listen to the Archers you'll have noticed that both soaps are featuring dementia. Two long running characters - Mike Baldwin and Jack Woolly - have developed the condition but it's taken a long time for dementia to be considered a topic worthy of prime-time slots. Writer and broadcast Joan Bakewell writes a column in the Guardian called Just 70, in which she discusses many issues affecting older people. For us she looks back at some of the most important portrayals of the condition.

BAKEWELL
Memories are the stuff of literature. Think of Proust and his Madeleine Cake. Wordsworth and his Lake District childhood. It's through their recollections that we often appreciate our own. Now writers are beginning to write about dementia. They're beginning to put into words what we can't express of our pain and distress. They're confronting us with experiences which we shrink from imagining. By the act of creative imagination they offer literature's solace for one of life's great tragedies.

I had no idea about dementia until I took part in the film Iris, interviewing the novelist Iris Murdoch, played by Judy Dench, at the very moment when her glittering intellect experiences its first loss. Before then, although I was in my 60s, I thought of it as some remote eccentricity that affected very few sad souls who then got put away in remote places out of general view. I don't think that anymore. The film Iris brought things closer to home.

I'd known Iris Murdoch herself as a lively personality with strong opinions, she was, after all, a Booker prize-winning novelist and a distinguished philosopher. Such a falling away seeming all the greater because of her illustrious achievements. There is great dramatic poignancy in such affliction, perhaps no where better imagined to them by Shakespeare himself, who somehow always manages to mine deep into the heart of human sensibility. Here King Lear, grown difficult and quarrelsome with age, expresses in sublime poetry the bewildered state of the lost mind.

KING LEAR Methinks I should know you. I know this man. Yet I'm doubtful for I am mainly ignorant what place this is. And all the skill I have remembers not these garments, nor I know not where I did lodge last night. Do not laugh at me.

When memories falter our very identity is threatened. Even what we good humouredly call "senior moments" can cast a shadow. Something as trivial as "Where did I put my keys?", "I know the face but what's her name?" Is that how it begins, we wonder. I got worried myself a few years ago and went for tests. Very thorough, very costly they were. Happily I was told my worries were misplaced. In general though the British are slower to report such symptoms to the doctor than other nationalities, something traditional about not making a fuss, not wanting to be a nuisance. Thank goodness writers have no such inhibitions. Speaking out boldly truths we might only whisper.

The poet Tony Harrison's television programme Black Daisies for the Bride, confronted us with some of those harsh realities. Before writing he charted the lives of a number of Alzheimer's patients in a Yorkshire hospital and used their individual voices and stories directly in his writing. And yes, it's harsh, almost cruel to hear. But the reality is harsh, our reluctance to confront such truths is an added obstacle for those trying to get a public hearing and public funding for this major problem. Because it's not only a medical matter, dementia strikes at the balance of the entire family, subjecting its careful structure of dependency and care to a tumultuous earthquake of change, everyone suffers.

Linda Grant in her memoir - Remind Me Who I Am Again - tells a story of her mother's dementia and the impact it had on her Liverpool Jewish family.

REMIND ME WHO I AM AGAIN - EXTRACT
"Oh no," my mother says grimacing, "oh dear."
"What's wrong?"
"Well this road is full of clocks."
"Clocks?"
"Yes, clocks that take you home."
"Do you mean buses?"
"Yes, that's it, I mean buses."

What hurts most is that dementia destroys one's intimate relationships. Formerly close bonds between parent and child, between husband and wife are stretched and twisted as they each battle to stay in touch, to retain shreds of contact.

Alan Bennett's writing is masterly in describing the subtleties of human relationships. In his most recent book Untold Stories he reveals, for the first time, his mother's sequence of mental illnesses, culminating in her final loss of identity.

UNTOLD STORIES EXTRACT
"Do you remember dad?" I ask her.
"Oh yes I remember your dad."
"What was he like?"
"Your dad? Oh well ..." and she studies a bit, "well he was a love."
"And do you know who I am?"
"You're a love too." Then she laughs.
"But who am I?"
"Well now then, you're my son aren't you?"
"Yes. And what's my name?"
"Oh I don't know that!" And she laughs again as if this isn't a piece of information she could be reasonably expected to have.

Where individual writers have led the way the more popular media are now taking up the story. There's the case of Mike Baldwin in Coronation Street. The message is let's not be afraid of this affliction, let's look it in the face and help each other deal with it. It may be in wait for many of us. It's certainly in wait for Jack Woolly in the Archers.

THE ARCHERS EXTRACT
"You don't understand what it feels like doctor."
"And how is that?"
"Well it's like, you know those telephone exchanges with the wires and the plugs and sockets?"
"The old fashioned switchboard, yes."
"Well it's like somebody's taking out the plugs and connecting them to the wrong sockets. I start off knowing what I want to say but it's not what comes out."

Through writing my column for the Guardian I came to know lots of older people who, like me, are living as busy and enjoyable lives as much younger people. We all stay young inside ourselves you know and don't want to be treated as pathetic and dependent. That's why my generation will, I hope, face up to reality with more openness and courage. And writers help us do that.

BARCLAY
Joan Bakewell.


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