Tag: Novels

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“Toffee” by Sarah Crossan

In this stunning verse novel from Carnegie Medal winning YA author Sarah Crossan we meet Alison, a young woman on the run from a difficult situation at home. She ends up in a bleak seaside town. Alone, and with nowhere else to sleep, she hides out in the shed of an abandoned house. It soon transpires the house isn’t empty. An elderly woman named Marla lives there. Dementia has left Marla confused and mistaking Alison for an old friend called Toffee. She invites the young woman to move in with her. At first Alison is quite blatantly taking advantage of Marla but soon she begins to care for her. What transpires is a strange but intriguing friendship where the women become increasingly dependent on each other for company and companionship. The novel is perhaps, best summed up by the short four sentence description on the back cover.

“I am not who I say I am. Marla isn’t who she thinks she is. I am a girl trying to forget. Marla is a women trying to remember.”

Despite their differences Marla and Alison have much in common. They manage to become a kind of support network for each other as Marla tries to make sense of her past and the fractured network of her memories while Alison attempts to brave the future and the big changes she’s going to have to make.

Essentially this is Alison’s story. It’s told in the first person from her perspective but includes descriptions and analysis of Marla, snippets of her dialogue and even secondary sources like text messages. Through Alison’s eyes we are given a wonderful picture of an older woman, living alone with Dementia who is anxious to maintain her independence and determined to continue being fully herself. Marla is not the usual dottery old lady, depicted in much of Dementia fiction. She is feisty, funny and desperately quirky; as annoying as she is likable. In Marla, Crossan has created a unique and incredibly appealing character. She’s made it ok to find aspects of Dementia truly hilarious.

“I can’t get my feckin’ tights on, Marla shouts

from the bedroom next to mine.

My arse has expanded.”

Perhaps the most unique feature of the novel is its style. Crossan has written the entire story in verse. It reads like a novel, though looks like a poetry collection on the page. All the white space around the words serve as a constant reminder of the fact that because of Dementia there is often as much said, or implied in the silences, as there is when Marla speaks. This sense of erasure and retaining what’s essential about who a person is and was, is mirrored in Alison’s story and eluded to in Crossan’s beautiful words.

“No goodbye is forever

unless you can

erase everything you ever knew about a person

and everything you once felt.”

Toffee is a truly beautiful novel. It’s fractured language and lyrical, mesmerising tone is perfect for exploring the theme of Dementia. As I read, I felt Crossan was trying to pin down something fleeting and elusive with her sentences. She does an amazing job of capturing what it’s like for a teenager to do life with someone who’s living with Dementia. I’d recommend this as an essential read for young adults and actual adults alike.

Toffee was published by Bloomsbury in 2019

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“Malcolm Orange Disappears” by Jan Carson

Summarising a book you’ve written yourself is a difficult and quite disconcerting thing to do. Malcolm Orange Disappears was my first published novel and, whilst I’m still quite fond of it and certain characters who appear within its pages, six books later, I can definitely see where it could be improved. The story focuses upon eleven year old Malcolm Orange, whose father has abandoned the family in Portland, Oregon. As he attempts to process this troubling situation Malcolm begins to notice he is, quite literally, disappearing. Malcolm’s mother has found a job as an orderly in a retirement village which comes with accommodation. As Malcolm settles into his new home he begins to befriend the elderly residents and together they go on a quest to stop him from disappearing.

Malcolm Orange is a magical realist text which uses metaphor and allegory to explore the various ways the older people in the retirement village feel as if they too are beginning to disappear. The loss of memory is explored at length. Many of the residents are living with Dementia and can’t remember important parts of their own stories. Malcolm and his friend Soren James Blue help the residents to form a kind of support group in order to capture one aspect of their history before it disappears.

“The People’s Committee for Remembering Songs existed solely for the purpose of remembering songs.” It meets several times a week and allows the residents to collectively recall the important songs which have shaped their identities. This section of the novel takes an imaginative look at how community and creative group exercises can, at best, help to slow the advance of Dementia and also help participants to find a sense of support and solidarity in being with others who are going through a similar experience. There is a particularly poignant scene towards the end of the novel where the residents all sing together in unison and experience a kind of miraculous release which doesn’t remove them from the realities of the illness but allows them to feel free and powerful as autonomous individuals. Much of this section was inspired by my own experience of volunteering with an Alzheimer’s Society, Singing for the Brain group.

“Emboldened by the miracles unfolding in every corner of the Treatment Room, the People’s Committee for Remembering Songs whooped and hollered, raising their wrinkled chins and hands in anticipation of further healing. The noise was deafening.”

As mentioned above Malcolm Orange is far from a perfect novel but it does give some interesting insight into how ageing, and in particular Dementia, is viewed from a child’s perspective. It explores the use of Dementia as a literary device for introducing fantastical elements into a story and also touches upon issues of sexuality, disability and autonomy in regards to those living with Dementia within a residential care environment. I hope it also advocates for the power of story in attesting to who a person living with Dementia once was and continues to be. 

Malcolm Orange Disappears was published by Liberties Press in 2014 

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“This Excellent Machine” by Stephen Orr

This Excellent Machine is the first volume in an anticipated trilogy of childhood novels by Australian writer, Stephen Orr. Set in a single neighbourhood of a small Australian town in 1984 it is narrated by seventeen year old Clem who lives with his mother, his sister, Jen and his Pop, Doug. Pop has been a surrogate father to Clem since his own dad disappeared when he was a small child. Clem is incredibly close to his grandfather. They fix up cars together in the drive and have been plotting for some time to take off on a road trip, using an old treasure map to track down a seam of gold. As the novel begins, the family are just beginning to realise the implications of Pop’s Alzheimer’s diagnosis. Whilst Dementia isn’t the primary focus of the novel -it’s more a coming of age kind of piece- Pop’s illness is a theme consistently revisited throughout the novel and shown to impact Clem’s life in significant ways.

There were several thing I really appreciated about Orr’s depiction of Alzheimer’s in This Excellent Machine. Primarily I liked the way Pop’s confusion and deterioration is explored within a community context. He goes out of his way to make the point that, at this time, Australians living at this socio-economic level, rarely considered external care provision. Pop’s Alzheimer’s is managed within the family but it is also heartening to see neighbours and members of the local community taking responsibility for the older man. They look out for him when he wanders off. Two of them agree to accompany Clem and Pop on their road trip. They even encourage him to continue tinkering with cars as a means of retaining his sense of self and ongoing purpose. I appreciated the idea of community support which Orr is exploring. Having grown up in a small, rural community, in the eighties, it’s something I recognised immediately. 

I also liked the way Orr gives Doug a certain amount of autonomy. Doug might have Dementia but his family and the community around him still look to him to contribute to decision making processes. They respect his opinion and look up to him. At one point in the novel Doug attempts to help a young delinquent get back on the straight and narrow and we are given a glimpse of the way people living with Dementia can continue to contribute meaningfully to society. 

This Excellent Machine is far from being a utopian portrayal of living well with Alzheimer’s. Orr doesn’t shy away from exploring the more difficult aspects of the illness. Doug’s daughter is often frustrated by her father’s condition and their relationship is under strain throughout the novel. Clem finds it hard to watch the man who has been like a father to him, decline and lose interest in the world around him. Orr also includes a heartbreaking scene where Doug gets to be a participant on the TV quiz show, Wheel of Fortune and becomes confused and frustrated while it’s being recorded. All this to say, I found This Excellent Machine to be an accurate and balanced portrayal of an older working class man experiencing the early stages of Alzheimer’s. It manages to hold the balance between honesty and hope throughout. 

This Excellent Machine was published by Wakefield Press in 2019 

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“Hour of the Bees” by Lindsay Eagar

Hour of the Bees is Utah-based YA writer, Lindsay Eagar’s debut novel. It’s a captivating story about a family spending a summer together on the sprawling sheep ranch which has been in their family for generations. The story centres around twelve year old Carol. At first Carol isn’t at all keen to give up her entire summer holidays to spend time with her grandfather, Serge on a sheep ranch in the middle of nowhere. Carol, her half-sister Alta, and little brother Lu are used to their life back in the city, with their friends and all the comforts of home. There’s absolutely nothing to entertain them on the sheep ranch, worse still the whole area’s been subject to a drought for decades and the summer months are unbearably hot. Carol and her family don’t really have a choice in terms of where they spend their summer. Serge is extremely elderly and has grown frail. His advancing dementia means he’s increasingly confused, mixing the past with the present and sometimes even mistaking Carol for his late wife as a girl. Serge is moving to a residential care facility at the end of the summer and the family have only a few months to get the ranch fixed up before it’s put up for sale.

Eagar weaves a beautiful magical realist story through the more familiar story of a family struggling to cope with change in the present and resurfacing hurts from the past. Carol grows close to her grandfather as he tells her a long and enchanting fairy tale about her families origins. She comes to understand that her roots and identity are tightly bound to the ranch and ultimately begins to empathise with Serge’s insistence that the land should stay in the family and not be sold to strangers. It’s a beautifully written story and a really enjoyable read with strong emphasis on the importance of listening to older people and valuing family connections.

However, I really struggled with the dementia narrative in this novel. Serge’s dementia feels like a kind of device used to propel the plot. He’s portrayed as confused and frail when the story requires him to be an object of pity or a bone of contention, grating up against the family’s plans. At other points he’s almost miraculously coherent and portrayed as quite strong and virile for such an elderly man. For example, though he frequently finds communication difficult he’s able to narrate, long and extremely eloquent stories about his past. I understand that the magic realist narrative running through the novel allows for a certain amount of liberty to be taken with how the characters are portrayed but I’d be a little concerned that young people with no experience of dementia who read this novel might not get an accurate idea of what the illness is actually like. Eagar, also weaves in a semi-miraculous happy ending for Serge and Carol which is very different from most people’s end of life experience with a loved one who has dementia. It’s an ongoing struggle when reading and writing fictional dementia narratives. The characters need to be written accurately and ethically and yet are also there to serve the story. For me, the balance isn’t quite right in Hour of the Bees, but it’s still an enjoyable read. 

Hour of the Bees was published by Walker Books in 2016 

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“The Vanishing Half” by Brit Bennett

I’ve been in two minds as to whether I should include Brit Bennett’s bestselling second novel, The Vanishing Half in my list of Dementia fiction narratives. The greater part of the novel does not touch upon the subject of Dementia. It’s an engaging, and incredibly timely, exploration of race issues in North America. Twins, Stella and Desiree Vignes, have grown up in Mallard, a tiny rural southern black community where lightness of skin is seen as desirable. The twins escape Mallard at the earliest opportunity and move to the big city where their lives diverge and take very different paths. Desiree marries a black man and after the relationship falls apart, moves back to her mother’s house in Mallard, with her daughter who is significantly darker than her. Stella, finding she can pass as white, marries a rich white man and moves to the West coast where her daughter grows up entirely unaware that she is mixed race. 

It’s a brilliant novel and a really engaging read and, like many contemporary novels, does not touch on the theme of Dementia until the final chapters. Lately, I’ve been noticing this as a reoccurring trope in contemporary fiction, especially novels which follow a kind of family saga narrative arc. As the protagonists -in this case the twins’ mother- grows older, they develop Dementia. I’m not questioning the appropriateness of Bennett’s choice to explore Mrs Vignes’ Dementia experience so late in the novel. However, in some novels, Dementia can feel like a tagged on afterthought or a neat way to resolve unresolvable plot issues. I’ve been noticing an increasing tendency to use a character with Dementia as a plot device. Confusion, memory loss and failure to recognise familiar people can, in fictional terms, be a handy device for creating mystery or suspending a moment of revelation. This is particularly apparent in the current craze for Dementia narratives in crime fiction. (I hope to write more about this at a later date). 

In The Vanishing Half, Mrs Vignes’ Dementia allows Bennett to swiftly and seamlessly reintroduce the long lost twin Stella, who has returned to Mallard decades after her initial escape. Her mother’s confusion and her inability to tell past from present means she accepts her prodigal daughter’s unexpected return with absolutely no questions. For Mrs Vignes’ it’s as if Stella never left. The cynic in me, could argue that Bennett uses Dementia as a handy device to resolve a lot of her plot lines in a swift and overly simplistic way. It’s awfully neat, to watch a family who’ve been fragmented and at loggerheads for three hundred pages, become united by their mother and grandmother’s Dementia for a handful of pages at the novel’s end. However, for the most part Bennet’s portrayal of Mrs Vignes’ Alzheimer’s is reasonably convincing and it’s so rare to see an exploration of Dementia within a black community I felt it important to include The Vanishing Half. 

I also felt compelled to note that Bennett’s inclusion of the line, “Alzheimer’s Disease was hereditary, which meant that Desiree would always worry about developing in,” is neither helpful nor accurate. Less than 1% of Dementia diagnosis are hereditary and ill-informed statements like this can cause distress and even panic in readers. I enjoyed The Vanishing Half immensely and I will defend to the hilt, the writer’s right to explore and record other’s experiences. But when it comes to publishing factual statements like the one above, especially in widely read novels like The Vanishing Half, I think it’s absolutely essential that the information conveyed is well-researched and accurate.

The Vanishing Half was published by Dialogue Books in 2020

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“There but for the” by Ali Smith

In true, and glorious, Ali Smith style, There but for the is a novel narrated from multiple perspectives, seamlessly weaving various timeframes, memories and characters together as their stories pivot around a central linked point. The pivotal point here is a dinner party gone dreadfully wrong. One of the guests, an almost stranger named Miles, excuses himself from the dinner table. He proceeds to lock himself in the spare bedroom and refuses to come out. Various characters are introduced into the story, helping to flesh out the life which has led Miles to this point. 

The point of the novel, as is often the case with Smith, is not stringing the reader along until they arrive at the big reveal moment when the whole locked room mystery will be revealed. Ali Smith is a much better writer than this. The point is that in getting to the point, or perhaps not even getting there, the reader relishes the journey and the opportunity to try on each character’s unique perspective and walk a chapter in their shoes. Thus, the plot device, though clever, always feels a little subsidiary to the incredibly well-crafted characters and the subtleties Smith weaves into each of their voices. This is a book about living and being and the way people’s lives crash into each other and how these crazy encounters are meant to be enjoyed not analysed. 

Around half-way into the narrative Smith introduces the reader to May Young, an older lady living with Dementia in a nursing home. May’s chapter is narrated in a close, and very intimate third, with much of the observation coming from what May calls, “the confines of her head.” It’s a very well-written exploration of how it must feel for someone living with Dementia during that strangely liminal period, when May is still aware enough to know something’s gone wrong with her mind, yet is already losing elements of her own autonomy. 

There’s a tremendous amount of physicality to Smith’s depiction of May. May is constantly narrating the movements and presence of her own body as if observing it at some distance. She is clearly struggling to situate her sense of self as attached to her own body when she thinks about the hospital band, digging into her wrist. 

“Well, but it was sore enough, that wrist on the bed, to be her own wrist, no stranger’s wrist after all, there where the plastic bit into it.”

Smith also explores the blurring of time within May’s head as she confuses a young visitor with one of her own children and talks about being overwhelmed by the memory of the three of them, frozen at particular points in their development.

“All three of her children ran about in May’s head in colour turned up too-high, on a throbbing green lawn bordered with throbbing yellow roses.”

May’s confusion extends to her own story. She’s trying to get the order of it straight in her head; to understand the implications and consequences of everything which has happened in her life. It isn’t easy. Dates slip and facts rearrange themselves. The story comes out back to front and in the wrong order. It’s a very believable account of Dementia. Ali Smith’s style of writing sits well with the fractured linguistic tics, the repetitions, questions and word associations which might be seen as typical of a person exhibiting the early stages of Dementia. May’s chapter exists as a microcosm of the themes running through There but for the. Yes, the reader wants to understand the story she’s telling. There’s a desire to pin down the narrative. But the true joy of May’s story is in the telling; in the getting to the point. Fractured, fumbled, shot through with humour and strange digressions, her elliptical narration gives the reader a wonderful insight into the workings of her brain and the sort of complex and wonderful person May Young is. 

There but for the was published by Penguin Books in 2012 

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“Small Mercies” by Bridget Krone

This beautiful novel aimed at upper primary children was an absolute joy to read. It’s set in post-apartheid Pietermaritzburg, South Africa and deftly explores a number of complex themes including Apartheid, the care system, class and ethnicity issues and ageing. The theme of Dementia could quite easily have been lost within the scope of the novel. However, Krone does such an excellent job of weaving her story together Dementia never feels like a tokenistic add on. It’s an integral part of the narrative throughout. The illness is written in such a way that young readers will encounter a very realistic, factually accurate depiction of Dementia without feeling threatened or fearful. This is a delicate balance to maintain in children’s and YA Dementia narratives and it’s testament to the skill of Krone’s storytelling that she maintains this balance throughout the novel.

Small Mercies centres around a young girl called Mercy who lives with her two eccentric, elderly foster aunts and their lodger in a ramshackle house on the edge of the town. Mercy is struggling to understand her family situation, the poverty she’s living with and the complex ethnic identity structures of South Africa as played out in her own classroom. She’s constantly worried that a Social Worker might appear and take her away from her beloved aunts. This anxiety intensifies when she realises they may lose their house and that her Aunt Flora’s increasing confusion is actually a symptom of Alzheimer’s disease. Eventually neither Mercy nor her Aunt Mary are able to cope with Flora’s confusion, accidents and wanderings. They find a place for her in a residential care facility and Flora must come to terms with losing yet another parent figure. 

Krone does a marvellous job of articulating Mercy’s complicated mix of emotions as she watches her foster family go through some radical and upsetting changes. I particularly loved the honesty with which Mercy describes her embarrassment over how Aunt Flora’s “strange” behaviour might appear to the other children in her school. Krone also writes extremely accurately about the way poverty can take an enormous toll on how a person living with Dementia is cared for. This little novel has a lot of heart. It speaks about the importance of community when it comes to care. It’s funny and wise and full of hope and there’s a brilliant, compelling story running throughout. I enjoyed it immensely and learned quite a bit about South African culture whilst reading it. 

Small Mercies was published by Walker Books in 2020

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“Still Alice” by Lisa Genova

Many readers will have come to Still Alice via the 2015 big screen adaptation starring Julianne Moore in the title role. Moore, quite justifiably, won a Golden Globe for her portrayal of Alice, the university professor, wife and mother who finds herself diagnosed with Dementia at the relatively early age of fifty. Genova chooses to focus her novel on a reasonably rare type of Alzheimer’s which can be passed genetically from parents to children. A large part of the novel explores the relationship between Alice and her three children as they decide whether to have a genetic test and how they’ll deal with whatever the results turn up. The Dementia also places strain upon Alice’s close family ties as her children and her husband have to learn how to navigate her rapid decline, repositioning  themselves as carers when they’ve previously been so dependent upon her. The third person narration offers us small glimpses into their confusion, disappointment and anxiety though most of the novel is focused on Alice. She is the hero of this quest.

I’d argue strongly that Still Alice is a quest narrative with much of the novel exploring ways in which Alice can find a way triumph over her diagnosis. You might argue that the possibility of suicide is introduced earlyish and revisited later when Alice is too confused to follow her own emergency exit instructions and consequently continues living by default. However, even the idea of an end of life plan could be seen as a kind of quest, with Alice retaining autonomy over her own existence. Genova is determined to find meaning and potential in the midst of Alice’s difficult story. A gifted public speaker and academic by trade, Alice gives a paper at a conference on Dementia, reminding the reader that she is still herself and can still contribute to society in spite of her diagnosis. Alice is also portrayed advocating for people living with Dementia and beginning a kind of support group for those diagnosed with the condition. The meaning is clearly implied. Alice is still an active and useful member of society. She is, in her own way, making Alzheimer’s work for her.

At several point, most notably later in the novel, Genova explores the complex tensions inherent within how Alice is viewed by the people around her. Her family are desperate for her to remain active, engaged and essentially, still herself. And yet, they’ve already begun the process of infantilising her as their roles as carers begin to trump their previously dependent roles.

“They talked about her, in front of her, as if she were deaf. They talked about her, in front of her, without including her, as if she had Alzheimer’s disease.”

Alice’s decline is rapid and brutal, Genova dates her chapters so the reader can see just how quickly the disease progresses over a period of two years. As the novel concludes Alice’s observations and interpretations about the world around her become less sophisticated, and in some ways, less anxious. By the final chapter, she’s lost the ability to recognise her own daughter and yet seems to be more peaceful than in the opening chapters where her mental confusion was a constant distress. 

“Everyone walked, busy on their way to where they must go. She didn’t need to go anywhere. She felt lucky about this.”

It’s a comforting way to conclude a novel about a woman whose life has been gradually erased. It’s hard not to wonder whether Genova, compromises accuracy, to give her readers a satisfying conclusion. The novel’s ending raises some of the biggest questions implicit in all serious attempts to write about Dementia: how cognisant is the person living with Dementia, especially towards the end of their journey? And, if people living with Dementia are relatively cognisant, even late into their diagnosis, is it less troubling for the rest of us, as friends, family members and interested bystander, to simply pretend they’re not?

Still Alice was published by Simon and Schuster in 2007 

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“Say Say Say” by Lila Savage

Whilst not strictly a novel exploring Dementia, Say Say Say has been an important addition to my reading list this year. It centres around a small cast of characters: Bryn, an older man whose wife, Jill has sustained a traumatic brain injury and Ella, the young woman he employs as a companion and carer for Jill. Jill exhibits many of the symptoms associated with Dementia. She struggles to process thought logically, no longer recognises herself or the people around her, requires a lot of physical assistance and, most notably, displays a form of aphasia which leaves her language and communication skills confused. Her lexicon is greatly diminished and she often resorts to expressing herself through a series of repetitive linguistic tics such as, “say, say, say,” as alluded to in the novel’s title.

Interestingly, Lila Savage doesn’t really attempt to explore or convey Jill’s experience or feelings as she becomes increasingly dependent on her carers. Say Say Say is a novel which focuses on the family and carer’s experience and as such, is an essential read. The reader is given a wonderful insight into what it’s like for a young woman like Ella to be responsible for someone so very dependent. We see her struggle to communicate effectively with Jill as her linguistic possibilities are incredibly limited. Eventually Ella lights upon some creative ways to connect with Jill. She begins to mirror the older woman’s linguistic tics.

“As the next best thing, Ella began to respond to Jill’s circular rants as though they were friends chatting, responding in a steady, sympathetic murmur, as though the natural back-and-forth of conversation were occurring.”

And in some of the most moving scenes in the book, Ella learns how to slow her normally hectic pace of life down in order to be present with Jill. Jill potters around the house and garden, often silent or mumbling to herself. While Ella reads, draws Jill and writes poems about her. In this way she manages to connect with some essential part of Jill and this connection makes it impossible to administer the physical side of the older woman’s care with anything but careful dignity. “Ella wants Jill’s every encounter to be respectful.”

Through Ella’s eyes we are also given a snapshot of how Bryn feels as he cares for his beloved wife who has become incapable of looking after herself and no longer knows who he is. “Bryn essentially lived in hell, Ella knew this even if she didn’t always acknowledge it. It was like he was confined to an empty white cell with nothing to do but observe the sights and sounds of the torture of the person he most loved.” Savage offers her readers a very honest portrait of a good man, who loves is wife and yet has become worn down and frustrated by the burden of caring for her.

It is this unswerving honesty about the carer’s experience which makes Say Say Say an exceptional read. The characters here aren’t remarkable. They’re honest, very recognisable, figures, doing their best under difficult circumstances, sometimes excelling and sometimes failing. They’re occasionally angry and despairing, occasionally able to seize small moments of unexpected joy. It reminded me of so many of my own experiences working with people living with Dementia and talking to their carers and family members. It’s a very moving book, beautifully written, shot through with small nuggets of humour and perfectly placed to give the reader an accurate understanding of how caring for someone with a life-changing illness will affect every part of a carer’s life.

Say Say Say was published by Serpent’s Tail in 2019

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“By the Pricking of My Thumbs” by Agatha Christie

First published in 1968, Agatha Christie’s 59th crime fiction novel, By the Pricking of My Thumbs might not be the most obvious inclusion in my Dementia bookcase. However, though it never mentions the word Dementia, (the term did not come into widespread use until the 1980s), the novel, much of which is set in a retirement home, is one of the first examples I’ve come across where Dementia -or senility as Christie calls it- is used as a plot device in crime fiction. Recently, we’ve seen a number of crime fiction novels include characters with Dementia as a means of adding confusion, delaying the investigation or increasing the intrigue elements of their plots. I hope to take a closer look at this practice at a later date. Arguably, there is a less well-developed, though even earlier, incidence of this trope in Christie’s work. In her 45th crime fiction novel, A Pocketful of Rye, the story begins with an elderly man experiencing a complete change of personality which, in the 1985 television adaptation, starring the great Joan Hickson as Miss Marple, is quite believably attributed to Lewy Body Dementia.

In, By the Pricking of My Thumbs, Christie’s husband and wife sleuthing duo, Tommy and Tuppence investigate what might or might not be a murder after a confused elderly lady in a nursing home tells them there’s a child’s body buried behind the chimney. The plot hangs upon this confusion. Are old ladies with Dementia to be believed when they make accusations and claim there’s a poisoner at large? Or, are they to be brushed aside and dismissed as Miss Packard, the nursing home’s director seems to think?

“They’re like children, really,” said Miss Packard indulgently. “Only children are far more logical which makes it difficult sometimes with them. But these people are illogical, they want to be reassured by you telling them what they want to believe.”

The implication is reasonably clear. Older ladies living with Dementia no longer have any agency. Miss Packard goes on to call their delusions fancies, although she insists they’re harmless enough. “We try not to take any notice, not to encourage them. Just play it down,” she says. In this sense, Christie could be seen to be echoing the predominant feeling of her time. People who developed, what was then known, as senile dementia were best ‘played down’ or even ignored. They were regularly institutionalised and rarely given access to the kinds of therapies, activities and outlets for self-expression which people living with Dementia routinely engage in these days. And so, it is actually quite counter cultural when Christie reveals, (I’ll be careful here to avoid plot spoilers), that the so-called “illogical” and “delusional” old ladies are actually speaking a version of the truth and attempting to draw attention to a real crime which has occurred. 

Like many tropes within Christie’s writing I go backwards and forwards on the ethics of what she’s doing with her plot and themes. In one sense her inclusion of people living with Dementia as vital, active and -most importantly- helpful characters is well ahead of her time. In another sense, I have reservations about using Dementia as a plot device. Is it ethical to include a character with an illness like Dementia simply to develop an aspect of the narrative? Isn’t this quite a reductive way to view both the illness and the characters themselves? What does this say about how authors view people living with Dementia or other illnesses? There are far too many questions to answer here in a short review. By the Pricking of My Thumbs is late Agatha Christie and probably not one of her best. But it’s still a very enjoyable read and a great treat for me as a big Christie fan to see her engage with the topic of Dementia. It feels a little like my planets have aligned.

By the Pricking of My Thumbs was published by Collins in 1968