Do not be fooled by the light-hearted ‘cake’ in the title of
this book. This is an account of the sombre journey made by the
author, on committing herself as the carer of her mother-in-law,
Nancy, who has dementia. However, Andrea Gillies travels this path
with a liberal sprinkling of humour to make what could otherwise be
a truly harrowing read, enjoyable and a page turner. It rightly won
the 2009 Wellcome prize for medicine in literature.
Andrea’s journey is an edifying read to any health care
professional who works with dementia and their carers. She presents
a disturbing account of how that ‘professionalism’ can seem
uncompassionate and unhelpful.
Andrea felt Nancy could hoodwink her doctors into thinking she
was more capable than she was. In one example, Nancy answers the
standard MMSE question: ‘what is your date of birth?’ with a
cheerful laugh about her poor memory, and questioning was dropped.
The doctors were successfully convinced; I found it hard to accept
that an experienced doctor would be so easily reassured.
Andrea found some touching ways to calm Nancy’s agitation, one
of them being the cake, which Nancy so obviously relished. Another
good distraction was the two of them playing ‘follow the leader’
and inventing silly walks for the other to copy. However, despite
the author’s obvious good humour and creativity, she also paints a
clear picture of her own deteriorating mental health as her role
became increasingly difficult.
Andrea Gillies is clearly a highly intelligent woman, and has
ably combined literary, artistic and scientific examinations of
dementia. Her scientific analogies of how dementia affects the
brain were extremely well described and could prove very helpful to
medical students struggling with the basic concepts of
I tentatively offered Keeper to a relative whose mother had
lived with dementia for the last 10 years of her life. She finished
the book in record time, saying she wished she’d read it while her
mother was still alive. Thus it’s certainly a book to recommend to
anyone who knows someone with dementia.
This is also a book that all health care professionals working
with dementia need to read, to understand our patients and their
Overall, this book deserved its accolade as winner of the
Wellcome prize for medicine in literature. It is beautifully
written, thought provoking and highlights many important
considerations about our ageing population.
Dr Aruna Sahni