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Travellers to Unimaginable Lands review: The true toll of dementia

In a wise and challenging book, Dasha Kiper focuses on the forgotten people caring for those living with dementia
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Dementia can be a cruel disease, both for the people with the condition and those who love and look after them
Jorm Sangsorn/iStockphoto/Getty Images


Dasha Kiper (Profile Books)

PEOPLE who care for those living with dementia, says Dasha Kiper, are its “invisible victims”, rarely discussed in the research literature and given little support. Kiper has made a career out of listening to them. At 25, she moved in with a 98-year-old Holocaust survivor in the early stages of Alzheimer’s disease and, after completing a master’s in clinical psychology, she spent 10 years counselling carers and running support groups.

Travellers to Unimaginable Lands: Dementia, carers and the hidden workings of the mind is her first book. It tells the stories of people with dementia and of their carers. Modelling herself on Oliver Sacks, Kiper weaves psychological and neurological research into her own insights about the work of writers including Samuel Beckett, Franz Kafka, Herman Melville and Jorge Luis Borges.

Kiper can write with a Sacks-like clarity. One carer “seemed coiled in place, as though it were painful to sit still”, while her mother “paced back and forth, with an irregular, limping gait… and each shuffling step felt like an interrogation”.

But where Sacks’s cases are outlandish, Kiper’s are desperately ordinary. Take Jasmine, who taped notes on doors and walls, imploring her mother not to take food out of the freezer, leave the house or be violent. Or Elizabeth, whose husband sometimes denied knowing her and would throw her out as a stranger.

“People always ask about the patient,” Elizabeth tells Kiper. “Let me tell you something, the patient is fine; it’s the caregiver who’s going crazy.” Carers often mirror the behaviours of those they look after, Kiper notes, engaging in denial, distortion, arguing, blaming and endless repetition.

The key driver is what Kiper calls dementia blindness. Much in the way our brain fills in for our visual blind spot, so carers see the person they are used to seeing. Discussing this, Kiper refers to writer Nassim Nicholas Taleb’s theory of narrative fallacies, philosopher Daniel Dennett’s intentional stance and neuroscientist Michael Gazzaniga’s left-brain interpreter – unconscious, evolved processes “responsible for sweeping inconsistencies and confusion under the rug”.

Conspiring with these processes are our emotional biases, Kiper writes, including our evolved need for “mutually agreed-upon reality”, which is most acute with those we are close to and in situations where we aren’t in control. This creates what she calls the carer’s dilemma: to “accept something less” than the person we knew means letting go of our idea of who they are, which risks dehumanising them.

Kiper’s literary interpretations echo her radical leap: to see impossible situations from the point of view of the carer or family member. Melville’s Bartleby, the Scrivener – the story of a clerk who rejects everything, saying he would “prefer not to” – is seen from his employer’s viewpoint as he struggles to make sense of the situation, while being in many ways needier than his self-contained clerk. Kafka’s Metamorphosis is read as a portrait of family dynamics taken to absurdity. Beckett’s Waiting for Godot dramatises how “we create and acknowledge the possibility that clarity, meaning, and connection exist even when there appears to be only strangeness and futility”.

These aren’t just original readings, they have a compassion that bring Sacks to mind. Carers, Kiper writes, are “‘tortured’ in living rooms and kitchens, rooms that hold memories and trigger old patterns of behaviour, rooms that damn them to choose an unhappy or unnerving dynamic over no dynamic at all”.

This is a wise book, and one that is unsettling in the best way.

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Topics: dementia