If your mother was old and unable to look after herself, what would you do? Take her in and look after her yourself, or would you find a suitable nursing home and admit her to it? This is a sensitive subject in our society which has been described as a ticking bomb due to the vast amount of people over retirement age who are living to be older and older due to better access to drugs which unnaturally prolong their lives. No doubt you have an opinion about what you would do in the hypothetical situation, though whether you would be prepared to share it honestly with your friends is another matter. Les Dennis jokes aside, would it make a difference to you if it were your mother-in-law, and not your own mother, who needed the care?

At first glance, these questions seem irrelevant to Keeper, Winner of the Wellcome Trust Book Prize 2009. Described as “a book about memory, identity, isolation, Wordsworth and cake”, Andrea Gilles’ book with its swirly, feminine, pastel coloured fonts initially looks like common or garden chick lit, unworthy of a second glance. Normally I would have done exactly that, but this book piled on a table in the Medical Reference section of Blackwell’s Oxford seemed profoundly out of place.

The book, you see, is about as far away from chick lit and happy endings as it’s possible to get. A gut wrenching personal account of a struggle to care for an elderly mother in law, retain a sense of your own identity and survive the havoc and destruction that Alzheimer’s disease wreaks upon family life, the book the experiences of Gillies’ family with unflinching honesty. This account, Gillies will be the first to admit, is subjective and that of one particular case. So the book goes further, exploring this history of medical opinion surrounding Alzheimer’s and other forms of dementia and the future of diagnosis and treatment. The book is chatty not preachy; full of anecdotes about the workings of the mind, famous dementia sufferers and philosophical musings about the nature of the soul and identity. Hard science is offset by human experience, leaving an end product which both informs and involves.

Despite her efforts in raising awareness of the disease, research into which is pitifully underfunded, Gillies has been as widely criticized for writing the book as she has been praised.

The praise is easy enough to understand. Alzheimer’s is a terrifying disease, but one which people are still reluctant to talk about. Seen as being an illness of the elderly or a natural decline into old age, research on the subject is slow and treatments hit and miss. Such a powerful memoir outlines the nature of the disease for those who have not encountered it themselves showing its crippling effects up on the individual suffer and the people who love them. Why then the criticism?

As an outsider, it’s easy to claim that Gillies was naive in moving their family from the familiar surroundings of Edinburgh to a remote Scottish peninsula to care for her mother-in-law. Naivety is no crime, and is in the most part forgivable. I did however find myself filled with the urge to criticise and judge when Gillies talks about her search for what she terms “the Sublime”. The capital R which characterises the Romantic poets, early in her memoir Gillies speaks of this immense union with nature she believes her mother-in-law will find healing, and which will fill her with the power to write a Great Work of Fiction. At best I found this vaguely ridiculous. I don’t think I need to discuss the vanity and conceit in this notion, that the decision to write a book by the sea will save a dementia sufferer where medicine can’t. Though, who knows what desperate people will do?

Worst of all though, was the dark hints between the lines that the situation might be somewhat manufactured. Cooking Julie and Julia style had been done, so let’s uproot the family, settle in the middle of nowhere with our vulnerable elderly relatives and see what happens.. sinister references to “the experiment” end early into the book, which was a relief, quite frankly, as they made me feel quite hostile towards Gillies. When they ended, along with the vainglorious wittering about the sublime, the account becomes less impersonal and more human.

Jo Brand described the book as being “darkly comic”, and Gillies herself admits that people have criticized her for writing about her mother in law who is unable to agree or disagree with the publication for the book. Personally, I don’t feel that the book was darkly comic. I certainly don’t feel that Gillies is poking fun at her mother in law. What might pass for slapstick in a tasteless Hollywood comedy is a bleakly tragic. The reader is not so much invited to laugh at the crazy old lady, but gently persuaded to see the frustration and terror that dementia sufferers live with day in and day out. Not knowing friends and family, losing your whole sense of self.

Don’t expect a happy ending, but do read the book. This is a topic which will affect us all before too long and merits deeper consideration.