A Silent Tsunami: Swimming Against the Tide of my Mother’s Dementia by Anthea Rowan (Bedford Square £20, 336pp)
One day in December 2019, Anthea Rowan’s mother, aged just over 80, forgot who Anthea was. At lunchtime, she still knew. By nightfall, she didn’t.
‘Tell me, where did we first meet?’ was her polite way of putting it. ‘You’ve known me since the day I was born, Mum. You’re my mother!’
Looking blank and shocked, she retorted, ‘You’re far too old to be my daughter.’ She would never recognise Anthea as her daughter again.
That was the moment when a great fissure appeared in Anthea’s life: ‘Before’ and ‘After’. The ‘Before’ time, when her mother loved, knew and remembered her, was a lost country. Anthea and her siblings now had to battle on, loving and caring for a woman whose brain was steadily being smothered and shut down by ‘the dust and cobwebs’ of dementia: a brutal disease which, just when you think it’s played its cruellest card, goes on and does something even worse, systematically dismantling a person piece by piece until they’re a frail, shivering, incontinent, confused, terrified wreck.
‘I don’t know it yet,’ writes Anthea, in this powerful, readable and salutary memoir, ‘but the distance my mother will travel from me has only just begun.’
Dementia is sometimes known as ‘the silent tsunami’ because by the time we spot it, it’s too late. In hindsight, Anthea writes, ‘it’s only silent because we’re not listening’.
She doesn’t spare us the details, recounting each of the small, pitiless, heart-sinking stages of her mother’s decline. The first stab of cruelty was that her mother did still recognise Anthea’s sister Carol. ‘I don’t need you. Carol can help me.’ And she gave Anthea ‘furtive, suspicious looks across the table’.
Anthea Rowan with her daughter Hattie and her mother
That was indeed just the beginning. One by one, every little comfort and reassurance that sustains someone’s personality and enjoyment of life was stolen from her mother.
She forgot how to read. She had to drink her tea from a sippy cup, and wear ‘dementia-friendly slippers’ to stop her from falling over, as well as wearing nappies. And (like a toddler) she complained and dropped her food on the floor if she didn’t like it.
‘It must be like looking after a baby,’ sympathetic friends said. No, Anthea insisted. It’s nothing like that. A baby is full of curiosity and vigour, with a greedy appetite for life.
Whereas ‘my mother is curled, crooked and broken’ and ‘everything about her speaks to decay and dying’.
Yet she didn’t want to die. Far from it: her primal instinct to survive had mushroomed. She would wake up in the middle of the night, fretting about the tiniest physical ailment.
The number of people going through exactly this kind of thing is frightening to contemplate. In 2020, a study found that 55million people in the world were living with dementia, or Alzheimer’s disease, and warned that the number would double every 20 years as humans live longer.
One doctor said to Anthea that today, people are more afraid of getting dementia than of getting cancer. ‘The Big D is bigger than the Big C.’ Reading this book, you can see why.
A professional journalist thirsty for scientific knowledge and understanding, Anthea sets out to find the answer to two questions.
A Silent Tsunami by Anthea Rowan is available now from the Mail Bookshop
First, what caused her mother’s dementia? And second, what should Anthea (and all of us) do to avoid this dreadful fate happening? She becomes an obsessive researcher, asking medics and reading every report and study she can lay her hands on.
When Anthea was 13 in the 1980s, her mother started to suffer from repeated bouts of crippling depression: ‘The train-wreck type, vitality-stealing, life-saturating, utterly alienating.’ (Anthea writes in powerful and evocative prose, as that sentence illustrates.)
Now, she discovers that depression and anxiety cause the stress hormone cortisol to flow – and cortisol ‘can underpin the development of Alzheimer’s disease, by driving the production of the type of amyloid which lays the foundation for amyloid plaques, the pathological marker for Alzheimer’s.’
Not only that, but the sleeping pills her mother took during that dark time may well have damaged her brain. The threshold of damage is between 180 days and three years – and her mother was on those pills for years.
One day, out of the blue, her mother said: ‘I don’t know why my parents never sent me to university. I should have gone. My life would have been quite different.’
A typical 1950s daughter, not expected to go to university, her mother didn’t have enough to do in adulthood, Anthea now surmises. ‘Dementia settled into the spaces in her brain, spaces gouged wide open by depression, inoccupation and social isolation.’
Anthea’s growing list of possible causes of dementia is so terrifying that it makes you not want to leave the house – although, of course, not leaving the house is one of the causes of dementia.
She sets out to live a dementia-avoiding life – as we all should. Smoking, drinking, hearing loss, loss of sight, poor sleep, not walking fast enough, sitting for too long, not thinking enough, not talking enough, not eating enough blueberries… all of these can be harbingers of the dreaded thing.
She advises cold-water swimming – but reminds us that hypothermia can be brain-damaging as well. As it happens, Anthea, who’s married with three adult children, lives in Africa (Tanzania), so there’s an exotic strain to this book.
Her mother comes and stays with her there, as she has a nice domestic helper to aid her. After a year of sleeping in the same spare room, her mother says one day: ‘Who moved my things – all my things – from my room to this new place?’ Then she starts hallucinating, seeing people with guns outside the window. Those traumas are all normal items served up on dementia’s poisonous menu.
The end does, eventually, approach. And a few days before her death, Anthea’s mother suddenly says: ‘I love you.’ And Anthea replies: ‘I love you, too, Mum.’
Only after she’d died did it occur to Anthea ‘that I’d forgotten to ask her who she thought I was then. It didn’t matter.’
