Keeper, by Andrea Gillies

Andrea Gillies thought that there was money to be made in writing books. And when she moved to a bleak Scottish peninsula the words did flow, but not in the way that she had intended. Instead of penning fiction she found herself documenting her incredible real life as a carer for her in-laws, as one slipped into immobility and the other into Alzheimer’s. The result is a beautifully observed, utterly honest and emotionally draining account of neurological illness, struggling to cope, and human identity.

The star of the book is Nancy, Gillies’ mother-in-law, who slides from forgetfulness to the full-on madness that is the lot of some Alzheimer’s patients.

While family finances dictate a move far north to a creaky old house that can accommodate a husband, three children, Nancy and her husband, Morris, the displacement becomes psychological as well as physical. Nancy quickly declines from a stiff, proud, well-turned-out woman into a belligerent, gibbering wreck who soils the carpet and refuses baths. This book won the Wellcome Trust Book Prize 2009, as well as the Orwell Prize this year. Not only does Gillies write about how her mother-in-law’s brain is changing (she is a gifted science communicator), she also deals unflinchingly with the public-image problem of dementia. It is regarded as a social epidemic rather than a medical one. So the difficulty of coping is magnified by having to work the social care system.