Book Review: I'm Ralph, I'm Dad: A Daughter Explores Identity, Relationship and a Gentler Dementia

Dementia is an increasingly common condition as the numbers of people living to an older age increases. It can, of course, affect some people at a relatively young age. Fortunately, as Emeritus Professor of Geriatric Medicine, Dr. David Richmond, states in his foreword to this delightful little book, it no longer carries the same stigma as it did in the past.

Dr. Glennis Mafi, a general practitioner, puts a name and a human face on this condition as she relates her experience of the development and progress of dementia in her father, Ralph Wood. This self-published book (though with the publishing expertise of Castle Publishing) provides both a personal and a practical insight into caring for someone with dementia, as well as capturing something of the experience of it through anecdote, description, and poems. Mafi appears on the front cover of the book, standing with family members, behind her father, Ralph, at the left of the picture (and, yes, I think that the faces of all except Ralph’s have been slightly blurred for effect).

Mafi states that this is not a technical, medically or scientifically detailed book about dementia, though as she relates Ralph’s story, she also makes observations and imparts information about the condition. She also provides a helpful set of appendices (see below).

What makes this book so useful and helpful is that it relates the experience and condition of dementia, not only through personal observation and commentary upon her father’s dementia but also captures something of the emotions, the frustrations, the joys, and sudden surprises of both those caring for Ralph and of Ralph himself. Some of the latter, of course, is captured in telling anecdotes, and especially poems that enable her imaginatively to express what dementia may be like for the person who has it.

In an “Introduction”, Mafi captures beautifully the onset of dementia in a poem entitled “Cup of Tea for Dad” (18–19). After some stanzas, obviously relating the drinking cups of tea in earlier (pre-dementia days), and one hinting at the onset of the disease, comes this:

Tea going cold, forgotten …
‘Drink it up, Dad!’
And he sits, immobile, staring into the blank page
of another today. (18)

The first chapter provides a brief biography of Ralph’s life, a necessary introduction to the later description and recounting of his life with dementia. It helps to paint a rounded picture of the man, but Mafi also ponders whether certain aspects of his character and his experiences also defined aspects of his personality in dementia.

In a chapter headed “Identity”, Mafi traverses the difficulty of determining when dementia begins to develop. She also provides a helpful discussion on learning to “become a friend of time” when caring for someone with dementia. She attempts to imagine what it might be like for someone losing his or her memory and speaks of ways in which certain practices or actions of others may help. She relates how her father retained his sense of humour, an important part of his identity. She speaks of his work identity as an accountant, and the habits and hobbies (or leisure activities; for Ralph and the family, it was sailing), that help to retain aspects of a former identity.

A chapter entitled “Life Day by Day” deals with some of the issues of daily living for someone with dementia, and for the carers. Incontinence is covered both humorously and respectfully in a poem called “Pooh Corner,” but wise advice is also given on steps that can be taken to mitigate the problem, and on maintaining dignity and treating it when it may be a temporary problem. A feature of this chapter was the way in which “small interventions” can make a difference. In Ralph’s case, a simple change of where he sat at the table enabled him to go in the right direction to the toilet. A tendency repetitively to lock and unlock the front door (with the consequent danger of leaving it open at night or locking himself out) was fixed by simply hanging a notice “Door Locked” on the latch at night, and hiding the key.

Finally, in a chapter called “Winding Down,” the difficulty Ralph had in coming to terms with his wife, Hazel’s death is covered. Also discussed is the role his Christian faith played in his dementia. Mafi calls his dementia a “gentler dementia” partly because of the way he, and the family, could call on their faith to help them through, but also because Ralph had the good fortune to have enjoyed a long, companionable marriage. In the years of his dementia, he was evidently cared for by a loving, supportive family who did all that they could to make sure he was safe and well-supported.

The book is not only laced with poems, but it is illustrated throughout with wonderful drawings done by his son, Graham Braddock, which supplement the text. A small issue is that one of the poems (“Ralph’s In”) appears misplaced. It is referred to in one chapter, but the anecdote is puzzling until one arrives at the poem several pages later in the next chapter.

The book ends with eight brief, but very useful and helpful appendices: a definition of dementia; early signs of dementia and other conditions; the cause of dementia and whether it can be prevented or treated; whether or not losing one’s memory makes one a “non-person”; making a present of the past by using photos that can help stave off memory loss (two appendices); medicines that can be used in dementia; and spirituality in dementia.

This book provides a brief and accessible entrée into what it is to care for someone with dementia. It will be helpful for those who are carers (keeping in mind the disclaimer that each person’s situation and case will be different), and possibly for those who are suffering from early-onset dementia (though this may depend on how robustly accepting and optimistic they are). All who would like to have an insight into, and some understanding of what dementia is and how one might deal with someone affected by it, will find this book both instructive and a delight to read. It may be obtained from the author at glennis.books@gmail.com.

Derek Tovey is the book review editor for Stimulus.