The armchairs were arranged in a semi-circle centred upon a large screen television on the wall. The hospital now provides only respite care so there are frequently empty chairs in the day room. It was not hard to find a chair to sit next to her. Conversation now is one-sided, sometimes there is a smile in response, sometimes words hang in empty space.

Quickly exhausting what might be said, I turned to look at the television. The volume was turned low and the screen was filled with advertisements. There was an advertisement for a fruit drink, it seemed confusing, a combination of real life and cartoon imagery, purple bubbles bounced across the screen. Somewhere an advertising executive thought this was going to improve sales, expand the market share, make the product instantly recognisable to those going to supermarkets. It was baffling that such broadcasting should have the capacity to increase one’s profits, making me realise how far removed was my world from that inhabited by twenty-somethings with sharp suits and fast cars.

The lady beside me stared at the screen, lifted her hand and pointed at the images. Her capacity to express thoughts has disappeared and it was bewildering to know how to respond.

“Yes,” I said.

Yes, what, though? What was I affirming or denying? Not understanding myself the purpose of the advertisement, what words were there that would have meant anything to the lady dwelling in the shadowlands of dementia?

Perhaps the bright colour and the combination of cartoon and real life was appealing, perhaps, when all else is confused, there is reassurance in images that make no demands on one’s capacity for logic or comprehension Perhaps the images conjured thoughts in her mind that she found happy, or at least not painful.

Who knows what might have been passing through her mind? No-one has come back from that dark world.

Maybe, somewhere, there is someone conducting research into what images seem conducive to the emotional welfare of people with confusion. Maybe in ten years’ time it will be possible to download sequences that can be run to stimulate the minds of those who can no longer communicate, sequences that will prompt otherwise non-communicative ladies to point to the screen. Perhaps advertisements for fruit drinks will feature on the menu of videos to be played. Even better, though, maybe in ten years’ time there will be some way of reversing the worst of all illnesses.