“I have this thing in my head, and it is embarrassing.” The photographs on the walls testified to the life of elegance and sophistication the woman had once enjoyed. The books that lined the shelves spoke of culture and travel and an enjoyment of literature. The house spoke of an affluence that was of no avail against the worst of all illnesses.

“It is embarrassing,” the woman would have concurred with the tragic figure of King Lear, William Shakespeare’s insight into the onset of dementia has a frightening quality:

“Pray, do not mock me.
I am a very foolish fond old man,
Fourscore and upward, not an hour more nor less;
And, to deal plainly,
I fear I am not in my perfect mind.
Methinks I should know you, and know this man;
Yet I am doubtful; for I am mainly ignorant
What place this is; and all the skill I have
Remembers not these garments; nor I know not
Where I did lodge last night. Do not laugh at me”

Once, I knew a doctor, a man prominent in his profession, distinguished in his service in the British army in the Second World War. Captured at the fall of Singapore, he had acted as medical officer in the prisoner of war camp in which he was held, working without proper medication or equipment.

In latter years, he received a diagnosis of cancer with complete equanimity, choosing to have neither intervention or treatment. It seemed an odd decision by a man who was leading a full and active life. After his death, a family member told me that the thing the man most feared was dementia and that the illness had ensured that dementia, if it arrived, would never have the opportunity to develop.

It was a decision that gave great cause for pondering, a man who had seen humanity at its worst, who had endured the most abominable conditions, had come through these things; his fear was not what happened on the outside, but what might happen within the brain.

To watch someone with dementia is very difficult, to be the sufferer, knowing that one has the illness, and that there is no prospect of improvement, must be the darkest of all feelings. The best that we can do is to ensure that an increasingly prevalent illness should never be the cause of a person feeling a sense of embarrassment.