For about five years before he died, my father had Alzheimer's disease. When it was first diagnosed we asked him how he wished his condition to be described when other people asked us about his health. He chose “bewildered”; and, indeed, bewilderment characterised his slow decline over the next five years. By far the most important part of his care was the loving support he received from a carer, who helped our family to cope.

We briefly considered the possibility of drug treatment at one point. The particular drug that we looked at caused diarrhoea in some patients, and that was not going to be welcome in someone who was already incontinent of urine and faeces. But the main problem was that we couldn't interpret the outcome measures from research studies (often scales of some sort). Although sufficient to secure drug marketing licences they had little practical meaning in my father's bewildered life.

In a paper published in 2001 Julia Cream and Harry Cayton of the …