I spent 6 months as a psychiatry trainee in The Waterside Hospital, Derry/Londonderry in Northern Ireland. My rotation was in psychiatry of old age, primarily on the dementia ward. Of note, their occupational therapy room was covered in very large photos from Ireland's showband era of the 1950s, harking back in a nostalgic way to a culture that has long been lost. This made a strong impression on me in terms of thoughts about what constitutes memory, how it changes and degrades over time, and linked my mind to a music project by an artist called ‘The Caretaker’.

The Caretaker is a musical project by English artist James Leyland Kirby running from 1999 to 2019 that has garnered critical acclaim for its exploration of themes related to memory and nostalgia. The music of The Caretaker is particularly notable for its links to dementia and its representation in unique fashion.

Through his use of samples of old, degraded music and sounds, often from ancient records he found, The Caretaker's music represents the process of degradation mirrored in dementia. The links are evident from the project's earliest releases, indeed one of the first bears the title ‘Theoretically pure anterograde amnesia’. These samples are then distorted, fragmented, looped and processed creating a sense of disorientation and confusion that mirrors the experience of living with dementia.

In addition, the music is often characterised by a sense of nostalgia, imbued from the maudlin source material he has sampled. This nostalgia reflects the way in which people with dementia may cling to long-term memories from their past as their present experiences become increasingly confusing and disorienting with the music representing these periods of lucidity.

One of The Caretaker's most evocative albums is ‘An empty bliss beyond this world’. It features samples of 1930s ballroom music, which have been distorted and manipulated, to create a sense of dislocation and decay. The music is often interrupted by bursts of static, suggesting the breakdown of communication, disorientation and confusion that is characteristic of dementia. The album title reflects the stage where the patient is beyond human contact. The album art comes from a painting entitled ‘in spite of’ by Ivan Seal, from a series named by psychiatrists and psychologists without pre-information. Ivan Seal's works are closely interlinked with The Caretaker's.

The most ambitious, and final project of The Caretaker was a six-album cycle called ‘Everywhere at the end of time’ released between 2016 and 2019. Conceptually this took the project to a logical conclusion by giving The Caretaker character himself dementia and the musical representation of this.

This was achieved via similar means of utilising, at first quite pleasant samples of old records but over the cycle they become increasingly distorted, manipulated and indeed destroyed, with the final album representing end-stage dementia and death.

It is an uncomfortable listen and almost overwhelming, but it is a magnificent achievement and almost sublime. The apotheosis of an extremely important corpus of work of this century that I think about often.

Image: ‘in spite of’ 40 × 30 cm oil on canvas. Copyright Ivan Seal 2010. Reproduced with permission from the artist.