Faculty address gaps in dementia care in U.S. and Mexico

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September 27, 2021

In the United States and Mexico, pandemic and climate-related news headlines have demonstrated a lack of preparedness for vulnerable populations, especially the number of seniors over age 65. In Texas, the number of seniors is expected to more than double from 3.9 million in 2020 to 8.3 million by 2050. In Mexico, it is nearly the same story. These increases are driven by longer life spans resulting from improved medical care and higher quality of life. But there are also new challenges emerging from the rapid growth in the number of older individuals, particularly those living with dementia.

A new peer-reviewed report from public policy researchers at The University of Texas at Austin published by The Gerontologist provides recommendations on affordable and sustainable dementia care in both countries, something that is currently lacking.

U.S., Mexico Are Falling Short in Care for Elderly With Dementia, Report Finds (UT News, Sept. 27, 2021)

The two countries suffer from a persistent shortage of high-quality care homes and geriatric primary care physicians and geriatricians. They also have limited availability and adequacy of adult day care centers in rural areas and densely populated urban areas of concentrated poverty. The Texas state border region is an exception; Texas has 254 counties with 443 licensed Adult Day Centers, which are disproportionately located in 32 counties along the Texas-Mexico border.

The report outlines that progress in both countries will require an expansion of programs or the generation of new ones to meet the needs of older adults, including improving access to services, educating caretakers about managing the dementia care burden, advances in telehealth and skills training of specialized staff. The report shows low-income people and women in both countries share a disproportionate dementia care burden. Additionally, returning migrants who spent many years working in the United States usually do not qualify for coverage by Mexico's social security institutions.

The researchers said a comprehensive federal health care safety net is needed in both nations, but economic realities constrain its implementation.

"Because women bear most of the caregiving responsibilities and costs and present higher risk of dementia, policies should aim to alleviate these stark gender differences in care burden." —Professor Jacqueline Angel

"In both countries, the traditional employment-based private health insurance system has left many older individuals without any coverage or adequate coverage when they need it most. And because women bear most of the caregiving responsibilities and costs and present higher risk of dementia, policies should aim to alleviate these stark gender differences in care burden," said Jacqueline Angel, a professor in the LBJ School of Public Affairs at UT Austin and the lead author of the study. "In the United States, expanding access to state mandatory family leave programs, for example, would provide much needed financial compensation for dementia caregivers to care for an aging parent or family member."

Political will, available resources and equitable distribution of services and supports will be key determinants for what each nation can accomplish, the researchers said.

The report's recommendations are the result of a binational conference, the 2019 National Institute of Geriatrics in Mexico and the International Conference on Aging in the Americas (INGER-ICAA) meeting held in Mexico City, that examined the institutional capacities and future ability of Mexico and the United States to address the growing need for affordable and sustainable dementia care. The recommendations reflect the large difference in resources between the two nations and each country's political and institutional capacity. The objective of the study was not to compare two nations but rather to assess the adequacy of older adult services within each society.

This study was funded by the National Institute on Aging and the Hogg Foundation for Mental Health.


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