Caring for the People of the Clouds: Aging and Dementia in Oaxaca

In rural Mexico, people often say that Alzheimer's does not exist. ""People do not have Alzheimer's because they don't need to worry,"" said one Oaxacan, explaining that locals lack the stresses that people face ""over there"" - that is, in the modern world. Alzheimer's and related dementias carry a stigma. In contrast to the way elders are revered for remembering local traditions, dementia symbolizes how modern families have forgotten the communal values that bring them together. In Caring for the People of the Clouds, psychologist Jonathan Yahalom provides an emotionally evocative, story-rich analysis of family caregiving for Oaxacan elders living with dementia. Based on his extensive research in a Zapotec community, Yahalom presents the conflicted experience of providing care in a setting where illness is steeped in stigma and locals are concerned about social cohesion. Traditionally, the Zapotec, or ""people of the clouds,"" respected their elders and venerated their ancestors. Dementia reveals the difficulty of upholding those ideals today. Yahalom looks at how dementia is understood in a medically pluralist landscape, how it is treated in a setting marked by social tension, and how caregivers endure challenges among their families and the broader community. Yahalom argues that caregiving involves more than just a response to human dependency; it is central to regenerating local values and family relationships threatened by broader social change. In so doing, the author bridges concepts in mental health with theory from medical anthropology. Unique in its interdisciplinary approach, this book advances theory pertaining to cross-cultural psychology and develops anthropological insights about how aging, dementia, and caregiving disclose the intimacies of family life in Oaxaca.

About the Author :
Jonathan Yahalom is a psychologist at the Department of Veterans Affairs in Los Angeles. He holds a PhD in clinical psychology from Duquesne University. Xavier E. Cagigas is Associate Director of the Hispanic Neuropsychiatric Center of Excellence and Codirector of the Cultural Neuropsychology Program at the UCLA Semel Institute for Neuroscience and Human Behavior.

Review :
Caring for the People of the Clouds is a serious and significant contribution to the ethnography of care. Important, original, and relevant to the global study of aging and dementia, this sensitive ethnography illumines a people, a time, and a disorder and its fate. A fine blend of scholarship and clinical sensibility "" - Arthur Kleinman, Harvard University, author of The Illness Narratives: Suffering, Healing, and the Human Condition ""Caring for the People of the Clouds offers an intimate look at how Zapotec families cope with 'forgetful elders.' Honoring local epistemologies of health, caring, death, and coping, Yahalom offers a new window on cross-cultural models of caregiving useful for a broad range of social, psychological, and medical sciences."" - Lynn Stephen, University of Oregon, author of We Are the Face of Oaxaca: Testimony and Social Movements ""With the aim of restoring a ""sensibility of care"" to his own profession of clinical psychology, Yahalom deftly uses the tools of anthropology to craft moving stories of how caregiving for elders with dementia is manifest in the intimate details of everyday life in Oaxaca. What results is a compelling argument about the need for a restoration of human dignity on both personal and societal levels, as well as in clinical practice."" - Larry Davidson, Yale University, author of Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia ""Person- and relationship-centered care are vital but can be achieved only with an understanding of and sensitivity to the unique cultural heritage of those in need of care. Yahalom speaks admirably and compellingly to this all-too-often sadly neglected aspect of providing care."" - Steven R. Sabat, Georgetown University, associate editor of Dementia: The International Journal of Social Research and Practice ""Caring for People of the Clouds makes important contributions to studies of Alzheimer's disease across cultures and to studies of caregiving. Yahalom challenges clinical assumptions about responses to Alzheimer's by taking readers to a cultural and social context where Alzheimer's is understood and responded to differently than in the United States."" - Peter J. Guarnaccia, Rutgers University, editor of A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship