McAnulty College and Graduate School of Liberal Arts
Paola M. Sesia
Alzheimer's disease, caregiving, medical anthropology, medical pluralism, Oaxaca, Zapotec
This dissertation provides an analysis of the social construction of Alzheimer’s disease within Teotitlán del Valle, a rural Zapotec-speaking community in Oaxaca, Mexico. It explores how Alzheimer’s disease is locally understood, how this understanding reconfigures traditional meanings of old age, and how broader social issues are negotiated through this reconfiguration. Through 10 months of fieldwork this dissertation draws on ethnographic observations and interviews with 22 family caregivers across 9 households. This study is noteworthy for being the first known investigation in Teotitlán whose primary data was collected in the Zapotec language. Further, this dissertation integrates methods across psychology, gerontology, and anthropology, resulting in a unique interdisciplinary approach and a novel interview technique called “locally-focused interviewing.”
Results are ethnographic in nature and provide insight onto local caregivers’ experience of attending to elders with Alzheimer’s disease and other dementias. Further, these results show how caregivers’ experience is situated within multiple local discourses – different medical systems, power structures, socioeconomic parameters, norms and traditions. In so doing, this dissertation advances a number of observations. First, this dissertation leverages anthropological insights about medical pluralism – the existence of multiple medical systems in a single location – and demonstrates how Alzheimer’s disease is socially constructed via medical theories and broader social dynamics. Second, this dissertation analyzes how caregivers make decisions on behalf of dependent elders, and how these decisions are made within a medically pluralistic landscape. Although medical decisions are based on concern for elders’ wellbeing, they also invoke dynamics between local traditions and contemporary changes. Third, this dissertation traces caregivers’ daily experience as an instance of what anthropologists refer to as social suffering by attending to caregivers’ challenges, strategies, and perceptions of elders. These features disclose how the caregiving relationship is situated within a tension between local values about aging and the reality of caregiving. Lastly, this dissertation explores how and why caregivers feel responsible to care for dependent elders, and illustrates the way that the broader community is involved in shaping caregivers’ daily experience. As a whole, this dissertation contributes to the fields of psychology and medical anthropology by highlighting the social dimensions of Alzheimer’s disease and how these dimensions shape the experience of providing care for dependent elders.
Yahalom, J. (2016). Social Dimensions of Alzheimer’s Disease Among Caregivers in Oaxaca, Mexico (Doctoral dissertation, Duquesne University). Retrieved from https://ddc.duq.edu/etd/94