Dementia Care in Guatemala, Central America

Abstract

Guatemala is a country that is very diverse linguistically, culturally, educationally, and economically. Half the country’s population is Mayan, speaks 23 different languages, and lives mostly in rural impoverishment with limited formal education. Most of the remainder of the population is Spanish-speaking and varies in income and education. Dementia care in the country likewise varies widely. Specialized dementia care is in its early stages of development. For example, medical understanding of dementia, its subtypes, and its evaluation and treatment are limited even within the medical professions, and such services reach only small parts of the population, predominantly urban Spanish speakers with strong financial means. Throughout Guatemala, at legal, institutional, and professional levels both public and private, there is considerable interest in modernizing and destigmatizing dementia care and offering greater support to families. The most promising directions in this regard appear to be in developing: dementia awareness and services within the newly developing social services for the elderly; dementia clinics and medical services within the large hospitals; dementia day health and residential care units; and specialized skill in the private sector, especially in neurology, gerontology, and neuropsychology. At a societal level, the challenge will be to develop such services in a manner that offers medical, behavioral, and social support without further stigmatizing dementia or undermining existing positive values and support that are present and reflected in the population’s religious beliefs, alternative healing systems, and family and community cultural systems. Close professional and population ties between Guatemala, Mexico, and the United States (U.S.) are likely to have a considerable influence on these processes.