Mrs C and her family, current experience | Mexico

Mrs C and her family, current experience | Mexico

14 Jun 2022

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About five years ago Mrs. C started to become forgetful. Now, 75 years old, Mrs. C hardly ever leaves her room in her daughter’s house where she was moved when it became clear that she could no longer look after herself. The daughter and her granddaughter help her with dressing, eating, washing and going to the bathroom. The family has to make sure that food is not too chunky as Mrs. C has difficulty swallowing. It is difficult for the daughter’s family to go away together for the day as someone always needs to be around to look after her. The constant care needs in addition to her own family responsibilities also pose a strain on Mrs. C’s daughter has her own health issues. Mrs. C’s other children visit during holidays but find it difficult as she cannot always remember who they are.

We assume Mrs Catalina and her family live in a capital city or large urban/metropolitan area. Mrs Catalina moved in with her daughter when she started to present more complications and stopped being independent as they were worried something could happen to her. Mrs Catalina and her husband, who is now deceased, come from middle-high income families. Mrs. Catalina’s husband worked in the private sector and was affiliated to the Mexican Social Security Institute, IMSS (Mexican social security institution for those employed in the private sector), as part of his overall benefits and entitlements, Mrs Catalina now receives his pension (widowhood pension) and, as before her husband died, she has access to IMSS health services. She also has some savings. While Mrs Catalina can access health services at IMSS, when her daughter and granddaughter see that she needs more and more help and is quickly being care-dependent, they decide to take her to receive medical care within the private sector. They know that social security institutions often take a long time to schedule an appointment, or likely, they will not be referred to a specialist doctor, so they decide not to wait.

However, as it usually happens, they have to go through different specialist doctors in the private sector, before they get a more precise diagnosis. They start with a geriatrician who can do a cognitive screening, s/he then refers the family to a neurologist or geriatric psychiatrist for a full screening-diagnosis. As part of the diagnosis within the private sector, Mrs Catalina will also have high technology diagnostic tests such as an MRI and blood tests. The specialist doctor recommends the latest medicines to manage cognitive impairment/dementia, but does not give Mrs Catalina’s daughter directions or information in terms of likely symptoms as the dementia progresses, what to expect, and how to handle them, with the exception that Mrs Catalina should not be left alone, especially when eating, as she could choke, leaving Mrs Catalina’s daughter and granddaughter with huge uncertainty on how to best care for Mrs Catalina.

As Mrs Catalina’s condition progresses, her daughter feels more and more pressure and feels her own health starting to deteriorate. She has a talk with her siblings to express the need for someone to support her, but as no one is willing to help, they decide to use part of the pension/savings to hire carers for their mother. They are not able to find any nurses or carers who are trained or specialised in caring for older adults, nor for people with dementia, but they find two nurses that have had some previous experience caring for older adults and are well recommended by a friend as they used to care for her father before he died. While the two nurses seem very professional and caring, Mrs Catalina’s daughter is sometimes worried as there is no legal, health or professional association that will protect the family in case something goes wrong.

Mrs Catalina’s daughter and granddaughter will continue to supervise the care for Mrs Catalina., but will have more time for themselves. In one of their visits to the specialist doctor, another family carer tells Mrs Catalina’s daughter about a support group in one of the few Alzheimer’s/Dementia Associations, she tells them it is far from there, but they are very helpful in sharing information, and care alternatives, much more so than their physician.