Dementia and isolation

Earlier this month, Newsweek pointed out that people who live in rural areas tend to suffer more from Alzheimer’s than other people with the disease do. The writer, Jessica Wapner, chronicled the decline of a farming community not far from Lake Ontario in upstate New York. The elderly couple Wapner depicts might be described as “salt of the earth.” While Rochester, a city of more than 200,000, is less than 30 miles away, the couple goes there only if it is necessary—for doctor’s appointments, for example. As Wapner recounts, the future couple were born three days apart, and have known each other since they were ten. They married at eighteen, and raised six kids. Not one of the children lives nearby.

Wapner writes, “They still hold hands and gaze into each other’s eyes, but these days the look in Dave’s eyes is cloudy and glazed. He seems absent, and it’s hard to tell if he’s following a conversation or just pretending to. And June never knows when his teasing is done with endearment or when he is hiding the fact that his mind is eroding.” Wapner added, “Soon, Dave will forget who June is.”

Much has been said and written over the decades of the decline of family farming, and one detail provided by Wapner speaks loudly: The death rate is 14 percent higher for upstate New York’s least populated counties. “I get angry with God,” June told Wapner. But the state recently allocated $62.5 million over five years to help people like Dave and June. According to Newsweek, similar programs have been established in other largely rural states, including Minnesota, North Dakota and North Carolina. As Wapner points out, “Family dynamics often become fraught. Children who have migrated to urban communities cannot help the caregiving parent” on a regular basis. Wapner quoted one family member as asking, “Where are the kids? Why aren’t they here?” June herself acknowledged, “I don’t feel terribly supported by them.”

One of the dark ironies among adult children and elderly parents is that care providers themselves often need help—burned out by the stultifying nature of their work. As the caregiver for Dave, June commented, “I get worried about myself.” Multiply people like Dave and June across the sparsely populated regions of the nation, and what you have is a largely invisible epidemic, too far for many frail seniors to drive alone. As Wapner states, “Caring for someone with dementia is more than a full-time job; it is a full-life job.” Even veteran care professionals can be worn down. According to Carol Podgorski, the director of the Memory Care program at the University of Rochester Medical Center, “I forget things. I get worried about me.”