This article presents data on family caregiving for elders with dementia in Oaxaca, Mexico. Drawing on a year of ethnographic research, this article explores how caregivers engage in health-seeking behaviors and how they choose between biomedical and traditional medical alternatives. While caregivers are primarily concerned to maintain elders’ health, decisions about which medical providers to (not) consult invoke broader social factors that go beyond their relationships with elders, and concern socioeconomic realms of power, as well as broader ideals concerning local tradition and its maintenance in the contemporary world.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
2.
Argáez-LópezN.WacherN. H.Kumate-RodríguezJ.CruzM.TalaveraJ.Rivera-ArceE.LozoyaX. (2003). The use of complementary and alternative medicine therapies in type 2 diabetic patients in Mexico. Diabetes Care, 26, 2470-2471.
3.
AustinA. L. (1988). The human body and ideology concepts of the ancient Nahuas. Salt Lake City: University of Utah Press.
4.
AustinJ. L. (1975). How to do things with words. Oxford, England: Oxford University Press.
5.
Ayora-DiazS. I. (1998). Globalization, rationality and medicine: Local medicine’s struggle for recognition in Highland Chiapas, Mexico. Urban Anthropology and Studies of Cultural Systems and World Economic Development, 27, 165-195.
6.
BeyeneY.BeckerG.MayenN. (2002). Perception of aging and sense of well-being among Latino elderly. Journal of Cross-Cultural Gerontology, 17, 155-172.
7.
BraunK. L.BrowneC. V. (1998). Perceptions of dementia, caregiving, and help seeking among Asian and Pacific Islander Americans. Health & Social Work, 23, 262-274.
8.
BurstonD.FrieR. (2006). Psychotherapy as a human science. Pittsburgh, PA: Duquesne University Press.
9.
CareyM. A.SmithM. W. (1994). Capturing the group effect in focus groups: A special concern in analysis. Qualitative Health Research, 4, 123-127.
10.
CipollettaS.BeccarelloA.GalanA. (2012). A psychological perspective of eye floaters. Qualitative Health Research, 22, 1547-1558.
11.
CipollettaS.ConsolaroF.HorvathP. (2014). When health is an attitudinal matter: A qualitative research. Journal of Humanistic Psychology, 54, 391-413.
12.
CohenL. (1998). No aging in India: Alzheimer’s, the bad family, and other modern things. Berkeley: University of California Press.
13.
CohenJ. H. (2004). The culture of migration in Southern Mexico. Austin: University of Texas Press.
14.
ComaroffJ. (1981). Healing and cultural transformation: The Tswana of Southern Africa. Social Science & Medicine. Part B: Medical Anthropology, 15, 367-378.
ConnorL. (2001). Healing powers in contemporary Asia. In ConnorL.SamuelG. (Eds.), Healing powers and modernity: Traditional medicine, shamanism, and science in Asian societies (pp. 3-21). Westport, CT: Greenwood.
17.
Cruz-ManjarrezA. (2013). Zapotecs on the move: Cultural, social, and political processes in transnational perspective. New Brunswick, NJ: Rutgers University Press.
18.
DuncanW. L. (2017a). Dinámicas Ocultas: Culture and psy-sociality in Mexican family constellations therapy. Ethos, 45, 489-513.
19.
DuncanW. L. (2017b). Psicoeducación in the land of magical thoughts: Culture and mental-health practice in a changing Oaxaca. American Ethnologist, 44, 36-51.
20.
DuncanW. L. (2018). Transforming therapy: Mental health practice and cultural change in Mexico. Nashville, TN: Vanderbilt University Press.
21.
EllK.CastañedaI. (1998). Health care seeking behavior. In LoueS. (Ed.), Handbook of immigrant health (pp. 125-143). Boston, MA: Springer.
22.
EstesC.BinneyE. A. (1989). The biomedicalization of aging: Dangers and dilemmas. The Gerontologist, 29, 587-596.
23.
FinklerK. (2001). Physicians at work, patients in pain: Biomedical practice and patient response in Mexico (2nd ed.). Durham, NC: Carolina Academic Press.
24.
FoucaultM. (1972). The archaeology of knowledge. London, England: Tavistock.
25.
FoucaultM. (1975). The birth of the clinic (SheridanA., Trans.) London, England: Tavistock.
26.
FoucaultM. (2003). The politics of health in the eighteenth century. In RabinowP.RoseN. S. (Eds.), The essential Foucault: Selections from essential works of Foucault, 1954-1984 (pp. 273-288). New York, NY: New Press.
27.
GiorgiA. (2000). Psychology as a human science revisited. Journal of Humanistic Psychology, 40(3), 56-73.
28.
GoodB. (1994). Medicine, rationality and experience: An anthropological perspective. Cambridge, MA: Cambridge University Press.
29.
GoodB. (2010). The complexities of psychopharmaceutical hegemonies in Indonesia. In JenkinsJ. H. (Ed.), Pharmaceutical self: The global shaping of experience in an age of psychopharmacology (pp. 117-144). Santa Fe, NM: SAR Press.
30.
GutmannM. C. (2007). Fixing men: Sex, birth control, and AIDS in Mexico. Berkeley: University of California Press.
31.
HaberS. H.KleinH. S.MaurerN.MiddlebrookK. (2008). Mexico since 1980. Cambridge, MA: Cambridge University Press.
32.
HendersonJ. N.HendersonL. C. (2002). Cultural construction of disease: A “supernormal” construct of dementia in an American Indian tribe. Journal of Cross-Cultural Gerontology, 17, 197-212.
33.
Hernández SáenzL. M.FosterG. M. (2001). Curers and their cures in colonial New Spain and Guatemala: The Spanish component. In HuberB. R.SandstromA. R. (Eds.), Mesoamerican healers (pp. 19-46). Austin: University of Texas Press.
34.
HigginsC. M. (1975). Integrative aspects of folk and western medicine among the urban poor of Oaxaca. Anthropological Quarterly, 48(1), 31-37.
35.
HintonL.FranzC.FriendJ. (2004). Pathways to dementia diagnosis: Evidence for cross-ethnic differences. Alzheimer Disease & Associated Disorders, 18, 134-144.
36.
HolmesS. (2013). Fresh fruit, broken bodies: Migrant farmworkers in the United StatesBerkeley: University of California Press.
37.
HuntL. L. M. (1992). Living with cancer in Oaxaca, Mexico: Patient and physician perspectives in cultural context (Doctoral Dissertation). Harvard University, Cambridge, MA.
38.
JenkinsJ. H. (2015). Extraordinary conditions: Culture and experience in mental illness. Berkeley, CA: University of California Press.
39.
KatzenbergerE. (Ed.). (1995). First world, ha, ha, ha! The Zapatista challenge. San Francisco, CA: City Lights Books.
40.
KendallG.WickhamG. (1998). Using Foucault’s methods. Thousand Oaks, CA: Sage.
41.
KiddP. S.ParshallM. B. (2000). Getting the focus and the group: Enhancing analytical rigor in focus group research. Qualitative Health Research, 10, 293-308.
42.
KirmayerL. J.GroleauD.LooperK. J.DaoM. D. (2004). Explaining medically unexplained symptoms. The Canadian Journal of Psychiatry, 49(10), 663-672.
43.
KitwoodT. (1997). Dementia reconsidered: The person comes first. Buckingham, England: Open University Press.
44.
KleinmanA. (1980). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: University of California Press.
45.
KleinmanA. (1988). The illness narratives: Suffering, healing, and the human condition. New York, NY: Basic Books.
46.
KnightA. (1990). Racism, revolution, and indigenismo: Mexico, 1910-1940. In GrahamR. (Ed.), The idea of race in Latin America, 1870-1940 (pp. 71-113). Austin: University of Texas Press.
47.
KohrtB. A.RasmussenA.KaiserB. N.HarozE. E.MaharjanS. M.MutambaB. B.. . . HintonD. E. (2013). Cultural concepts of distress and psychiatric disorders: Literature review and research recommendations for global mental health epidemiology. International Journal of Epidemiology, 43, 365-406.
48.
KruegerR. A. (2009). Focus groups: A practical guide for applied research. Thousand Oaks, CA: Sage.
49.
LatourB. (1993). We have never been modern. Cambridge, MA: Harvard University Press.
50.
LaubscherL. (2016). Introduction to psychology as a human science. San Diego, CA: Cognella.
51.
LeibingA. (2002). Flexible hips? On Alzheimer’s disease and aging in Brazil. Journal of Cross-Cultural Gerontology, 17, 213-232.
52.
LeslieC. (1980). Medical pluralism in world perspective. Social Science & Medicine. Part B: Medical Anthropology, 14, 191-195.
53.
LewisS. E. (2006). The nation, education, and the “Indian problem” in Mexico, 1920–1940. In VaughanM. K.LewisS. E. (Eds.), The eagle and the virgin: Nation and cultural revolution in Mexico (pp. 176-195). Durham, NC: Duke University Press.
54.
Lewis-FernándezR.KleinmanA. (1995). Cultural psychiatry: Theoretical, clinical, and research issues. Psychiatric Clinics of North America, 18(3), 433-448.
55.
LockM.NichterM. (2002). From documenting medical pluralism to critical interpretations of globalized health knowledge, policies, and practices. In LockM.NichterM. (Eds.), New horizons in medical anthropology: Essays in honour of Charles Leslie (pp. 1-35). New York, NY: Routledge.
56.
MattinglyC. (2014). Moral laboratories: Family peril and the struggle for a good life. Berkeley, CA: University of California Press.
57.
MattinglyC.GarroL. C. (Eds.). (2000). Narrative and the cultural construction of illness and healing. Berkeley, CA: University of California Press.
58.
McMullenL. (2011). A discursive analysis of Teresa’s protocol: Enhancing oneself, diminishing others. In WertzF.CharmazK.McMullenL.JosselsonR.AndersonR.McSpaddenE. (Eds.), Five ways of doing qualitative analysis: Phenomenological psychology, grounded theory, discourse analysis, narrative research, and intuitive inquiry (pp. 205-233). New York, NY: Guilford Press.
59.
MenéndezE. (1994). La enfermedad y la curación ¿Qué es medicina tradicional? [Illness and Cure: What is traditional medicine?] Alteridades, 4(7), 71-83.
60.
MoscoviciS. (2000). Social representations: Explorations in social psychology (DuveenG., Ed.). Cambridge, MA: Polity Press.
61.
MoscoviciS. (2008). Psychoanalysis: Its image and its public (MaceyD., Trans. & DuveeG.n, Ed.). Malden, MA: Polity Press.
62.
MurphyA. D.StepickA. (1991). Social inequality in Oaxaca: A history of resistance and change. Philadelphia, PA: Temple University Press.
63.
NapolitanoV. (2002). Migration, mujercitas, and medicine men: Living in urban Mexico. Berkeley: University of California Press.
64.
NichterM. (1978). Part Two: Patterns of resort in the use of therapy systems and their significance for health planning in South Asia. Medical Anthropology. 2(2), 29-56.
65.
NorgetK. (2006). Days of death, days of life: Ritual in the popular culture of Oaxaca. New York, NY: Columbia University Press.
66.
NuckollsC. W. (1991). Deciding how to decide: Possession-mediumship in Jalari divination. Medical Anthropology, 13, 57-82.
67.
OrtizF. A.DavisK. G.McNeillB. W. (2008). Curanderismo: Religious and spiritual worldviews and indigenous healing traditions. In McNeilB.CervantesJ. (Eds.), Latina/o healing practices: Mestizo and indigenous perspectives (pp. 271-300). New York, NY: Routledge.
68.
PackerM. (2010). The science of qualitative research. Cambridge, MA: Cambridge University Press.
69.
PiggS. L. (1995). The social symbolism of healing in Nepal. Ethnology, 34, 17-36.
70.
PiggS. L. (1996). The credible and the credulous: The question of “villagers’ beliefs” in Nepal. Cultural Anthropology, 11, 160-201.
71.
PostS. G. (2000). The moral challenge of Alzheimer disease: Ethical issues from diagnosis to dying (2nd ed.). Baltimore, MD: Johns Hopkins University Press.
72.
PotterJ. (2003). Discourse analysis and discursive psychology. In FoxD.PrillenteskyI. (Eds.), Qualitative research in psychology: Expanding perspectives in methodology and design (pp. 73-94). Washington, DC: American Psychological Association.
73.
PotterJ.WetherellM. (1987). Discourse and social psychology: Beyond attitudes and behaviour. Newbury Park, CA: Sage.
74.
PouillonJ. (2016). Remarks on the verb “to believe.”Journal of Ethnographic Theory, 6, 485-492.
75.
RortyR. (1979). Philosophy and the mirror of nature. Princeton, NJ: Princeton University Press.
76.
RoseN. (2007). The politics of life itself: Biomedicine, power, and subjectivity in the twenty-first century. Princeton, NJ: Princeton University Press.
77.
RubelA. J. (1960). Concepts of disease in Mexican-American culture. American Anthropologist, 62, 795-814.
78.
RubelA. J.BrownerC. (1999). Antropología de la salud en Oaxaca [Medical anthropology in Oaxaca]. Alteridades, 9(17), 85-94.
79.
SaldañaJ. (2012). The coding manual for qualitative researchers. Thousand Oaks, CA: Sage.
80.
Secretaría de Salud. (2007). Programa de Accion Especifico (2007-2012), Medicina Tradicional y Sistemas Complementarios de Atención a la Salud [Specific Action Program (2007-2012), Traditional Medicine and Complementary Health Care Systems]. Mexico City, Mexico: Author.
81.
Secretaría de Salud. (2010) Programa de Acción en Salud Mental [Action Program in Mental Health]. Mexico City, Mexico: Author.
82.
SesiaP. M. (1996). “Women come here on their own when they need to”: Prenatal care, authoritative knowledge, and maternal health in Oaxaca. Medical Anthropology Quarterly, 10, 121-140.
83.
SesiaP. M. (2001). Aquí la PROGRESA está muy dura: Estado, negociación e identidad entre familias indígenas rurales [Here PROGRESA is very difficult: State, negotiation and identity among rural indigenous families]. Desacatos, 1(8), 109-128.
84.
Somolinos d’ArdoisG. (1973). La medicina en las culturas mesoamericanas anteriores a la Conquista [Medicine in Mesoamerican Cultures Prior to the Conquest] (Vol. 1). Mexico City, Mexico: Sociedad Mexicana de Historia y Filosofía de la Medicina.
85.
Somolinos d’ArdoisG. (1976). Historia de la psiquiatría en México [History of Psychiatry in Mexico]. Mexico City, Mexico: Secretaría de Educación Pública, Dirección General de Divulgación.
86.
StephenL. (2005). Zapotec women: Gender, class, and ethnicity in globalized Oaxaca (2nd ed.). Durham, NC: Duke University Press.
87.
StephenL. (2007). Transborder lives: Indigenous Oaxacans in Mexico, California, and Oregon. Durham, NC: Duke University Press.
88.
TempleB.EdwardsR. (2008). Interpreters/translators and cross-language research: Reflexivity and border crossings. International Journal of Qualitative Methods, 1(2), 1-12.
89.
TraphaganJ. W. (1998). Localizing senility: Illness and agency among older Japanese. Journal of Cross-Cultural Gerontology, 13, 81-98.
90.
TreviñoC. V. (2001). Curanderismo in Mexico and Guatemala: Its historical evolution from the sixteenth to the nineteenth century. In HuberB. R.SandstromA. R. (Eds.), Mesoamerican healers (pp. 47-65). Austin, TX: University of Austin Press.
91.
WentzellE. (2015). Medical research participation as citizenship: Modeling modern masculinity and marriage in a Mexican sexual health study. American Anthropologist, 117, 652-664.
92.
WhitefordM. B. (1995). Como se cura: Patterns of medical choice among working class families in the city of Oaxaca, Mexico. In WarrenD. M.SlikkerveerL. J.BrokenshaD.DecheringW. H. (Eds.), The cultural dimension of development (pp. 218-230). Rugby, England: Practical Action Publishing.
93.
WoodL. A.KrogerR. O. (2000). Doing discourse analysis: Methods for studying action in talk and text. Thousand Oaks, CA: Sage.
94.
WoodW. W. (2008). Made in Mexico: Zapotec weavers and the global ethnic art market. Bloomington: Indiana University Press.
95.
WorthenH. (2015). Indigenous women’s political participation: Gendered labor and collective rights paradigms in Mexico. Gender & Society, 29, 914-936.
96.
YahalomJ. (2016). Social dimensions of Alzheimer’s disease among caregivers in Oaxaca, Mexico (Doctoral dissertation). Duquesne University, Pittsburgh, PA.
97.
YahalomJ. (2017). Levinasian caregiving: Dementia and the other-in-between. Philosophy in the Contemporary World, 24(1), 51-62.
98.
YahalomJ. (2019a). Caring for the people of the clouds: Aging and dementia in Oaxaca. Norman: University of Oklahoma Press.
99.
YahalomJ. (2019b). Pragmatic truths about illness experience: Idioms of distress around Alzheimer’s disease in Oaxaca, Mexico. Transcultural Psychiatry, 56, 599-619. doi:10.1177/1363461519847304
100.
YahalomJ. (in press). Toward a methodology of chance: On obstacles to research and their advantages. Qualitative Psychology.
101.
YarrisK. E. (2017). Care across generations: Solidarity and sacrifice in transnational families. Stanford, CA: Stanford University Press.
102.
YoungJ. C.GarroL. C. (1993). Medical choice in a Mexican village. Long Grove, IL: Waveland Press.
