Date of Award

2024-08-01

Degree Name

Master of Science

Department

Industrial Engineering

Advisor(s)

Arunkumar A. Pennathur

Abstract

Dementia is an umbrella term for different diseases such as Alzheimer's, vascular dementia, Lewy body, frontotemporal, and mixed dementias. Dementia is caused by a variety of diseases that cause damage to brain cells interfering with the ability of brain cells to communicate between each other. Dementia is associated with different types of brain cell damage in a specific region of the brain (What Is Dementia?, 2024).Dementia affects 55 million people worldwide, where the most affected population is the low-income and the middle-income countries. (Greenblat, 2023). Every 20 years the number almost double, and by 2039 is estimated to reach 78 million and 139 million in 2050. In 2025 the total estimated cost was $818 billion, representing 1.09% of global GDP that year. When the global annual cost of dementia is above $1.3 trillion, and it is expected to rise to $2.8 trillion by 2030. People that are currently living with dementia are not officially diagnosed. (ADI - Dementia Statistics, 2021). One of the most expensive health conditions impacting elderly adults in the US is Dementia, where 6 million people from 65 years or older lives with Alzheimer's disease, representing about 1 in 10 older Americans. In the US, individuals with lower levels of education, women, and racial and ethnic minorities are at greater risk (Mather & Scommegna, 2020). It is interesting to note that states and counties in the eastern and southeastern U.S. have the highest prevalence of Alzheimer's dementia, with El Paso TX having the 10th highest prevalence of dementia. It is also important to note that Black and Hispanic residents are the groups that are at higher risk of Alzheimer's dementia, which, in the eastern and southeastern US, is proportional to large percentages of these minority populations. The baby-boomer generation was the largest demographic generation of the American population in 2011, making this segment of the US population aged 65 in 2030 projected to be 71 million older Americans, making up over 20% of the total population (Alzheimerâ??s Association 2024 Alzheimer's Disease Facts and Figures, 2024). This augurs even worse for the proportion of older persons who would be impacted by the incidence of dementia and Alzheimer's. What exacerbates the problem even further is that 60% of health care workers believe that the US health care system is not efficiently helping navigate dementia (New Alzheimer's Association Report Reveals Top Stressors for Caregivers and Lack of Care Navigation Support and Resources, 2024). Mexican Americans are one and a half times more likely to be diagnosed with Alzheimer's or other dementias (Older African-Americans and Latinos with Cognitive Impairment Live Longer than Whites; Less Likely to Be in Nursing Homes, 2010). Due to health disparities, Hispanic Americans have a lower early detection rate. Compounding this problem is that they have limited access to quality care, and they are underrepresented in research and clinical trials. Further, because 57% of Hispanics believe that significant loss of memory is a normal part of aging, dementia is often dismissed as an impact of getting older, which delays access to treatment, and decreases time for care planning, has a higher cost of care, and negatively affects physical and mental health of cared for and caregiver (Alzheimer's Association 2024 Alzheimer's Disease Facts and Figures, 2024). In the US there are more than 11 million unpaid care providers for a family member or a friend with dementia, valued at nearly $350 billion. Caregiving responsibilities often fall on women disproportionately as evidenced by the fact that approximately two-thirds of dementia caregivers are women. One-third of them are daughters caring for a parent. Close to half of Hispanic adults with dementia currently live with their adult children. The high number of Latino dementia informal caregivers may be due to cultural expectations and norms that families are the predominant/only support network for Latino individuals with dementia. People living with dementia may often need help with instrumental activates of daily living (IADLs), that could include transportation, scheduling doctor's appointments, managing finances and legal affairs. People with dementia who are care for by their family may also need help to follow treatment recommendations and administrating medications (Alzheimer's Association 2024 Alzheimer's Disease Facts and Figures, 2024). Given the high incidence of dementia among Hispanic American adults and given the lack of a clear understanding of how informal, family caregivers of Hispanic American adults with dementia navigate the care process, this thesis examines the home care of dementia patients being cared by informal caregivers such as a loved one. Based on an extensive review of the literature on the methods and tools available in the human factors engineering literature on work systems analyses, and based on the recommendations in the health disparities literature, the thesis combines and integrates the sociotechnical systems framework in the SEIPS 3.0 model and the research framework of the National Institute on Minority Health and Health Disparities (NIMHD) to develop a multi-layered, culturally informed model of care work performed by informal caregivers of Hispanic adults with dementia.

Language

en

Provenance

Received from ProQuest

File Size

106 p.

File Format

application/pdf

Rights Holder

Laura Cristina Tovar Felix

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