Specialized Adult Day Programs and Family Resources
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Specialized Adult Day Programs and Family Resources. Supportive. Social. Stimulating. Safe. Ray Valle PhD Mario Garrett PhD Anette Asher Dawn Carnerie DeStefani , BSW. Diversity in dementia. MetLife Foundation 2010

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Specialized Adult Day Programs and Family Resources





Ray Valle PhD

Mario Garrett PhD

Anette Asher

Dawn CarnerieDeStefani, BSW

Diversity in dementia

  • MetLife Foundation 2010

  • 2011 in Alzheimer's & Dementia: National Institute on Aging + Alzheimer's Association

  • International studies

  • Caregivers

  • Local


  • Ethnic Composition in San Diego

  • Realities of Cultural Diversity

  • Sweeps of Cultural Immigrants


San Diego County population growth

California receives ~ 38% of all Immigrants to the USA


San Diego County


San Diego County


Largest Hispanic Origin Group by State 2010

Population by Nativity, and Hispanic: 200760.2% latinos Born in US

Elizabeth M. Grieco. Race and Hispanic Origin of the Foreign-Born Population in the United States: 2007. American Community Survey Reports. 2010 U.S. Department of Commerce. Economics and Statistics Administration. U.S. CENSUS BUREAU

  • 698,000 immigrants

  • 23% of the total population

  • 76% since 1980

  • 24% in last 10 yrs

  • From Mexico = 47%

  • From Philippines = 13%

San Diego County


  • National Studies

  • Local Studies

  • Quandary: Services are Local Prevalence Rates are National

Latino dementia prevalence

  • Projections: Developing an Algorithm

  • Demography of Aging in Place

  • Projections of Dementia

Developing Dementia Prevalence Rates Among Latinos: A Locally-Attuned, Data-Based, Service Planning Tool

Ramón Valle, PhD

Mario Garrett, PhD

Roberto Velasquez, MSG

The Algorithm

Population projections were obtained from the State of California, Department of Finance’s (CDF),population projections for counties for 2000-2050

Haan, M. N., Mungas, D. M., Gonzalez, H. M, Ortiz, T. A., Acharya, A., & Jagust W. J. (2003). From Prevalence of Dementia in Older Latinos: The Influence of Type 2 Diabetes Mellitus, Stroke and Genetic Factors. Journal of the American Geriatric Society 51:169–177

ADAD Prevalence RatesMalesFemales`

60-69 1.31%60-690.61%

70-794.66%70-79 4.71%


85+23.33%85+17.65 %



Male Female

Age 1 year

Latino vs White

2000, 2010, 2030, 2050

The Algorithm

D.A. Evans et al, “Estimated Prevalence of Alzheimer’s Disease in the United States” The Milbank Quarterly 68:2 (1990) 267-289

Evan’s Combined & Haan Comparative Latino ADAD Prevalence Rates

Evans Haan’sMale/Female Male/Female

65-74 3.9%65-74 2.4%

75-84 16.4%75-84 6.4%

85 +47.55%85+19.5%

All11.3%All 5.0%

San Diego Latino 60+ Aging-in-Place Estimates 2000-2050

Table 1a:

Percentage difference from 2000

YearLatino 60 +Anglo 60+Latino 60 +Anglo 60+


201080,180348,24366% 13%



Source: agingstats.gov

Percentage San Diego Latino 60+ Aging-in-Place Estimates 2000-2050

Latino Age 60+ San Diego ADAD Prevalence Projections 2000-2050

Table 1c Percentage difference from 2000

YearLatino 60 +Anglo 60+Latino 60 +Anglo 60+

2000 1,88916,592-----------------

2010 3,26718,02573% 9%

2030 8,81529,019 367% 74%


Percentage Latino Age 60+ San Diego ADAD Prevalence Projections 2000-2050

Latino 60+ IN San Diego ADAD Prevalence + Caregivers 2000-2050

  • Focus Groups

  • Service Organizations

Reality on the ground

  • Understanding depression & other mental systems Dementia

  • Developing culturally specific treatments

  • Ways to engage communities

  • Resources & access to patients

Learning Objectives

  • Understanding Dementia is to see how

    in-discriminate it is. Every patient presents symptoms uniquely.

    • Degenerative, terminal

    • Beta Amyloid protein (the goop), tau and tangles

Reality on the ground

  • Brain MRI with AD

Reality on the ground

  • Dementia and Depression

  • Service Organizations

    • Adult Day Care

    • Programs: brain fitness, support groups, caregiver training

Reality on the ground

  • History

  • Demographics: Diversity is here

  • Approach: How and what we do serves as outreach in community

Glenner memory Care center

Glenner memory Care center- Demographics

  • Approach: How and what we do serves outreach in community

    • Day Care

    • Support Groups

    • In-Service training

    • New Programs: Oak Tree Brain Fitness Club, Train the Trainer

Glenner memory Care center

  • Learn early signs of dementia/non-amnestic mild cognitive impairment.

  • Work closely with special interest groups or associations.

    • National Association of Hispanic Nurses http://nahnnet.organd in SD http://www.sdnahn.org

    • San Diego Black Nurses Association http://www.sdblacknurses.org

    • The Philippine Nurses Assoc. of San Diego County www.pnasd.org

What we all can do in the community

  • Runkeeper (free iPhone app)

  • Anti-aging games (fun internet site)

  • The Glenner Memory Care Centers new iPad App. To be launched in January. (working on a app name… Memory Maker, Memory Finder…

Techy tools for you and clients

Techy tools for you and clients

Go to Apple’s App Store

FREE App due to release in

January 2012.

Drop off your business card

at the Glenner exhibit table or

contact us to get on

mailing list for the




The Latino culture respects their elderly and usually accompanies an expectation that the family will provide all care needs for their loved ones.

There is usually reluctance and distrust of community options such as day care and nursing home placement.

Few services have successfully provided a culturally correct and competent model that includes the proper language, sights, sounds and rapport.

Latino caregivers

Latino caregivers express many of the same concerns as other ethnicities: denial, stress, resistance but one area that separates them is their concerns with doctors in the U.S. Many continue to travel to Mexico as they feel their doctors are more patient and less rushed.

Voices of Latino Caregiving, Latino Alzheimer’s Community Forum June 19, 2010

Latino Caregivers

Latino caregivers often resist outside support and therefore carry high amounts of stress and a higher risk of depression.

There are a limited amount of physicians and professionals that are bilingual to obtain a proper diagnosis and treatment plan for the caregiver and their loved one.

Caregiver stress and depression

Center is located in a primarily Latino neighborhood.

Enrollment of 80% Spanish Speaking participants.

Staff are bilingual, activities and meals are geared to represent the participants.

Professional staff also speak Spanish to provide support and resources.

Ample time is given to build rapport with home visits and assessments.

Have used Latino caregivers in a volunteer capacity to market in the community.

Glenner Southbay ADHC/CBAS

Multi-cultural events

  • Apply Algorithm to other Ethnic Groups

  • Develop Protocol for addressing Diversity in Dementia

  • Final Remarks

Future and recommendations

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