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In Starr County, Texas, near the state’s southern tip along the U.S.-Mexico border, escaping dementia can feel impossible. The condition affects about one in five adults on Medicare—more than double the national rate. “Everybody has somebody in their family” with dementia, Gladys Maestre, a neuroepidemiologist who studies aging at the University of Texas at Rio Grande Valley, told me.
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For Jessica Cantú, it was her father, Tomas. He asked her, his eldest daughter, never to put him in a nursing home. She promised. “We take care of our own,” she told me. As Tomas’s dementia progressed, the former pastor held to his routines. He played with his 19 grandchildren. He preached Wednesday-night services and hand-delivered donations of rice, beans, and oil across the border. He fed his chickens and sheep, and ate his favorite homemade foods—pineapple upside-down cake, enchiladas with saltine crackers, and cream-of-mushroom chicken over rice.
Dementia looms over the Cantú family tree. Two of Tomas’s 10 siblings had it; Jessica wondered whether more might have, if they’d lived longer. Her maternal grandmother had dementia too. Seven months after her dad’s death, she began working as a nurse practitioner at the county’s first private Alzheimer’s-specific research site, El Faro Health and Therapeutics. “Patients will come in and say, ‘So have you figured it out? What is it?’” she told me. She tells them the truth. “I don’t know what it is that’s causing all of this.”