Breaking the silence: confronting dementia care stigma in Jamaica
Published:Wednesday | February 25, 2026 | 12:07 AM
In many Jamaican homes, dementia is not spoken about openly. It is whispered about, dismissed as ‘just old age,’ or quietly concealed for fear of being labelled ‘mad.’ Families often struggle in isolation as a loved one gradually loses memory, independence, and sometimes even the ability to recognise those closest to them.
The stigma surrounding dementia continues to shape the quality of care received by those diagnosed with the illness. While the disease does not discriminate by class, status, or education, the shame associated with cognitive decline frequently forces families into silence. The result is a heavy emotional burden carried behind closed doors.
Dr Sharon E. McKenzie, senior lecturer at the University of the West Indies, Mona, and dementia care specialist at the University of the West Indies, says the challenges families face go far beyond financial strain.
“The psychological burden is significant,” Dr. McKenzie explained. “Families are dealing with grief, frustration, guilt and exhaustion, sometimes all at once. It is not just about the cost of medication or doctor visits. It is the emotional weight of watching someone you love change.”
Dementia is among the most common neurological disorders affecting older adults worldwide. It is a disabling condition that interferes with daily functioning, impacting memory, thinking, language, judgement, and behaviour. The condition results from diseases that damage brain cells.
The most common form is Alzheimer’s disease, though other types include vascular dementia and Lewy body dementia. While dementia typically affects persons aged 60 and older, cases have been documented in individuals in their 40s and 50s. Women are disproportionately affected.
In Jamaica, dementia is emerging as a pressing public health issue. Research conducted by the Mona Ageing and Wellness Centre indicates that one in 16 Jamaicans aged 65 and older is living with dementia, a prevalence rate of approximately six per cent among the elderly population.
Meanwhile, the Statistical Institute of Jamaica reports that older adults represent roughly 13.9 per cent of the total population, a proportion that continues to grow as the country experiences population ageing.
Despite these figures, Dr McKenzie cautions that Jamaica remains ‘a long way from capturing the total number of individuals living with dementia and understanding its full impact.’
Dementia care in Jamaica is largely informal. It is provided primarily by unpaid family members, most often women, within private households. Caregivers may be spouses, adult children, grandchildren, or extended relatives. In many cases, financial support comes from relatives overseas, while daily care falls on one individual at home.
Caregiving frequently takes place with limited resources, particularly in rural communities. Access to medication may be inconsistent, and respite care is scarce. Depending on the type and stage of dementia, care needs may range from simple supervision and reminders to full assistance with feeding, bathing, and mobility.
Yet stigma often delays families from seeking help.
“In our culture, there is still fear about being labelled,” Dr. McKenzie noted. “As a result, some families may not disclose a diagnosis or may avoid seeking help until their loved one is in the later stages of dementia, when care becomes overwhelming.”
Such delays can mean missed opportunities for early intervention, education, and structured support.
Early detection is critical. Cognitive screening for older adults is recommended, as mild cognitive impairment can precede more severe dementia. Many general practitioners use paper-based tools such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA) to assess memory, orientation, attention, and language function.
However, screening alone is not sufficient.
Further evaluation by a geriatrician or neurologist is often required to determine the specific type and underlying cause of dementia. Unfortunately, the cost of specialist consultations, including neurologists and neuropsychologists, is beyond the reach of many Jamaican families.
“There are limited tests being conducted to identify the underlying causes,” Dr McKenzie said. “If families knew the specific cause of the dementia, treatment and management strategies could be implemented earlier. Education about preventative strategies to delay progression would also be helpful.”
She also advocates for expanded training in geriatric medicine, noting that as Jamaica’s population ages, more physicians must be equipped to diagnose and manage age-related conditions effectively.
While dementia progressively affects cognitive abilities, it can also erode the physical and mental health of caregivers. Many report chronic stress, sleep deprivation, anxiety, and social isolation. Some reduce working hours or leave jobs entirely to provide care.
Respect, dignity, and structured support are critical, not only for those living with dementia but also for those caring for them.
Across Jamaica, informal networks, churches, neighbours, and extended families, often provide essential support where formal systems fall short. Strengthening these grassroots structures through public education and community-based programmes is essential.
Reducing stigma remains perhaps the most urgent intervention. Dementia is not madness. It is a medical condition, a disease of the brain, deserving of the same compassion and structured care afforded to illnesses such as diabetes, hypertension, or cancer.
Public awareness campaigns, workplace sensitisation, and community forums can help families feel less isolated and more empowered to seek help early. Creating safe spaces for open dialogue is critical.
As Dr. McKenzie emphasises: “We have to create safe spaces for families to talk about dementia without shame. The earlier we detect and intervene, the better the outcomes. This is not only for the person living with dementia but for the entire family.”
In a society where community and family are foundational values, breaking the silence around dementia care may be one of the most important public health steps Jamaica can take.