San José, Costa Rica, since 1956

Program to Foster Better Care for the Elderly

It’s frightening for Katya De Luisa to think what might happen to Costa Rica’s baby boomer population when they reach retirement age.

According to a 2008 report by the University of Costa Rica, in 15 years, the number of elderly is expected to double, climbing from just 1 percent of the population to 11.5 percent, and a lack of infrastructure and a dearth of caretaker education places them at risk(TT, July 7, 2009).

“We have a huge aging population and not enough young people to care for us,” said De Luisa, a 62-year-old Chicago native. “The elderly care system is going to be totally saturated.”

While developed countries have long had nursing homes, assisted living facilities and in-home care, Costa Rica – which has long depended on the family structure to care for its elderly – is far behind.

De Luisa is a trendsetter by nature. She started the first nature tours in Manuel Antonio when the tourism industry there had yet to take off, pioneered mapping of environmental tourism routes, and founded an association for street children before government officials acknowledged it was a problem. Now she is unveiling a program to help prepare Costa Ricans for the coming era of baby boomer retirement.

Next week, De Luisa will begin offering informative workshops for people who want to learn more about how to care for people with dementia or Alzheimer’s disease. The workshops are part of a larger campaign she calls “Picture the Voice.” The goal is to train people to care for the elderly in a more humane and intelligent way.

“Private homes are not set up to care for people with dementia. Many families don’t know how to care for their abuelos,” De Luisa said. Part of this lack of care means that older relatives are home alone while adult children are away at work.

“Care for people with Alzheimer’s, much less care for the elderly, is not great in Costa Rica,” said Lucy Barquero, dean of the Evangelical University of the Americas.

Barquero is developing a similar program directed at improving strategies to care for the elderly.

“We are going to need families who are prepared for this type of care,” she said.

De Luisa’s idea for a Costa Rican program stems from her time working in a U.S. nursing home, where for several years she managed an art program for patients with dementia and Alzheimer’s. At her first class, she was surprised when none of the patients responded to the painting materials offered them.  

“No one paid any attention,” she recalled, adding that some people slept while others simply stared at the walls.

After two weeks of experimentation, De Luisa designed a program that she believes has the potential to break down the communication barrier between families and loved ones with dementia. She works individually with each person, asking them to flip through magazines and select images they may identify with. Some choose scenes of fishing; others, puppies or children. But in each case, the photos allow patients to reconnect both with families and with memories.

“If you can’t communicate, you are going to decline pretty quickly,” De Luisa said. “It’s a matter of reaching what still remains, and pictures can do that.”

In one particularly moving workshop, De Luisa spent an afternoon working on a collage with a patient whose wife had grown discouraged over her husband’s condition. With De Luisa’s help, the husband crafted a collage that read simply, “I’m okay. I’m alive.” The gesture was an unforgettable moment for the couple.  

“When people suffer from dementia, family members say their personalities change, that they don’t know them anymore,” De Luisa said. “But they are still there, and it’s important to keep the connections alive.”

In Costa Rica, De Luisa says her workshops will encourage a hands-on approach to learning, as well as strategies on how to care for loved ones with Alzheimer’s or dementia. The first workshop will be held Nov. 26 in Spanish. The second is scheduled for Dec. 3 and will be in English. Both will be held at the Hogar de Ancianos in Piedades de Santa Ana, southwest of San José. For more information or for a private consultation, contact De Luisa at or 8950-0786.

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