Book Review 
 
Review of Yahalom, Jonathan. Caring for the People of 
the Clouds: Aging and Dementia in Oaxaca. Norman: 
University of Oklahoma Press. 2019. pp. 231. Price: $55 
(Hardcopy); $24.95 (Paperback and eBook). 

 

Cíntia Engel 

Federal University of Bahia (UFBA) 
cintiaengel@gmail.com 
 

 

 

 

 

 

 

 

 

 

 

Anthropology & Aging, Vol 42, No 1 (2021), pp. 164-166 

ISSN 2374-2267 (online) DOI 10.5195/aa.2021.343 

 

 

 

  

 

 
 

 
This work is licensed under a Creative Commons Attribution 4.0 International License. 

 
This journal is published by the University Library System of the University of Pittsburgh as 

part of its 

D-Scribe Digital Publishing Program, and is cosponsored by the University of Pittsburgh Press. 



           Book Review | Engel |  

  

 

Anthropology & Aging  

Vol 42 No 1 (2021) ISSN 2374-2267 (online) DOI 10.5195/aa.2021.343 http://anthro-age.pitt.edu 

164 

 

 
 
Book Review 
 
Review of Yahalom, Jonathan. Caring for the People of 
the Clouds: Aging and Dementia in Oaxaca. Norman: 

University of Oklahoma Press. 2019. pp. 231. Price: $55 
(Hardcopy); $24.95 (Paperback and eBook). 

 

Cíntia Engel 

Federal University of Bahia (UFBA) 

cintiaengel@gmail.com 

 

 

“But regardless of what concrete action one comes to take, 

caregivers teach that appropriate interventions are ones 

 that meaningfully acknowledge individuals  

for their daily efforts. 

 They are ones that honor caregivers’ dedication  

to maintain a sense of cohesion  

within parameters of contemporary life”  

(169). 

 

In Caring for the People of the Clouds, psychologist Jonathan Yahalom utilizes socio-anthropological 

research methods to shed light on the cultural specificities of dealing with dementia in Teotitlán, 

Oaxaca. He provides caregivers’ perspectives on Alzheimer’s Disease while also highlighting how the 

community of Teotitlán understands forgetfulness in the process of aging, such as if and when 

forgetfulness is interpreted as a disease and how and why it should (not) be cared for. Based on in-

depth interviews and observations, Yahalom proposes that the reflexive potentialities of 

anthropological theory and ethnographic method can help alleviate the social ostracism dementia 

caregivers may experience and foster psychologists and other health professionals’ understanding of 

life with dementia from an emic perspective. Yahalom incorporates social constructivism in part of his 

analysis, considering illness experiences and trajectories as social phenomena, and also relies on 

pragmatism to defend the multiplicity of lived realities. In the book, Yahalom’s main objective is to urge 

psychologists, doctors, and other health professions to recognize the culturally and historically 

contingent spaces of and for dementia, alongside and together with biomedical approaches.  

 

Based on interviews with family caregivers and analysis of local newspapers, street art, and public 

campaigns on aging, Yahalom argues that older adults in Oaxaca are traditionally admired and 

respected for being carriers of cultural knowledge. Becoming forgetful, however, they begin to lose this 

status. For citizens of the community, forgetfulness in older adults can indicate the disintegration of 

kinship ties and a general decay of traditional ways of living. In Oaxaca, Alzheimer’s is a disease mainly 

related to stress and modern life. Most of Yahalom’s interlocutors would say that Alzheimer’s is caused 

by a stressful way of life associated with the country’s modernization, and some would even add that 

families that do not preserve the traditional way of life are most at risk of developing the disease. 

Caregivers manage these tensions between the traditional and the modern, as it plays out in the bodies 

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           Book Review | Engel |  

  

 

Anthropology & Aging  

Vol 42 No 1 (2021) ISSN 2374-2267 (online) DOI 10.5195/aa.2021.343 http://anthro-age.pitt.edu 

165 

they care for and are at risk of being held responsible for the decay of tradition. Following the current 

literature on care (e.g., Buch 2015; Parreñas 2015; Yarris 2017), Yahalom insists on the ambiguous, 

“segre-social” (20) character of caregiving: it’s an activity that reproduces and maintains social cohesion 

but is similarly entwined with social transformation, isolation, and conflict. In Yahalom’s words, segre-

social is “an admittedly clumsy term that attempts to capture how caregivers are simultaneously drawn 

into new familial relations centered on dementia but, in doing so, risk becoming misunderstood by and 

segregated from the larger community” (20). 

 

The introduction to the book’s five chapters contextualizes the community and the city and gives an 

overview of Yahalom’s research methodology. Chapter 1 discusses local perspectives on aging and 

forgetfulness: normally, an older adult will be treated as a mature and respectable member of society; 

experiences of forgetfulness, however, can change that perception and relegate older persons with 

dementia to the social space of children. Yahalom argues that the ethics of caregiving in the region is 

rooted in social values of communitarianism and familism; referentially, care is done at home by family 

members. Chapter 2 explores how forgetfulness among older adults is normalized when kin 

relationships are not endangered. On the other hand, however, caring for kin becomes problematic 

when those who suffer from memory loss forget who they are or stop recognizing their kin. 

 

In Chapter 3, Yahalom further explains the modern/traditional dichotomy in the etiology and treatment 

of diseases. Since in Teotilán, Alzheimer’s is a disease associated with modernity and stress, it is thought 

to belong to the field of expertise of modern medicine. Other episodes of forgetfulness are treated as 

traditional diseases, such as susto, a condition related to encounters with spirits. This chapter also 

mentions how historical and contemporary power relations, as well as structural inequalities, influence 

the choice between traditional healing or modern biomedicine. Believing in traditional knowledge, for 

example, can be an act of resistance since those practices have a history of public persecution. Seeing a 

specialist, on the other hand, is unsettled by the fact that health care provision in the community is 

limited to basic care; a specialist that could diagnose Alzheimer’s is too expensive for most families. 

 

Chapter 4 further explores this tension between traditional and biomedical treatment and observes 

caregivers’ strategies to negotiate ‘good care’ for forgetful older adults, caregivers tinker different 

values through socio-material practices (e.g., how to care, when to see a doctor, and how to divide the 

care tasks among family members) (Mol, Moser, and Pols 2010). Chapter 5 reflects on caring for people 

with memory impairment and the vulnerable position of caregivers in the community.  Those caring 

for older adults with memory impairment are constantly investigated by neighbors and are frequently 

targets of gossip. As forgetfulness might be viewed as the decay of social values such as supporting the 

family and the community, caregivers can be held personally accountable for the worsening of dementia 

symptoms in older adults and at the same time for the general decay of social cohesion. In the Epilogue, 

Yahalom synthetizes his plea for a pragmatic approach to dementia (research). According to him, 

doctors and psychologists must work to understand cultural concerns and disease categories and the 

social suffering of caregivers.  

 

This work provides interesting insights on forgetfulness and aging in dialogue with current literature 

on the cultural specificities of caring in Mexico. Particularly powerful, is this book’s attempt to open up 

a dialogue between anthropological research and clinical interventions. Nonetheless, some aspects of 

this book leave room for further exploration. For example, the status that “familism” is given as a 

cultural aspect of social cohesion is problematic. Of course, the centrality of family care is prominent in 

the interviews and literature about care in Latin America, but “familism” is also a term used in critical 

Latin-American literature on care to express a state ideology that justifies improperly investing care 

infrastructures (see for example Debert 2012). The social and political implications of the centrality of 

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           Book Review | Engel |  

  

 

Anthropology & Aging  

Vol 42 No 1 (2021) ISSN 2374-2267 (online) DOI 10.5195/aa.2021.343 http://anthro-age.pitt.edu 

166 

family in caring for dementia are thus far more complex than that of a cultural characteristic that 

reproduces social cohesion in the region. Perhaps, a critical cultural sensitivity for the present politics 

of care in Latin America could have steered the analytical attention away from social cohesion as a 

cultural concern towards more realist and speculative approaches to care for dementia in Oaxaca. 

Something that could have prevented this shortcoming is a more reflexive attitude towards the 

ethnographic methodology itself. In Chapter 3, for example, Yahalom describes the difficulty of 

accessing a specialist that could diagnose Alzheimer’s. Nevertheless, the author does not draw any 

conclusions from it for the everyday enactment of dementia.  

 

The book ends on a down note (169). Understandably, Yahalom advocates for a type of anthropological 

sensibility in clinical work. For the author, culture cannot be understood just as a general context for 

experiencing the disease; approaching culture requires an ethnographic mode of attention to include 

the complexity of sociocultural experiences of illness and caregiving. But, after the complexity of disease 

identity and caregiving was brought to the fore in ethnographic data, this conclusion seems a little too 

naïve, rationalist, and even apolitical: how exactly can this sensibility be a solution for caregivers’ 

dilemmas?  

 

Despite these shortcomings, this is an important book for the study of dementia and caregiving in Latin 

America and beyond. It showcases experiences that necessitate critical thinking and complex 

perspectives on caregiving and aging. Anthropologists, researchers, and practitioners of psychology, 

geriatrics, and psychiatry will benefit from reading it. 
 

References  

Buch, Elana. 2015. “Anthropology of Aging and Care.” Annual Review of Anthropology 44: 277-293.  

Debert, Guita. 2012. “Imigrantes, Estado e Família e Suas Vicissitudes.” In Cuidado e Cuidadoras: As Várias Facetas do 

Trabalho de Care. Edited by Helena Hirata and Nadya Araujo Guimarães, 216-233. São Paulo: Editora Atlas. 

Mol, Annemarie, Ingunn Moser, and Jeannette Pols. 2010. “Care: Putting Practice into Theory.” In Care in Practice: 

On Tinkering in Clinics, Homes and Farms. Edited by Annemarie Mol, Ingunn Moser and Jeannette Pols, 

277-300. Bielefeld: Transcript Verlag.  

Parreñas, Rhacel. 2015. Servants of Globalization: Migration and Domestic Work. Stanford, CA: Stanford University 

Press. 

Yarris, Kristin. 2017. Care Across Generation: Solidarity and Sacrifice in Transnational Families. Stanford, CA: Stanford 

University Press. 

 

 

 
 

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