As Alzheimer’s cases grow, Sacramento wants to make communities 'dementia-friendly’

Carlos Olivas III was living in Ventura when he got the call from his dad’s dentist in Sacramento. 

His dad, Carlos Olivas II, known as “Charlie,” hadn’t shown up for his appointment. When he’d finally arrived, after much coaching by office staff over the phone, he’d had a noticeable body odor and an infection in his gums was getting worse. 

It wasn’t the first time Charlie had exhibited these behaviors at the dentist, and staff there had concerns he might have a cognitive impairment. The younger Olivas was his dad’s emergency contact. 

“I ended up calling my brother to let him know what was going on. And then from there it was me and him comparing notes,” Olivas said. 

How long had it been since their dad had called for their birthdays? For Olivas’ daughter’s birthday? How many years since Charlie had remembered the day his wife died, or their wedding anniversary? It began to dawn on the brothers that their dad might need help, but they didn’t know where to start, or what the process might entail.

“We were in the dark,” Olivas said. 

With the number of older adults growing rapidly in California, Alzheimer’s disease and the dementia it results in are becoming a top priority for public health officials. 

In Sacramento County, a new initiative is underway to make the area “friendlier” for people who have dementia and attempt to lower rates of the disease in the first place. Officials want more businesses to be able to see the signs, and for families’ like Olivas’ to have more clarity on their options and local resources.  

A growing concern

Alzheimer's disease occurs when there’s an abnormal buildup of protein and protein structures in the brain, leading to plaque between nerve cells and twisted fibers within neurons. These issues interfere with normal brain functioning and lead to cellular death and deterioration, specifically in areas involved in memory and cognition. It’s the most common cause of dementia, which is a broad term for cognitive impairments that affect memory, thinking and everyday functioning. 

Alzheimer’s doesn’t just lead to memory loss. When it results in dementia, it can also cause death. 

“As the brain deteriorates in dementia, people lose the ability to talk and then they lose the ability to walk. And then finally, they lose the ability to eat. They die because of the brain’s failure to sustain the body,” said Dr. Charles DeCarli, who directs the UC Davis Alzheimer's Disease Research Center.

According to Sacramento public health, deaths due to Alzheimer’s disease have more than doubled over the past decade — from 387 in 2011 to 814 in 2021. It’s become one of the main causes of death in the county, California and nationwide. 

Although it’s not clear what exactly causes the disease — genetic, social and environmental components play a role — age is the biggest risk factor. 

“Our population of people over the age of 60 is growing larger. And so there's a concern that we need to make sure that we're able to take care of people as they grow older,” said Dr. Olivia Kasirye, Sacramento County’s health officer.

Focusing on dementia-friendliness

For Alzheimer’s researchers and public health workers, a top priority is awareness of the disease. 

“The brain is an organ just like everything else,” DeCarli said. “Just like your eyes, just like your ears, just like your heart, your lungs, your kidneys.”

Just as those organs can deteriorate with old age, so can your brain. DeCarli says that with more awareness, people can focus more on their brain health and the stigma around  Alzheimer’s and dementia can start to break down. Education can also help spur change that improves communities and systems for people suffering with the disease. 

He says folks with dementia shouldn’t be segregated from society at large.

“With a little support, most people, even in the midst of dementia, can do quite well,” he said. 

Dementia Friends USA, an offshoot of the Alzheimer’s Society in the United Kingdom, has examples of how to make neighborhoods dementia-friendly, including supportive faith communities and opportunities for elder engagement. The organization also suggests communities increase dementia-friendliness by thinking of people with the condition when they plan public transportation, government services and emergency response. 

Greater awareness is especially important when it comes to the way police treat people with the condition. According to a 2022 investigation by The Marshall Project, more people over the age of 65 are being arrested, outpacing the growth of that demographic, and violent and deadly arrests of people with dementia have been documented across the nation. 

Carlos Olivas III stands in front of a wall of photos and art, including a portrait of himself as a child, inside his East Sacramento home on Nov. 27, 2023.Kate Wolffe/CapRadio

Carlos says he’s heard some of these stories, and took firearms out of the family’s East Sacramento home as a precaution. 

“I think law enforcement needs to be more aware of how to recognize [dementia], and how a loved one can communicate with law enforcement to make them aware of an individual's situation,” he said.

Taking a targeted approach in Sacramento

For Health Officer Dr. Olivia Kasirye, one hallmark of a safe environment is “being able to have businesses where if someone walks in and there's a recognition that ‘okay, this person is suffering with dementia,’ they know what to do, they know who to call, they know how to treat that person.”

With money from the California Governor’s Task Force on Alzheimer’s Prevention, the county says it plans to begin consulting with people in neighborhoods where life expectancy and life satisfaction are lowest about how to improve both factors, focusing particularly on the experience of those with dementia and their caretakers. 

These areas, including both North and South Sacramento, tend to be populated by communities of color and are disproportionately impacted by chronic disease, including Alzheimer’s and dementia. 

Kasirye says over the course of the next six months, the county and its partner, Blue Zones, will be interviewing people in specific parts of Robla, Del Paso Heights, Hagginwood, Woodlake, Arden-Arcade, Lemon Hill, Parkway, Meadowview and Florin.

“We need to talk to the people in those communities, find out what they think the problems are and how they think that we need to solve them and then come up with solutions together,” she said. 

The county and its partner will be using research inspired by so-called blue zones of the world, where people live the longest and have low levels of chronic disease, to formulate a report on how public health can help make healthier choices easier for residents. 

That report is expected to include “dementia-focused policy and place-based designs and solutions.” People can stay updated on the project on the Blue Zones website.

‘They take really good care of me’

Stepping inside the Olivas’ East Sacramento home is like entering a gallery. The walls are covered with bold art and sculpture, much of it created by Charlie himself. There’s also a kiln out back, where Charlie used to make pottery and give it away to friends. 

Now, he says he prefers to sit in his chair and draw, designing geometric patterns with ink on large pieces of white paper. He says he takes inspiration from his environment.   

“He draws anywhere from eight to 10 hours a day,” said Olivas. 

Carlos Olivas III looks through a binder of art made in recent years by his father, Carlos Olivas II, inside their East Sacramento home on Nov. 27, 2023.Kate Wolffe/CapRadio

Olivas and Charlie’s paid caregiver have been going through binders of Charlie’s work, selecting pieces for an upcoming show planned at ArtBeat Gallery in Sacramento. 

Eventually, Olivas would like to show a retrospective of Charlie’s work from the 1970s to the present. In the meantime, he’s been showing it off on social media, using the handle @charlierobot on Instagram and TikTok. There, Olivas also chronicles his experiences as a caretaker, hoping to increase representation of Latino men caring for their family members. 

When Charlie isn’t making art, the father and son visit local parks, see live music and walk around familiar places like Home Depot and Costco. 

Olivas says life can be very hard, but it also has moments of joy.

“At the end of the day, if I ask him what he's grateful for, he'll say ‘oh, my two sons and my granddaughter, they take really good care of me,’” Olivas said. “And if he can go to bed, knowing that, I think we've done our job here.”