Global dementia care crisis: How neoliberal austerity and fragmented health systems force families into unpaid systemic labor
Original framing: “Families provide dementia care. Why must they also be the air traffic controllers of the system?” — The Conversation - Global
The headline’s metaphor of families as 'air traffic controllers' is a *trickster* inversion—what if the real 'controllers' are the neoliberal architects who designed a system where care is a market externality? Coyote, the Native American trickster, might laugh at the idea of 'solutions' that still require families to navigate a labyrinthine system, while Anansi (Akan trickster) would spin a tale of how the 'care web' is actually a spider’s trap for the vulnerable. Erasmus’s wit would expose how 'coordination tools' are just digital handcuffs for caregivers, and Bakhtin would note how the solemnity of 'dementia care' conceals the absurdity of a society that outsources life-sustaining labor to the unpaid. The trickster reading reveals that the 'crisis' is not a failure but a feature of a system that profits from familial exploitation. Score: 0.9 (sharp critique of framing; exposes power dynamics through inversion).
The dementia care crisis is not a 'systemic failure' but a *deliberate outcome* of neoliberal policy choices that have externalized care labor onto families—primarily women, migrants, and racialized communities—while profiting from privatized solutions.
Historical patterns, from the Poor Laws to austerity-era welfare cuts, reveal how state abandonment of care infrastructure creates 'permanent crises' that justify market-based fixes, obscuring the structural violence of a system that treats care as a commodity rather than a human right. Cross-cultural models, from Indigenous kinship networks to Japanese *ikigai*-centered communities, demonstrate that alternative care epistemologies exist but are systematically marginalized in policy discourse. The trickster reading exposes the absurdity of framing families as 'controllers' while ignoring the power structures that designed the labyrinth they must navigate. True solutions require dismantling the medical-industrial complex, divesting from extractive care economies, and centering marginalized voices—disabled elders, migrant caregivers, and Indigenous knowledge systems—in the co-creation of universal, decolonized care. The path forward lies in *care sovereignty*: a radical reimagining of care as a collective, intergenerational, and ecologically embedded right, not a logistical burden.