Leveraging the Dyad to Inform Dementia Care Policy: Some Anthropological Precautions and Possibilities

As anthropologists, we welcome Peterson and colleagues (2026) call to consider dementia caregiving as relational and dyadic—an approach resonant with longstanding anthropological challenges to the presumed boundaries of mind, self, and individual (Bateson 1972; Mauss 1985 [1938]; Strathern 1988). We also share their concern that the cognitive and relational dimensions of caregiving—what they term “mind care”—are routinely eclipsed by dominant framings that equate caregiving with “body care.” But while we agree that dementia care work could—and should—be “recast as that of body and mind support” (Peterson et al. 2026, XX), we diverge from their framing of mind care as categorically exceptional to dementia. In this brief response, we first draw on anthropological scholarship to complicate Peterson and colleagues’ framing. We then propose that foregrounding mind care’s non-exceptionalism may better advance the authors’ aim of reshaping how dementia caregiving is recognized, valued, and resourced.

Close, long-term anthropological studies of caregiving relationships across many contexts indicate that mind care—care for cognitive health, meaning, identity, and emotional life—is widespread yet often overlooked, challenging the idea that it is unique or exceptional to dementia care. Mattingly (2014) describes how parents of disabled Black children in the United States must, as caregivers, continually engage in moral deliberation to support their children’s sense of self and pursuit of a good life amid medical uncertainty, limited access to care resources, and racialized inequities in health and social service systems. Garcia (2010) shows how, within the long afterlife of colonial dispossession, multigenerational New Mexican families living with heroin addiction enact care for personhood through the relational work of accompaniment—care that endures in the face of unlikely recovery and recurring loss. Nakamura (2013) documents how schizophrenia patients and caregivers in a group living setting in Japan build community together, treating hallucinations as experiences to be worked through collectively rather than a basis for social isolation. Stevenson (2014) traces how youth in an Indigenous community in Canada find meaning in sustaining relationships with friends and family who have died by suicide, while also showing how government-led suicide prevention efforts, which focus narrowly on what Peterson and colleagues might consider “body care,” are ill-equipped to recognize or engage these ties. While we agree with Peterson and colleagues that attending to the specific features of dementia and dementia care—such as the temporalities of cognitive decline—is crucial to strengthening support for dementia dyads, these ethnographic works suggest that the relationship between dementia and mind care is not as singular as Peterson and colleagues imply. Rather, mind care emerges as a foundational— and alarmingly underacknowledged—dimension of a broad array of caregiving experiences, domains, and relationships.

Notably, attending to mind care from an anthropological perspective also calls into question the very premise of a universal or stable mind-body binary. By upholding this binary, Peterson and colleagues risk reproducing the problem they seek to remedy: the failure to recognize caregiving, in all its complexity, as simultaneously cognitive, bodily, relational, and moral. The analysis also leaves underdeveloped how the erasure of this complexity is part of a broader devaluation of reproductive labor (Federici 2012)—the work that makes human flourishing possible.

In offering this critique of Peterson and colleagues’ framing of mind care, our aim is to bolster their goal of radically improving recognition of and support for dementia care. We suggest that this goal may be better served not by underscoring dementia care’s exceptionalism with respect to mind care, but by linking it to other underrecognized instances of deeply relational caregiving enacted amid profound precarity. To ground this point, we turn to a disability rights movement example that Peterson and colleagues reference in passing: curb cuts. While the authors note that curb cuts are an accessibility measure widely “taken for granted” (Peterson et al. 2026), the ubiquity of curb cuts was neither natural nor inevitable (Blackwell 2017). Instead, they emerged through sustained, collective disability activism that reframed accessibility as a shared social obligation.

This example offers a generative model for realizing the urgent goal that Peterson and colleagues illuminate. Staking the need for change in dementia care support on the claim that stigma is greater for dementia than for other disabilities risks reinscribing the very lack of intimate understanding of life-altering disability that Peterson and colleagues compellingly challenge. Instead, meaningful policy change is more likely to be achieved through coalition-building across disability and caregiving domains—just as the history of curb cuts demonstrates.