In the United States, dementia is a prevalent problem that people face. Jason D. Flatt et al. (2017), an Associate Professor at the Institute for Health & Aging, found that specifically in California, from 2015 to 2030, it is estimated that the percentage increase of Californians with Alzheimer's will be 80%. This will overall decrease the well-being of hundreds of thousands of Californians because, according to Stephan Blossom C. M. et al. (2020), who work at the Division of Psychiatry and Applied Psychology, Dementia leads to diabetes, social isolation, depression, and more. California leads the US with the most unpaid care for Caregivers of $ 44,272 million. The total value of unpaid care in the US is $346,585 million, according to the Alzheimer's Association. The continuous unpaid care could reduce the number of caregivers. The lack of care for people with dementia can lead to a reduction of social interaction, preventing cultural expression and diversity. Organizations such as the Alzheimer's Association work on increasing support and research on dementia, which will also help support unpaid caregivers and people with dementia. Unfortunately, according to John Carmody et al., who are from the University of Wollongong, the inadequacy of federal funding reduces the progress of projects for organizations and programs. To address cultural diversity in California, it's important to understand if the lack of federal funding for dementia-based organizations like the Alzheimer's Association is a concern for the cultural diversity of California in the future.

Evidence: “Despite enormous progress in our knowledge of some pathophysiologic mechanisms in the last decade, we are still far from understanding AD and probably from finding a cure. The available medications or medications may, however, help us to manage some symptoms for our patients, and gain some time for them”

In-text Citation: (Jahn, 2022, p. 452)

Connection to Claim: This shows that more federal funding and support are needed for dementia-based organizations and projects to understand Alzheimer's more deeply and to work to find a cure for memory loss. This would help with the expression of people's identity, leading to cultural diversity.

Evidence: Social isolation with a PAR of about 2.4. Social isolation is a risk that people with dementia have later in life.

In-text Citation: (BCM et al., 2020, p. 1450)

Connection to Claim: It shows how social isolation is one of the problems that the population experiences later in life. This can help emphasize that research and support are needed for organizations because there is a potential for decreased cultural expression and dispersion in the community.

All of these sources mention the importance of funding dementia-based programs as they help reduce social isolation and verbal fluency of people through increasing research on dementia or funding cultural and dementia communities that encourage people to express their identity, including their culture. This can be achieved through federal funding. This proves that the lack of federal funding impacts the expression of identity. Although funding these programs is important, the lack of funding isn't the only thing that is impacting the social interactions of people with dementia. The social beliefs are impacting how these people are treated and labeled in society. Ultimately, funding dementia-based programs will be more effective with the expression of identities, contributing to the diverse community.

By exploring how the rising number of people with dementia in California can impact their well-being due to the lack of care support, we should consider how a specific part of their well-being, identity expression, is impacted by memory loss.

Memory loss affects the expression of cultural identities and reduces the number of people spreading their culture. Dementia-based organizations and programs should be explored to see how cultural diversity in California can be grown/maintained, and how federal funding plays a big role.

2. Restate each of your claims, weaving them together to illustrate your line of reasoning

3.  Reiterate your main idea/thesis

Dementia is a problem that many Americans face, especially Californians. The cases of dementia are rising while the care and programs are receiving reduced federal funding. Organizations specifically work to create communities that make people with dementia and caregivers feel "empowered, supported and included in society, understand their rights and recognize their full potential" (Maki et al., 2020, p. 511). This action will allow people to share their identities comfortably. Understanding how organizations, like the Alzheimer's association, work to increase people expressing their identity (Shatnawi et al., 2023), how memory loss impacts the expression of cultural identity (Fuchs, 2015), the exploration of dementia in California, and potential solutions are needed to help sustain the cultural diversity in California in the future. Through the exploration of how dementia could impact the cultural diversity in California and the lack of federal funding, which is limiting progress (Carmody et al., 2015), it clearly shows that the federal government should specify medical funding so people with dementia get the support they need to express their identity.

The lack of quality care in California due to insufficiency of federal funding impacts the people's health. To work towards improving the funding for people with dementia, potential solutions should be considered.

Evidence: “securing sufficient funding for cultural inclusivity in dementia friendly communities”

In-text Citation: (Shatnawi et al., 2023, p. 2037)

Connection to Claim: This mentions how additional funding, such as federal funding, can help with cultural inclusivity for patients with dementia, which proves that the lack of funding can impact cultural diversity, and it’s a problem that communities are trying to fix. All of this will help empower these patients and make them feel more comfortable to share and express their culture in their community, helping with cultural diversity. 

Evidence: “California initiated an effort to improve care for PLwD within its Financial and Administrative Alignment(duals) demonstration project, Cal MediConnect (CMC), which serves individuals dually eligible for Medicare and Medicaid through managed care HPs. CMC's HPs served as the single point of entry for enrollment and access to medical care, behavioral health, and LTSS…the participating HPs had little experience working with older adults or addressing LTSS needs”.

In-text Citation: (Hollister et al., 2021, p. 3642)

Connection to Claim: It shows that various organizations, like those in California, are working to improve care for PLwD by expanding accessibility. However,  the only downside to this is that the HPs/ workers have less experience working with older adults or addressing LTSS needs. This shows that the rise of people with dementia poses a threat to well-being due to the lack of equal care. .

Evidence: “She later told people of her experiences on the mountain, and this narrative has become a part of the oral tradition of the next generation".

In-text Citation: (Binney, 2004, p. 207)

Connection to Claim: It shows that allowing more people to talk about their experiences and identities can be something that can be passed down, so California can maintain its cultural diversity. Therefore, memory can reduce the expression of one's identity and experiences since they don't have a story about them in memory. The continuous reduction of the expression of one's cultural identity will gradually decrease cultural diversity.

Evidence: “dementia not only as a series of signs and symptoms but also as a category of differentiation, discrimination, and ascription of cultural values that shapes the experience and interpretation of functional decline in old age".

In-text Citation: (Cipriani & Borin, 2015, p. 198)

Connection to Claim: Although supporting programs help increase cultural expression and therefore cultural diversity, the society's beliefs about dementia lead to discrimination towards people with dementia, leading to the reduction of cultural expression and cultural diversity. Therefore, societal beliefs can also negatively impact cultural diversity.

Evidence: “they are no longer able to account for the origin of this familiarity, nor to tell their life story”

In-text Citation: (Fuchs, 2015, p. 674).

Connection to Claim: It shows how dementia can impact how people tell their life stories and remember the memories that feel/ look familiar. This proves that memory loss impacts how people may express their identity, limiting the number of people spreading their culture.

All sources show how memory can impact self-expression and, therefore, cultural expression as well. The side effects of dementia would impact how people with dementia communicate with people within their community. Anything that has to do with memory will impact how people express their identity to the people around them. The lack of attention to dementia can greatly impact the expression of various cultures. This proves that the growing number of dementia cases in California will impact the cultural diversity in the future.

All of these sources show the rising number of dementia cases in California and how this can be detrimental to the overall well-being of Californians due to the lack of care. Hollister et al. and the Alzheimer's Association show the importance of paid care by showing California programs that work to address these needs and how more support and funding are needed to increase quality care, the scope of the unpaid care in California, and why caretakers are important. These sources show the rising problem of dementia in California and how funding can improve the care patients receive, elevating their health.

Evidence: “Over five million older adults in the U.S., some 630,000 of them in California alone, are currently living with Alzheimer’s disease and related dementia (ADRD). This number is expected to rise to 16 million people nationally, with over a million in California by 2050”.

In-text Citation: (Flatt et al., 2017, p. 4).

Connection to Claim: This shows that there is a rapid growth of Californians with dementia. Due to the growing numbers, it would be hard for everyone to get the care they need which impacts their well-being.

Evidence: California has the greatest value of unpaid care, which is 44,272 million of dollars. 

Caregivers help people with dementia by “finding and using support services such as support hours and adult day service programs”.

In-text Citation: (Alzheimer's Association, 2024).

Connection to Claim: It shows the scope of the problem in California and the importance of caretakers. Furthermore, California has the greatest number of unpaid caregivers. It also proves that much funding is needed to pay for these caregivers to take care of people with dementia. 

Evidence: “Governments can also contract with nongovernmental organizations or other private groups to provide care to subgroups of the population. In any event, monitoring mechanisms will be needed to ensure that the intended services are provided to the target population”.

In-text Citation: (Bodadilla et al., 1994, p. 660).

Connection to Claim: It shows how the government can interact with nongovernmental organizations to provide care to subgroups to give care to a specific group of people. This proves that the government should work with the Alzheimer's association to help provide care to people with dementia through funding for care or research.

Evidence: “overall pattern showing lack or inadequate elaboration of terms signifying EBIs makes it difficult for applicants to comply with federal policies regarding use of EBIs for behavioral healthcare”.

In-text Citation: (Lee-Easton et al., 2022, p. 1).

Connection to Claim: It shows how the lack of specificity can impact how each sector that needs to be funded doesn't get the support it needs. There is a need for federal policies to ensure this doesn’t happen, so programs can help with social interactions, allowing people with dementia to express their identity and beliefs.

Evidence: “Current attempts to engage in qualitative dementia research are hampered by numerous obstacles. Inadequate funding—the “elephant in the room”—hinders progress and condemns many worthwhile qualitative studies to failure”.

In-text Citation: (Carmody et al., 2015, p. 1017)

Connection to Claim: It shows how the lack of funding from the government to research facilities impacts the process towards dementia. This emphasizes the need for the government to provide funding because it could help with sustaining people’s memories and identity. This will eventually add to the diverse community.

All of these sources show potential solutions to increasing dementia-based care, and specifically Carmody et al.. show the connections between research and the importance of funding for research and care. This proves that federal funding for dementia is needed to improve dementia rates and its impacts on the expression of identity, including cultural. This will then help with cultural diversity in California.

Evidence: "The Meeting Centers Support Program...provides opportunities to promote social participation in local community centers".

In-text Citation: (Maki et al., 2020, p. 514)

Connection to Claim: It shows there are programs that fight for the social participation of people with dementia in community centers, which shows that dementia can reduce how people interact with one another. Therefore, programs are needed to increase the social participation of people so they can express themselves, contributing to the culturally diverse community.