For nearly nine months, U.S. Immigration and Customs Enforcement has held a 72-year-old grandfather with Alzheimer’s disease in a Texas immigrant detention center. As Noé de la Cruz’s attorneys fight to win asylum status, his only daughter worries that he is forgetting his own grandchildren—and is in danger of losing his life if he is deported.

“When a person gets sick with this kind of disease, it’s a very different situation for that person, and their family, because they are not who they were anymore—they’re more like a child,” Sandra de la Cruz, Noé’s daughter, told The Daily Beast. If her father is deported to his native Mexico, Sandra said, she fears his condition may deteriorate even more quickly.

“He’s going to get lost, and we don’t have family over there who can take care of him,” Sandra said. Speaking through tears, Sandra recounted instances where her father called “three, five, ten times a day” from the Port Isabel detention facility near Los Fresnos, Texas, asking the same questions over and over.

“He also says that he’s getting into fights, but when we go to see him, he doesn’t have bruises,” Sandra said. “We think that the fights are happening in his mind.”

Although his family has petitioned to have de la Cruz released into their care while his removal is adjudicated, ICE has refused, according to Tatiana Obando, de la Cruz’s attorney.

“They decided that he’s not dangerous to himself right now, and that he’s not deteriorating, and that’s why it’s not required for them to release him,” said Obando, a managing attorney with the Refugee and Immigrant Center for Education and Legal Services (RAICES). ICE’s alternative, Obando told The Daily Beast, was to put de la Cruz in solitary confinement for his own protection. For a man with dementia, the damage of being completely isolated could be irreversible.

“They could put him in protective custody, meaning segregation,” Obando said. “I don’t think that putting someone with a mental illness in protective custody is the right way to go about this.”

The only contact the de la Cruz family had with him, Sandra said, has been through a glass partition at the Port Isabel detention center, the same facility where a woman who was six months pregnant delivered a stillborn baby boy last month.

“We couldn’t go and have a physical interview or visit with him because he is the one who needs to request it, but he doesn’t know how; he forgets how to do the request,” Sandra said tearfully. “There’s no way for us to help him, and that’s hard. That’s hard.”

A spokesperson for ICE, which does not have a specific policy regarding detention for people with diagnosed cognitive decline, defended de la Cruz’s detention.

“ICE makes custody determinations on a case-by-case basis, in accordance with U.S. law and Department of Homeland Security policy, considering the merits and factors of each case while adhering to current agency priorities, guidelines and legal mandates,” said spokesperson Dani Bennett.

Alzheimer’s experts warned that detention in an unfamiliar place with unfamiliar people is potentially dangerous for anyone with the disease, particularly if access to dementia-capable caregivers is limited—as it appears to be in Port Isabel.

“Multiple moves to different places, a disrupted schedule, that’s all going to be difficult,” said Beth Kallmyer, vice president of care and support with the Alzheimer’s Association, the nation’s largest Alzheimer’s nonprofit. Without familiar faces and a structured schedule of care, Kallmyer said, those with Alzheimer’s can see symptoms like confusion, agitation, and aggression worsen.

“Sometimes they can come back from that, but it’s definitely difficult when environments are changed,” Kallmyer said.

De la Cruz’s family has seen that deterioration firsthand.

“His family sees he’s getting worse and worse by the day,” Obando said. “He’s forgetting his grandchildren.”

De la Cruz first came to the United States in the 1970s, working as a welder for oil companies along the Texas border. His wife is an American citizen, as is Sandra, his only child. By all accounts, de la Cruz is a loving and devoted father, husband, and grandfather to Sandra’s three children, who call him “Papa.”

“We’re very close—he is always with us, with his family,” Sandra said. “He’s always trying to help anybody. If you ask him for a favor, he’s there, he tries a way to make it happen. With my kids, they are everything for him.”

Even when her father was under her watchful eye and just a short drive away, Sandra said, the onset of de la Cruz’s Alzheimer’s presented a potentially dangerous situation. Once, while Sandra was taking her mother to the doctor, de la Cruz’s attempt to make himself lunch nearly ended in disaster.

“He almost burned down the kitchen,” Sandra said. “He was trying to cook something on the stove and he forgot to put the food in the pan—thank God I came home. I had to call the firefighters.”

De la Cruz’s Alzheimer’s disease may even have played a role in his detention. In 2015, shortly after he was first diagnosed, de la Cruz was arrested for possession of a controlled substance, and was sentenced to eight years of probation, Obando said. Researchers have documented potential links between dementia onset and antisocial, even low-grade criminal, behavior, and have pushed for the criminal justice system to factor in such diagnoses into charging and sentencing.

For an undocumented immigrant, even one with longstanding community ties and almost no criminal record, any drug charge, no matter the mitigating circumstances, can mean deportation.

“If you are an immigrant and you have any type of controlled substances [charge], you are removable—that means the government can decide to remove you,” Obando said. After de la Cruz, who lives in a Texas border town, crossed back from a family visit on June 25, 2018, he was arrested and placed in removal proceedings. With his probation, Obando said, de la Cruz became subject to mandatory retention at Port Isabel—where he has been locked up ever since.

After de la Cruz was detained, Obando applied for asylum based on the country conditions in Mexico, where his family worries that he will face persecution and victimization by criminals who see the elderly and infirm as easy marks.

“The immigration judge did not agree with us,” Obando said, and ordered de la Cruz’s removal.

While Obando appeals that ruling, de la Cruz’s cognitive decline has made his detention—already a major health risk, according to physicians—even more challenging. Sandra, whose father is also in cancer remission and has diabetes, is unsure what medical treatment he is receiving at the facility, or if he is being protected from other detainees.

“When we send money to him, he forgets that he received the money,” Sandra said. “We don’t know if someone is taking the money from him, because he always says, ‘I don’t have money, I don’t have money.’”

Sandra’s observations are consistent with Alzheimer’s symptoms, Kallmyer said, which might be exacerbated by a detention setting.

“When you have somebody that has dementia, you can explain what’s going on, but they might not remember it,” Kallmyer said, likening the conditions inside detention to those of Alzheimer’s patients who were evacuated to emergency shelters following Hurricane Katrina. “Alzheimer’s disease is a disease , and the symptoms that might occur in a setting that’s a detention center, a person doesn’t likely have control over some of those behaviors—fear, agitation, confusion.”

Crucial to keeping Alzheimer’s patients healthy, Kallmyer said, is familiarity and consistency in their daily routine—and familiarity with those taking care of them.

“Making sure those folks are with someone familiar, someone who can look out for them,” Kallmyer said. “Through all stages of the disease, people have feelings, and when they don’t understand what’s going on, they’re going to be afraid.”

Sandra is deeply concerned about the inherent threat to her father’s well-being posed by his detention, but even more worrying is the prospect of his potential deportation to Mexico. Healthcare for Alzheimer’s patients in Mexico is either unavailable or inconsistent, Sandra said, and de la Cruz’s sisters, his only family in the country, are 83 and 93.

“They cannot take care of him,” Sandra said. “I understand we have to follow the rules, that’s why we have laws. But sometimes, it’s a different situation. He’s not a dangerous person, he’s just not in a well condition.”

“This is very hard, and I’m the only kid they have—it’s a lot of responsibility, and also I have three kids and a husband. We cannot move to Mexico,” Sandra said tearfully.

Most heartbreaking, she said, is that her father is forgetting his beloved grandchildren, who still can’t comprehend why their grandfather is detained.

“Every time we go to see him, they ask me, ‘when does Papa come back?’”