Our kūpuna need our attention now more than ever. The pandemic hinders not only casual gatherings but also activities that contribute to the happiness of our elderly. This is especially hard for them, since they eagerly look forward to family time, when they get to truly enjoy our undivided attention and company.
Physical Distancing Not Isolation
Dr. Alicia Arbaje, an associate professor of Medicine at the Johns Hopkins University School of Medicine, says physical distancing should not be confused with social isolation. More than a year of social distancing could easily be misconstrued as a no-contact situation. Visits with our elderly, especially those in facilities, may have been affected because of this, but there are several ways to make them feel loved and cherished. Innovations such as video calling and virtual conferences are great, temporary alternatives to visitations. Families can set up video calls through their parents’ caregivers or facility management. Or we can teach our elderly to use gadgets for video conferencing. For example, I taught my 85-year-old grandfather to use Skype!
We should not forget, however, that being with them in person, face to face, is very important to their overall well-being.
Our kūpuna need our attention now more than ever. The pandemic hinders not only casual gatherings but also activities that contribute to the happiness of our elderly. This is especially hard for them, since they eagerly look forward to family time, when they get to truly enjoy our undivided attention and company.
Take inventory of your situation before you begin looking into senior retirement communities. You can start by determining your timeline and reviewing the information in this article. You will then be ready to call the senior community sales department and ask the right questions.
Below is a list of some of the services and amenities offered at senior living communities. Some are included in the standard monthly rent or fee and others incur an additional cost. Decide which are necessities and which are “nice to have.”
❏ cable TV, movies, documentaries, sports
❏ wi-fi & computer room
❏ bus service to drug stores, medical offices or shopping malls
❏ hair & nail salon
❏ physician available for on-site appointments
❏ meals & guest meals
❏ room service
❏ walking path
❏ exercise equipment & classes
❏ heated swimming pool &/or spa
❏ social activities
❏ art & music classes
❏ contemporary library
❏ utilities
❏ housekeeping
❏ parking
❏ laundry rooms
Will you need additional services, for example, assisted living services, for an additional cost?
These assisted living services could include:
❏ assistance to in-house meals and activities
❏ shower/bathing assistance
❏ assurance checks
❏ medication management
❏ personal laundry services
Ask the sales department:
❏ Do you sign a contract?
❏ Is it a month-to-month agreement with no long-term lease?
Familiarize yourself with apartment layouts, sizes and availability.
❏ Do the apartments have lanai?
❏ Are the apartments furnished or unfurnished?
❏ What is the view from the apartment?
❏ Where is the community located?
❏ Is there a waitlist?
Once you have narrowed down your search, call for a tour. Have your calendar available and know when you would be available.
Many seniors have been waiting for a reduction of the pandemic numbers before making a move. The vacant apartment inventory is limited as more seniors are arranging for tours and confirming move in dates. Begin your search today.
Take inventory of your situation before you begin looking into senior retirement communities. You can start by determining your timeline and reviewing the information in this article. You will then be ready to call the senior community sales department and ask the right questions.
Many experts believe that art therapy can help individuals with dementia express themselves — beyond words and language. “In nurturing, calm, supportive settings, they sometimes have moments of clarity and express things that shock us all,” says Ruth Drew, director of family and information services for the Alzheimer’s Association.
Creating art engages a part of the brain that is different from language. Creativity can actually emerge even after the effects of dementia have progressed. “We think that in patients with language loss, the visual side of their brain stops being inhibited by the verbal side and that allows their visual creativity to be released,” says Dr. Bruce Miller of the Memory and Aging Center at UCSF.
Project tips from The Alzheimer’s Association:
• Keep the project on an adult level. Avoid anything that might be demeaning or seem childlike.
• Build conversation. Discuss what the person is creating or reminiscing about.
• Help the person begin the activity. If painting, you may need to start the brush movement.
• Use safe materials, tools and substances.
• Relax and enjoy the process. The artist doesn’t have to finish the project in one sitting.
THE PLAZA ASSISTED LIVING
6 Locations on Oahu: Punchbowl, Mililani, Moanalua,
Pearl City, Waikiki, Kaneohe 808-900-8544 | PlazaAssistedLiving.com
Many experts believe that art therapy can help individuals with dementia express themselves — beyond words and language. “In nurturing, calm, supportive settings, they sometimes have moments of clarity and express things that shock us all,” says Ruth Drew, director of family and information services for the Alzheimer’s Association.
The unexpected can occur at any time, no matter how prepared we think we are. A crisis will bring families together in an instant. If you are distanced from the area, there are ways to manage the situation. Working as ‘ohana with strong communication will help coordinate what is needed.
Recently, I experienced a crisis when my mother fell and broke the head of her femur — otherwise known as a hip fracture. This is a common occurrence in our elderly, mostly in women. I got the call from 5,000 miles away. “Mom is having surgery on her hip tomorrow.” Emotions welled up in my chest, fears in my head and so many questions arose. How did this happen? What was she doing? Did she hit her head? Is she in pain? Is someone with her? Can I call her? Can she talk?
Relieved by the sound of her voice, I found she was coherent but loopy from the pain medication. Fortunately, she had a friend with her who had called 911 when found on the floor of her bedroom. As it turns out rubber slippers and carpet create chaos. In a moment, she was down on her side and could not get up. She was able to drag herself to the phone and call my sister, who lives 1,000 miles away. As a family, we spread the word to her children and grandchildren. Group texts went on for a week or two after that, as she made her way through surgery, into a hospital room and magically was able to stand on her new hip the very next day!
The hospital stay controlled her pain, monitored her incision, and physical therapy got her up and moving.
I called her daily and gave reports to the ‘ohana regarding what might happen next. After five days, she was moved to a rehabilitation facility, where she was given intensive therapy three times a day. I am convinced this is what enabled her to recover with confidence.
Meanwhile, the family planned a collective schedule for the next 30 days. My mother lives alone where she had been independent and providing for herself for years. She did all her own shopping, cooking, cleaning, yard work and home maintenance, and played golf four days a week. At 86 years old, she did not show any fragility. This was the first time she needed help.
My niece took the first shift by flying in and getting her home. Afterward, I flew in and spent a week taking her to follow-up appointments and driving her around. My daughter came next and at the end of her trip, it had been 25 days.
We did it by working together. Even though we all lived in different states, with our own lives, cooperation among family members, and sharing our time and our resources worked very well as we rallied for this crisis.
If not for our family’s flexibility and ability to work toward a common goal, home healthcare would also have been a viable option. We may need to call upon those services the next time.
I am happy to report that Mom has recovered and is independent once again. She has even made her way back to the golf course!
ATTENTION PLUS CARE HOME HEALTHCARE
Accredited by The Joint Commission
1580 Makaloa St., Ste. 1060, Honolulu, HI 96814 808-739-2811 | www.attentionplus.com
AGING IN HAWAII EDUCATIONAL OUTREACH PROGRAM
by Attention Plus Care — a program providing resources for seniors and their families, covering different aging topics each month. For class information and upcoming topics, call 808-440-9356.
The unexpected can occur at any time, no matter how prepared we think we are. A crisis will bring families together in an instant. If you are distanced from the area, there are ways to manage the situation. Working as ‘ohana with strong communication will help coordinate what is needed. Recently, I experienced a crisis…
“You have 10 days to live,” the doctor told John. What do you do with only 10 days? John picked up his phone and called his little brother, Stan. His kidneys were failing. The next morning Stan was on a plane to Hawai‘i to be with his brother. Back in their younger days, John and Stan would spend time at the beach. Stan thought it would be wonderful to relive those brotherly memories. Navian Hawaii helped to make this possible.
Navian Hawaii’s comprehensive, interdisciplinary program of care is designed to provide patient-centered care for every life journey, offering relief from suffering, support for the entire family, and hope, compassion and love.
Navian focuses on patients’ and their families’ physical, psychosocial, emotional and spiritual well-being. United as Navian Hawaii, we are on a journey to improve the lives of Hawai‘i’s people, to celebrate every one of life’s moments and to navigate always in the direction of hope.
Originally founded as Hospice Hawaii in 1979, Navian has built a strong reputation for providing quality hospice care on O‘ahu, Molokai and Lāna‘i. In 2019, Navian expanded its services to include Integrated Care.
With this expanded model of care came the new name. “Navian,” formed from the words “navigator” and “guardian,” is a modern take on the critical roles each staff member performs. As navigators, the Navian ‘ohana provides clarity and guidance through times of uncertainty. As guardians, they provide care for people and protect their wishes.
John was provided with a special chair to keep him comfortable during outings. It was a perfect day as Stan eased John into Waikiki’s inviting waters. John felt the warm sunshine on his face, he felt the cool ocean water caress his skin and he also felt something he hadn’t felt in a while — hope — hope that his last days didn’t have to be filled with pain, but could be infused with love and wonderful memories. John surpassed his initial diagnosis and lived three additional months.
Navian continues to bring hope, reduce fear and impact lives as a trusted, local nonprofit organization, fulfilling needs in Hawai‘i by providing education, cultivating acceptance, and guiding patients and families through their journey.
Hospice Means Hope
Hospice is really about hope. Navian’s caregivers are dedicated to helping patients and their families face this transition without fear, but with hope and unconditional love.
The care Navian provides allows individuals to remain at home or in their chosen setting and to live life to the fullest with their loved ones. Navian cares for the whole family by providing relief from physical, emotional and mental suffering.
Many patients who go through our hospice care program continue to live very productive and rewarding lives — without pain and anxiety.
Many people think that hospice is only for cancer patients or the elderly, but more than half of our hospice patients are diagnosed with conditions such as heart failure, dementia or chronic lung disease. Navian also has the state’s first pediatric hospice care program that offers comprehensive care for children and their families.
Bob was diagnosed with prostate cancer and stage three kidney disease. It was difficult news for a farmer who was used to working the land and nurturing the trees. A dedicated team from Hospice Hawaii ensured that Bob was comfortable.
Navian Hawaii’s Hospice Care program provides support to enhance comfort and promote the quality of life for individuals with life-limiting conditions. Typically, hospice services are available to patients who have six months or less to live, should the disease run its course. A patient can self-refer or be referred by a physician, family member or other loved one at any time.
Hospice care is fully covered by most health insurance programs, including Medicare, Medicaid and most private insurance providers. No one who is medically eligible will be turned away if they are unable to pay for the services.
Integrated Care Offers Specialized Support
People living with serious illness who aren’t ready for hospice care, but require support services to improve their quality of life can receive Integrated Care, which provides specialized medical and emotional support for patients living with serious, but treatable illness.
Meet Aaron. “He’s such a goofball,” says Tamra, when asked to describe her 5-yearold son. He has metachromatic leukodystrophy, a rare disease that attacks the nervous system. Through Navian Hawaii’s Little Things, Big Differences program, Aaron was provided assistance and care to help him breathe easier.
Seriously ill patients who live alone, and have limited resources and caregiver support may find it difficult to navigate the healthcare system. The Integrated Care program alleviates those challenges and helps end the vicious cycle of unmet care needs that often leads to hospitalization.
Anyone can refer a patient to Integrated Care and there are no time limitations on this service. Care settings may include a patient’s home, skilled nursing facility or residential care home.
How to Get Involved
• Make a Donation:Contributions directly help patients and their families. Navian raises funds throughout the year to ensure that eligible patients are never turned away.
• Volunteer:There are no words that can express the impact a regular volunteer can have on the well-being of a terminally-ill patient. New volunteers are accepted on an ongoing basis. Navian strives to align volunteers with their interests. There is a role for everyone.
• Attend Navian’s Community Connect Educational Series:This monthly series of one-hour webinars connects caregivers with community partners and resources.
• Join an Adult Grief Support Group:Navian offers ongoing support groups to help those who have lost a loved one move through the healing process. Virtual group sessions are held monthly.
• Participate in one of Navian’s Annual Events:Each year, Navian hosts A Night To Remember memorial service and a gala.
If you or a loved one are in need of hospice care or Integrated Care, contact Navian using the information below.
Navian Hawaii’s comprehensive, interdisciplinary program of care is designed to provide patient-centered care for every life journey, offering relief from suffering, support for the entire family, and hope, compassion and love.
Adult day care services offer professional care for seniors and adults living with dementia and other disabilities. They receive therapeutic, social and health services during the day. Adult day care is also a great solution if the senior needs supervision for safety reasons, is expressing depression or isolation, needs socialization and engaging activities, or if the caregiver simply needs respite. Adult day care gives caregivers the opportunity to work while their loved one is safe.
If Mom and Dad want to age in place at home, adult day care offers an affordable solution for working caregivers (see table). The figures are based on national averages — Hawai‘i’s figures are generally higher.
Providing meaningful activities for your loved one with dementia is very possible. Activities can add meaning, boost quality of life, and provide beautiful opportunities for connection.
Here are some tips:
• Consider past interests:Activities that bring up memories and past skills are more likely to be successful and meaningful. So try choosing an activity that is familiar and provides opportunities to reminiscence.
• Approach with ease: Make your loved one feel safe — speak in a calm tone of voice and explain in simple words what is happening before you begin the activity together.
• Sneak in physical activity: Gardening, assisting with dishes and going shopping all involve being active, and may be able to fit more naturally into the day than formal exercise.
• Engage the senses:Your loved one may not be able to “do” an activity but can still “experience” an activity. Things like light-touch massage, music and sitting outdoors can provide calm engagement.
• Share love: Emotion still holds meaning for those with dementia, and sharing kind or loving words can bring joy.
Caregiving for someone with dementia is challenging. Keep in mind that your loved one lives in moments, so aim to provide moments of joy throughout the day to boost their quality of life.
Providing meaningful activities for your loved one with dementia is very possible. Activities can add meaning, boost quality of life, and provide beautiful opportunities for connection. Here are some tips…
A valuable resource to help us cope effectively during our most trying times is available through Kōkua Mau. Hawaiian for “continuous care,” the statewide network supports and assists people who may be facing serious illness, as well as their loved ones.
Kōkua Mau provides information that helps to relieve the symptoms and stress of illness. It also includes information about hospice care, in order to provide the best care possible at the end of life.
A set of five, 20-page booklets developed by the Center on Aging at the University of Hawai‘i are practical, pragmatic and easy-to-use guides available at no charge from Kōkua Mau’s website.
Booklet 1: Advance Care Planning — Making Choices Known is a workbook for documenting the kind of care you want if you are unable to make decisions for yourself. Knowing your wishes will help your family and loved ones if they have to make medical decisions on your behalf. In this booklet, you will learn about the types of decisions you can make ahead of time and how to let others know what you want.
Booklet 2: Planning Ahead — Funeral and Memorial Services offers options for funerals, memorials and burial. Which plans should you make now? Making plans ahead of time will help reduce the stress on surviving family members and loved ones when death occurs. Planning your funeral or memorial service with mindfulness is a gift you share with those you love. This booklet will help you make and document those decisions for the events following your death.
Booklet 3: Preparing To Say Good-Bye — Care for the Dying describes common symptoms experienced by dying people and how to best provide comfort. Those with a terminal illness will show a steady decline. Those with a serious chronic illness may have peaks and valleys. Learn to anticipate and manage changes that may occur.
Booklet 4: When Death Occurs — What to Do When a Loved One Dies is a guide to help you immediately following the death of a loved one. Honoring family and cultural rituals allows you to acknowledge the reality of the death and begin the healing journey. At the same time, you have much to do after a loved one passes. The document includes a checklist and practical help.
Booklet 5: Help For The Bereaved — The Healing Journey outlines what experts feel is normal grieving and what is abnormal or complicated grieving. Expressions of grief are as individual as fingerprints. There is no “right” way or specific length of time required.
A valuable resource to help us cope effectively during our most trying times is available through Kōkua Mau. Hawaiian for “continuous care,” the statewide network supports and assists people who may be facing serious illness, as well as their loved ones.
What do you think of when you hear the word ARCH? A vertical, curved structure or perhaps those golden ones that McDonald’s is famous for? Or do you think of a cathedral arch typically used in bridge architecture? Did you know that in senior care, the acronym “ARCH” means adult residential care home?
ARCHs are homes that are licensed and regulated by the Hawai‘i State Department of Health, Office of Health Care Assurance. They provide room and board, as well as 24-hour oversight by a licensed nurse for anywhere from five to 45 kūpuna. They focus on socialization, nutrition and healthcare. Much like your own home, residents can either share a room or have their own, but they partake in meals and activities together as a group. Residents are rarely just sitting in their room!
ARCHS also can take you to doctor appointments or bring in specialists, such as podiatrists, or physical/occupational therapists.
Hawai‘i has over 200 of them! So, if you are looking for residential care, but are not quite ready for a nursing home, an ARCH may work best for you.
LUNALILO HOME
Adult Residential Care Home located in Hawaii Kai
501 Kekauluohi St., Honolulu, HI 96825 808-395-1000 | www.Lunalilo.org
What do you think of when you hear the word ARCH? A vertical, curved structure or perhaps those golden ones that McDonald’s is famous for? Or do you think of a cathedral arch typically used in bridge architecture? Did you know that in senior care, the acronym “ARCH” means adult residential care home?
When our loved one with dementia cannot clearly express their own wishes, it becomes a guessing game. When you stumble across an unanswered question in your role as caregiver, just think of the difference guidance from your loved one would have made! So it is clearly important that we do our own preparation for our own potential caregiving needs. Documenting your wishes for your future will be a much-appreciated tool for your own loved ones.
A Personal Care Planning Notebook can be an invaluable tool. It should include:
• A Physicians Orders for Life Sustaining Treatment (POLST) form (update it regularly)
• An Advanced Health Care Directive
• A Power of Attorney document that goes into effect only when you become incapacitated
• A copy of your birth certificate, wedding certificate and the birth certificates of your children
• A will including a nomination for personal representative
• Location of your trust document
• Your health insurance, dental insurance and Medicare cards
• A list of the doctors you normally see
• A Quality of Life Statement
A Quality of Life Statementis a document for your family that describes the care you want:
• Where would you like to receive that care? Get as specific as you like.
• Who would you permit to bathe you, etc.?
• If your finances are depleted, what are other finance options for your continued care?
• Include details about life support or physical conditions you would find acceptable.
• What treatment or loss of physical ability would you not accept?
• A topic that also needs to be addressed is what you consider to be a “good death.” Do you want to be left alone or be surrounded by family? You will lessen stress for your loved ones by providing this important information in advance.
Start on your Personal Care Planning Notebook today and update it at least once a year — your
family will be eternally grateful to you.
When our loved one with dementia cannot clearly express their own wishes, it becomes a guessing game. When you stumble across an unanswered question in your role as caregiver, just think of the difference guidance from your loved one would have made!
Caring for a loved one can be stressful, even for the most resilient people. Over time, this can harm your health. Consider these four caregiver tips to help preserve your health and well-being:
■ Accept your limitations. It’s normal to feel guilty sometimes, but understand that no one is a perfect caregiver. Believe that you are doing the best you can at any given time.
■ Seek help. Be prepared with a list of ways others can help you. Let friends and family members choose what they would like to do. Some may offer to take your loved one on a walk a couple of times a week. Others may be able to run an errand or cook for you.
■ Set personal health goals. For example, set goals to establish a good sleep routine, find time to be physically active on most days of the week, eat a healthy diet and drink plenty of water.
■ Get connected.
Find out about caregiving resources in your community. St. Francis Healthcare System has free caregiver education and wellness classes that offer practical tips to help you avoid burnout. Connecting with other caregivers can be a source of inspiration and a reminder that you aren’t alone.
Caring for a loved one can be stressful, even for the most resilient people. Over time, this can harm your health. Consider these four caregiver tips to help preserve your health and well-being.
Facing the potential that the COVID-19 variants may keep this virus around, it makes sense that practitioners are looking for other treatments to slow the spread of the disease. The results of a clinical trial in India using two natural supplements to treat COVID-infected individuals showed that these herbal products can speed up recovery time from the disease. On average, after five days, 88 percent of those treated tested negative for the virus, compared with 72 percent of those receiving hospital-standard anti-viral medications. By day 10, the ratios rose to 100 percent versus 88 percent. This begs the question, how can nutritional supplements assist the body in fighting the virus?
When considering specific supplements such as vitamins, it should be noted that the real issue is not the amount of vitamin that is ingested, since the body can only utilize so much of it before expelling it. A person’s “nutritional profile” is what really matters. Someone who lacks vitamins and minerals needed for proper immune system function will benefit from adding certain supplements to their diet. A German study indicates that vitamins D, K and A could bind to the viral spike protein of the COVID-19 virus and reduce its effect. This is already being used in hospitals as part of an integrative approach to COVID-19.
Other individuals have a lack of vitamins and nutrients because of poor nutrition, and will need to develop healthier eating habits before any boost from supplements will help. Adopting a healthier nutritional attitude can be as easy as adding specific foods to your diet. Another study found the natural compounds in green tea, muscadine grapes, cacao and dark chocolate interact with the COVID virus to make it harder for it to propagate in humans. On the other hand, cholesterol was found to have the opposite effect, making COVID-19 more severe by interacting with the spike to increase concentrations of the virus. This supports evidence of more severe cases of the disease among overweight individuals.
This confirms what we have known all along — the overall quality and balance of nutrition has a strong influence on our immune system’s ability to fight infection. Once the system is out of balance, it is vulnerable and more likely to result in a longer, more severe illness from the disease. Making up for lack of nutrition by taking lots of vitamins does little to restore the needed nutritional balance. It comes down to these basics:
❶ Eat a variety of fresh, raw produce
❷ Strictly limit processed foods and sugar
❸ Get regular exercise, preferably outdoors
❹ Maintain a healthy physical and mental equilibrium in your daily routine
The goal here is not to load up on 1,000 percent of any particular supplement, most of which will be flushed out of the system, but to establish a good nutritional foundation, eat regular meals of the right size, and build on this base with natural supplements as recommended by your physician or naturopath.
And of course, COVID-19 vaccines are now available to all age groups to give your immune system a head start in warding off the virus.
ATTENTION PLUS CARE HOME HEALTHCARE
Accredited by The Joint Commission
1580 Makaloa St., Ste. 1060, Honolulu, HI 96814 808-739-2811 | www.attentionplus.com AGING IN HAWAII EDUCATIONAL OUTREACH PROGRAM by Attention Plus Care — a program providing resources for seniors and their families, covering different aging topics each month. For class information and upcoming topics, call 808-440-9356.
Facing the potential that the COVID-19 variants may keep this virus around, it makes sense that practitioners are looking for other treatments to slow the spread of the disease. The results of a clinical trial in India using two natural supplements to treat COVID-infected individuals showed that these herbal products can speed up recovery time…
Our kūpuna need our attention now more than ever. The pandemic hinders not only casual gatherings but also activities that contribute to the happiness of our elderly. This is especially hard for them, since they eagerly look forward to family time, when they get to truly enjoy our undivided attention and company.
