Cataracts affect more than 24 million Americans, with nearly 115,000 of them right here in Hawai‘i. A cataract is when the normally clear lens of the eye starts to become cloudy, which blocks and distorts light necessary for the retina to process images.
The disease occurs naturally as we age, but some risk factors include exposure to ultraviolet light, diet, smoking, diabetes, use of some steroid medications and serious eye injuries. Cataracts usually worsen over time and can lead to blindness if left untreated.
Signs of cataracts include blurred vision, sensitivity to light, fading or yellowing of colors, poor night vision, sensitivity to glare and seeing a halo around bright lights. People at risk should get regular eye exams and be aware of the symptoms, especially if you are over the age of 40.
There are various methods available to correct cataracts, but the general procedure involves removing the clouded lens of the eye and replacing it with an artificial lens implant. Surgery is typically outpatient with very little pain or discomfort. Modern cataract surgery can often be upgraded to include vision correction to reduce dependence on glasses and contacts for those with vision impairments near, far and in between.
Hawaiian Eye Center O‘ahu: 606 Kilani Ave., Wahiawa | 808-621-8448 Big Island: 1178-A Kinoole Street, Hilo | 808-969-1419 Toll Free 1-888-621-2020 | www.HawaiianEye.com
Cataracts affect more than 24 million Americans, with nearly 115,000 of them right here in Hawai‘i. A cataract is when the normally clear lens of the eye starts to become cloudy, which blocks and distorts light necessary for the retina to process images. The disease occurs naturally as we age, but some risk factors include…
A large, well-funded national organization has been taking out print ads and airing TV commercials that claim that doctors in Hawai‘i are providing lethal doses of medication to individuals who desire “aid in dying.” According to the ads and commercials, this is perfectly legal because of a newly discovered loophole inHawai‘i law.
As it turns out, however, the ads and commercials ignore what Hawai‘i’s chief law enforcement officer, attorney general David Louie, has said about this topic. In an opinion letter dated December 8, 2011, Louie addresses:
whether section 453-1 of the Hawai‘i Revised Statutes (the supposed newly discovered loophole) authorizes a physician to assist a terminally ill patient with dying
whether any criminal laws prohibit “aid in dying”
Louie opines that the loophole being touted in favor of physician-assisted suicide simply allows doctors to prescribe unconventional “remedial agents or measures” (i.e. medication or treatment intended to make the patient better — or at least to provide pain relief and comfort), not cause the patient’s death. In the attorney general’s view, the law clearly does not allow doctors to prescribe lethal doses of medication.
As to the second question, Louie opines that physician-assisted suicide would constitute the crime of manslaughter. However, proving that the crime had been committed would involve convincing a jury that the physician intended for the patient to commit suicide, and that the lethal medication prescribed by the physician accomplished its intended task. As we all know, proving that a crime has been committed is not necessarily an easy task. But the fact that a crime is difficult to prove does not mean that no crime was committed. Obviously, any physician who follows interpretation of Hawai‘i law urged in the current advertising blitz could be in for serious trouble.
So don’t be fooled by the commercials and ads. Our existing hospice and palliative care (alleviating pain) physicians and services do a wonderful job of assisting the terminally ill and their families face death. There are legitimate and compassionate ways of dealing with end of life issues that do not involve suicide or raise the prospect of euthanasia.
For more information, or if you would like a copy of the Attorney General’s opinion, email info@est8planning.com.
Scott Makuakane, Counselor at Law Focusing exclusively on estate planning and trust law. Watch Scott’s TV show, Malama Kupuna Sundays at 8:30 p.m. on KWHE, Oceanic channel 11 www.est8planning.com O‘ahu: 808-587-8227 Email: maku@est8planning.com
A large, well-funded national organization has been taking out print ads and airing TV commercials that claim that doctors in Hawai‘i are providing lethal doses of medication to individuals who desire “aid in dying.” According to the ads and commercials, this is perfectly legal because of a newly discovered loophole inHawai‘i law. As it turns…
It is no secret that the number of individuals over the age of 60 is increasing exponentially. Without massive changes to operations, there will be no way to effectively meet the needs of seniors in the future. This we know. What may not be so evident are the strides forward that the Hawai‘i State Executive Office on Aging and the Area Agencies on Aging (AAA) in Hawai‘i are making in “getting ahead” of the population boom.
About 18 months ago, the Maui County Office on Aging (MCOA) implemented a new assessment protocol that each AAA in Hawai‘i will eventually use. (Kaua‘i began the use of the new tool a year ago). And let me warn you, it is a long assessment. So, why implement an assessment that could be construed as cumbersome and downright bothersome for frail seniors?
The answer lies in what seniors and family caregivers end up receiving from the assessment. Imagine a senior who needs assistance in order to remain safely at home. Maybe the senior and family identify a few services that would allow him/her continued independence. Rather than having to call numerous agencies and participate in separate assessments, the AAA can conduct one assessment that provides a comprehensive view of how to help keep that senior at home.
I like to think of the assessment as a traffic light. MCOA used to only determine the red and the green lights. We could easily identify when seniors were in the “red” and required immediate in-home assistance. We could also determine functions for which the senior required no assistance — the “green” areas. The new assessment process allows us now to identify the “yellow” at-risk areas as well. These are the areas that do not yet require intervention but that could eventually undermine the senior’s desire to remain independent at home.
By identifying the at-risk areas, MCOA can assist families in taking a proactive approach. We no longer simply authorize necessary services, but we help the individual and family plan to avert the need for services in the future.
So, yes, we spend a few hours getting to know the senior and family caregiver. But the time is well spent. We identify not only needs, but also areas of strength and potential areas of risk. Seniors receive a comprehensive support plan designed to meet current needs, improve function when possible, and prevent further decline.
This proactive approach, combined with evidence-based health promotion activities, is critical to the future success of the aging network. We know the amount of funding we receive will not keep pace with the aging population. Therefore, we must engage in coordinated planning efforts that maximize health and independence in a preemptive manner and be able to meet the needs of at-risk seniors for years to come.
Maui County Office On Aging
J. Walter Cameron Center
95 Mahalani Street, Rm. 20, Wailuku
808-270-7774 | F: 808-270-7935
Toll Free in Hawai‘i 808-643-2372 | www.co.maui.hi.us
It is no secret that the number of individuals over the age of 60 is increasing exponentially. Without massive changes to operations, there will be no way to effectively meet the needs of seniors in the future. This we know. What may not be so evident are the strides forward that the Hawai‘i State Executive…
One-third of the population over the age of 65 falls each year, and the risk increases proportionately with age. At 80 years, over half of seniors fall annually. Those who take a spill often develop a fear of falling. Fear gone unchecked may lead to limiting activities and loss of physical fitness, increasing risk of falling.
In these situations, it’s important to consider alternate interventions for the elderly — especially for those with joint pain and medical conditions that restrict land training. A recent study from University of California, San Francisco found that water exercises were more effective in improving balance than land exercises.
The buoyancy of the water helps patients stay upright and reduces their fear of falling. The water’s resistance allows patients more time to detect and correct postural errors that may lead to a fall. With aquatherapy, there is less chance for injury, and patients are able to push the limits with their balance, allowing for quicker carry over to functional, land-based activities.
The Endless Pool’s adjustable current offers a unique environment to challenge patients with speed, resistance and water depth, allowing them to advance to higher levels of stability and strength. Seniors are taught center of gravity control, postural strategies, gait exercises, strength, endurance and flexibility training.
Aquatherapy, with the Endless Pool, offers many benefits and should be seen as the modality of the future for fall prevention for the elderly.
Moon Physical Therapy, LLC 320 Ward Avenue, Suite 107; Honolulu, HI 96814 808-597-1005 | www.moonpt.com
One-third of the population over the age of 65 falls each year, and the risk increases proportionately with age. At 80 years, over half of seniors fall annually. Those who take a spill often develop a fear of falling. Fear gone unchecked may lead to limiting activities and loss of physical fitness, increasing risk of…
We all know death is a natural part of life and something we will all experience. But have you thought about how you want to be treated during your final days? How you would like to die?
Though it’s not an easy topic, and most of us avoid thinking about it, consider giving your death some thought this holiday season. What better way to start the New Year than with a resolution to complete your advance healthcare directive and talk to your family about what you want at the end of life?
In fact, there is a growing movement in Hawai‘I and the nation toward considering how we want to die and sharing those wishes with doctors, caregivers and loved ones. Increasingly, people feel everyone deserves to make their own personal decisions for dying with comfort, dignity and control.
Compassion & Choices Hawai‘i is part of this movement. They help people receive state-of-the-art care and the full range of options at the end of life, including disease-specific treatment, palliative care, hospice, avoidance of unwanted medical treatment and access to aid in dying, which is the option to advance the time of death if suffering becomes unbearable.
How do you get the conversation started?
After many attempts to engage family members, one Compassion & Choices client set her holiday table with advance directive forms at every place setting and announced, “Nobody gets dinner until these are filled out.” Now that’s some tough turkey!
And while the paperwork is important, the essential thing is to get the conversation going. Try starting with, “If one of us ever had to make decisions about your treatment because you couldn’t, it would be much easier if we knew what you really want.” Then ask the following:
Would you want life support if you have a terminal illness? What if you’re in a permanent coma? What if you have a chronic illness such as Alzheimer’s disease?
Do you always want to know the truth about your condition? About treatment options and their odds of success? And what does “success” mean to you and quality of life?
What will be important to you when you are dying? No pain? Hold on as long as possible? Family members present? What are your priorities?
Would you want to be in a nursing home if your condition warranted?
Compassion & Choices’ End-of-Life Consultation is a free service. Professional consultants listen to each unique situation and provide information, emotional support and patient advocacy as people navigate complex choices about terminal illness or the dying process.
For more information, free consultation, access to the Good-to-Go Toolkit and much more, call 1-800-247-7421 or visit www.CompassionAndChoices.org/hawaii.
We all know death is a natural part of life and something we will all experience. But have you thought about how you want to be treated during your final days? How you would like to die? Though it’s not an easy topic, and most of us avoid thinking about it, consider giving your death…
Planning ahead for 2014, made me stop and ponder for a moment … what are the things that are really important to me? First thing that came to my mind was my family. Second was the health of my family and myself. This article is dedicated to Medicare recipients and their caregivers so that we can all have a healthy and happy New Year. Here are 8 easy things that can help you navigate the healthcare maze.
1] Make an appointment for your Annual Wellness Visit. This is a Medicare benefit that provides you and your physician an opportunity to sit down and develop or update a personalized prevention plan to protect you against disease and disability, based on your health and risk factors. This is not an annual physical exam.
2] Follow that prevention plan!
3] Sit down with your loved ones and discuss your end-of-life wishes and complete an advanced health care directive form. Your medical team and family will use this document if you are ever unable to make your wishes known. Forms are available online at www.kokuamau.org and www.hawaiiship.org, or by calling the Sage PLUS Program at 1-888-875-9229.
The advanced health care directive can be as detailed as you like. Be sure to discuss it with your family and give a copy to your physician. If you currently have an advanced healthcare directive, take a moment and make sure it is still in line with your wishes.
4] Do you have a POLST (Physicians Orders for Life Sustaining Treatment) document on file? Printed on bright pink paper, and signed by both a doctor and patient, POLST helps give seriously ill patients more control over their end-of-life care. For more information, pick up the upcoming Feb/March issue of Generations Magazine.
5] Medicare provides most preventive benefits with no co-pay. Take advantage of them to keep you on track toward good health.
6] Do you have family members that help you with your health insurance? Health and drug plans offer a “authorized representative” form that enables that person to obtain information about your health coverage and billing on your behalf.
7] VOLUNTEER! Volunteering is a great way to meet new people, help your community and keep you active. The Hawaii SHIP has several different volunteer opportunities.
8] Do you belong to a community group that would like an educational Medicare presentation? Call or email Hawaii SHIP to request a speaker.
The Hawaii SHIP (State Health Insurance Assistance Program) is a volunteer-based Medicare counseling program that is available statewide through a grant from the Centers for Medicare & Medicaid Services. For assistance, volunteer information or to request a Medicare speaker, contact us 1-888-875-9229 or help@hawaiiship.org.
Planning ahead for 2014, made me stop and ponder for a moment … what are the things that are really important to me? First thing that came to my mind was my family. Second was the health of my family and myself. This article is dedicated to Medicare recipients and their caregivers so that we…
Are you aware of the caution about drinking cola drinks? According to a 2007 study, “carbonated beverage consumption has been linked with diabetes, hypertension and kidney stones, all risk factors for chronic kidney disease (CKD). Cola beverages, in particular, contain phosphoric acid and have been associated with urinary changes that promote kidney stones.”(1) Drinking two or more colas per day was associated with increased risk of CKD.
Researchers are also learning that the issue may be more pervasive than carbonated beverages. The National Kidney Foundation recently reported that people who “consume a diet that is high in phosphorus could be doing damage to their heart, with or without pre-existing kidney disease.” The foundation reports that some studies link high amounts of phosphorus from food with increased phosphorus in the body, ultimately leading to cardiovascular disease(2) and kidney problems.(3)
Phosphorus is a mineral that is found in the body and aids in making strong bones, among other things. However, if too much phosphorus is consumed damage can result. The most common form of phosphorus in foods is an additive called “phosphate,” which can even be found in so-called “all natural” or “organic” foods and beverages.
It has been estimated that the average American adult needs only 700mg of phosphorus per day but is consuming at least twice this amount.(4) Phosphate can be found in some prepared boxed and frozen foods, many sliced breads, cereals, meats, dairy products and flavored drinks, among other items. Moreover, this form of phosphorus is nearly 100 percent absorbed by the body, unlike plant-based phosphorus like whole grains, dried beans, nuts and seeds, of which only 30 to 50 percent is absorbed.
People can control the amount of phosphorus they consume by reading food labels. Keep an eye out for the letters “PHOS” as part of an added ingredient when shopping for foods and beverages. The National Kidney Foundation recommends that people eat fresh, unprocessed foods. Also consider enjoying water with a twist of lemon rather than that cola or other carbonated drinks.
1 Epidemiology. 2007 July; 18(4): 501–506.doi: 10.1097/EDE.0b013e3180646338 2 AKA Framingham Offspring Study 3 http://www.kidney.org/news/monthly/phosphorus.cfm?homestatic=PhosphorusInfographic?homeslider=Phosphorus 4 Food and Nutrition Board, Institute
Are you aware of the caution about drinking cola drinks? According to a 2007 study, “carbonated beverage consumption has been linked with diabetes, hypertension and kidney stones, all risk factors for chronic kidney disease (CKD). Cola beverages, in particular, contain phosphoric acid and have been associated with urinary changes that promote kidney stones.”(1) Drinking two…
siblingship [sib-ling-ship] noun (November 9, 2013):
1. The state of being related or interrelated
2. A state of affairs existing between one of two or more individuals having one common parent.
You will not find this word in the dictionary — it is a new word as of November 9, 2013. It describes the unique, textured, dynamic relationship existing between siblings. Think about the uniqueness of this relationship. Siblings begin their relationship at a very young age. My twins, for example, literally started their lives together. And, if they are fortunate, they will experience their lives to old age together. They experience joys and setbacks together, laugh and cry together, and fight together. And through the fighting, they can learn conflict resolution together. No other relationship is quite like a “siblingship.” Parents are there at the beginning, but all too often they leave too early. Spouse’s join us in our adult lives. Friends often come and go.
When parents die, siblings are called home to “divide up the pie.” And what I experience all too often with the families that I work with, is that the siblings fight over the same things that they fought over when they were kids — property and fairness. However, the parents are no longer there to referee and help divide up the pie fairly.
The estate planning process, if done properly, can do much to minimize the risk of fighting when parents die. However, many plans do not speak clearly enough in this respect. Leaving a family home or a heirloom “equally to the children” does not go far enough to help avoid the family fight. To leave it up to grieving adult children to decide what is “equal” when it comes their inheritance, puts too much pressure on their relationship.
If the parents and the estate planning attorney do not spend enough time minimizing the risk of fighting between the siblings, we risk fracturing, or worse destroying this unique, wonderful relationship — the siblingship.
The estate plan ultimately is supposed to mirror and reflect our lives, and the relationships we built. If your plan does not mirror and reflect your most important values, or does not speak clearly enough to ensure that it helps to preserve the relationships between your children — their siblingship — I encourage you to review your plan with your estate planning attorney.
siblingship [sib-ling-ship] noun (November 9, 2013): 1. The state of being related or interrelated 2. A state of affairs existing between one of two or more individuals having one common parent. You will not find this word in the dictionary — it is a new word as of November 9, 2013. It describes the unique,…
When Generations invited me to write an article about my high school days, one of the first memories that came to mind was of riding in the backseat of my dad’s 1959 Chevy Impala every morning, heading to school and listening to his favorite radio program.
In the 50s, there was this DJ named Hal Lewis (aka J. Akuhead Pupule) but I really wasn’t “tuned in” to his show, however, he amused my dad and constantly made him laugh out loud. Aku broadcasted from the “Tree House” at the International Market Place in the early 1960s and played big-band music and stand up singers like Frank Sinatra, Vic Damone, Dean Martin, The Lennon Sisters, The McGuire Sisters, etc. I’ve come to realize now that what I listened to back then affected me for the rest of my life. (Keep that in mind … your kid is being shaped while sitting in the back seat of your car. I have people come up to me and say they listen to my radio show now because their mom and dad used to listen to me in the morning, too.)
When not with dad, I would listen to this other guy named Elvis Presley on KPOI. So the music that came from dad’s radio each morning was something I had to endure. And to see my dad moving his shoulders to the music, it was kinda goofy! But oddly enough, sitting back there all those years, I started to appreciate the big-band sound and recognize the songs and the people who sang them — Tony Bennett and Nat King Cole. But I had no idea as to the weight of this music and what it meant to my father’s generation — The Greatest Generation.
It wasn’t until much later that I realized I was a product of the generation who grew up in the U.S. during the deprivation of the Great Depression, and then went on to fight in World War II. I’m a WWII baby. A baby boomer!
The Greatest Generation dealt with segregation, detention, internment, prejudice and so much more. Yet, many national figures and heroes came out of those trying times. Martin Luther King, for example, came from the Greatest Generation and he spoke eloquently from the depths of disparity, rising up and changing our country and the world forever. And the 442nd Regimental Combat Team and 100th Infantry Battalion local boys who gave more than most … these men were not going to let anything get in their way in achieving their best.
The Greatest Generation went for it!
And when I think back on riding in my dad’s car, I feel like I was on the end of a very long shooting star, streaking across the midnight sky. I really had no idea what my parents had gone through but I knew that everything was changing.
All I’m saying is we must always holomua, keep moving and look forward, but never forget what was laid down before us.
Join the conversation with Frank B. Shaner on Facebook and experience his art online at www.frankbshaner.com.
“The Greatest Generation” … Go for Broke! Oil on canvas, 24” x 18”
When Generations invited me to write an article about my high school days, one of the first memories that came to mind was of riding in the backseat of my dad’s 1959 Chevy Impala every morning, heading to school and listening to his favorite radio program. In the 50s, there was this DJ named Hal…
Every year, a few weeks before Halloween, I get dozens of calls from Medicare beneficiaries with questions about Medicare’s Annual Enrollment Period, which begins October 15 and ends December 7. It is the time when Medicare beneficiaries can decide to keep their existing health plan or select a new plan that becomes effective January 1 of the following year. I provide tips to help callers review their options. This year, in addition to those calls, my voicemail overflowed with seniors who received an unexpected letter from about their Medicare health coverage. The notice explained that their Medicare plan would not be offered in 2014 and was ending December 31, 2013. As a result, they would need to take action and select a new plan by December 31, 2013, or their coverage would revert to Original Medicare only.
SO HERE ARE MY TOP FIVE TIPS:
Tip 1: You qualify for a special enrollment period from October 15 to February 28, 2013. So now is the time to consider your options. If you don’t take action by December 31, you’ll have Original Medicare coverage only, and will lose prescription drug coverage unless you join a separate Medicare prescription drug plan.
Tip 2: Decide to join another Medicare Advantage health plan because your plan has notified you that your existing plan will no longer be offered. If you wait until after February 28 to join a new plan with prescription drug coverage, you may have to pay a late-enrollment penalty.
Tip 3: Call Medicare 24 hours, 7 days a week at 1-800-MEDICARE for help.
Tip 4: Refer to the 2014 Medicare & You Handbook for detailed information.
Tip 5: For help comparing plans: Call Hawai‘i’s State Health Insurance Assistance Program, Sage PLUS at 1-888-875-9229. All counseling is free.
Martha Khlopin hosts the popular weekly radio program “Medicare Moment with Martha — The World of Medicare” sponsored by AlohaCare. It airs on KHNR-690AM on Saturdays from 11–11:30 a.m. and on KGU-99.5FM on Sundays from 10–10:30 a.m. For info, call (808) 973-0754, mkhlopin@alohacare.org.
Every year, a few weeks before Halloween, I get dozens of calls from Medicare beneficiaries with questions about Medicare’s Annual Enrollment Period, which begins October 15 and ends December 7. It is the time when Medicare beneficiaries can decide to keep their existing health plan or select a new plan that becomes effective January 1…
Look around. Gleaming new solar panels are going up on roofs all over Hawai‘i. It’s no wonder — with our exorbitant electricity rates, year-round sun and substantial tax credits, installing a PV system in Hawai‘i makes so much sense, especially if you’re on a fixed income. Homeowners who educate themselves before investing will enjoy reliable energy savings for generations to come.
Here are four tips from the pros:
Be aware of sales gimmicks like cash rebates or free trips. Because of the tax credits involved, the government frowns upon these kinds of incentives. Avoid being vulnerable to an audit.
Insist on a reputable solar panel manufacturer. There are literally dozens of new brands jumping on the PV bandwagon. You are making an investment that should last decades. Will the company be around to honor its warranty?
Ask if the provider employs its installers. Many providers use sub-contractors to handle the all-important installation aspects. If something goes wrong two years down the road, you don’t want your provider passing the buck.
Be sure to hire a full-service, licensed solar company. Look for the state’s C-60 Solar Power Systems Contractor license. This ensures your provider has passed rigorous testing and has the necessary experience with solar, roof work, hookups and permitting to do a top-notch job.
Look around. Gleaming new solar panels are going up on roofs all over Hawai‘i. It’s no wonder — with our exorbitant electricity rates, year-round sun and substantial tax credits, installing a PV system in Hawai‘i makes so much sense, especially if you’re on a fixed income. Homeowners who educate themselves before investing will enjoy reliable…
Congratulations! You have made your decision of the Medicare Health and Drug Plan for 2013. For many, this might mean that you stayed with the plan that you had in 2012 and for some, you may have looked at the options available in your area and have enrolled with a new Medicare plan. The decision that you made is for the calendar year 2013: so let’s look at some ways that you can use the plan to your “advantage”— after all, they are called Medicare Advantage Health Plans.
When you receive your health or drug plan packet that includes the evidence of coverage and other important information, make sure you and your caregiver take a moment to look at what the plan covers and how to access those services. Also, if you would like someone else to be able to ask questions of your plan on your behalf, take a moment and fill out the “authorized representative” form. This is always better done sooner rather than later.
First, what should we NOT do? We should not assume that your neighbor, friend or family member has the same plan as you and ask them what providers to use. Plans have different rules and different providers. A health maintenance organization (HMO) works very different from a preferred provider organization (PPO). We have seen many a Medicare member be responsible for a medical bill because they went outside the allowable network.
What should we do? Understanding what type of plan you have enrolled in is the first step; we have several different types of plans in Hawai‘i including HMOs (you must use the plan’s network or their contracted providers) PPOs (you can use both preferred providers (and pay less money out of pocket), PFFS (works with any provider who accepts the plan and agrees to treat you) and SNP (special needs plans that are available for those with Medicare and Medicaid), who are the providers and how can you save the most money.
Still have questions, first call your health or drug plan (remember when possible it is best to call later in the afternoon in Hawai‘i and you will have less of a wait time), they are best able to answer the questions about your specific coverage. You can always find the phone number on your membership card.
Are you new to Medicare in 2013? Join us on our “Welcome to Medicare” webinars that are held in February/April/June/August. To sign up for one, go to www.hawaiiship.org and look for the webinar box. Certified SHIP volunteers are also available to help you navigate the Medicare system. We can be reached at 1-888-875-9229. The Hawai‘i SHIP receives a federal grant from the Centers for Medicare & Medicaid Services to provide information and assistance to you regarding your Medicare benefits. The program is located under the Department of Health’s Executive Office on Aging.
Congratulations! You have made your decision of the Medicare Health and Drug Plan for 2013. For many, this might mean that you stayed with the plan that you had in 2012 and for some, you may have looked at the options available in your area and have enrolled with a new Medicare plan. The decision…