Category: Articles

Pneumonia: No. 1 Cause of Death

Community-acquired pneumonia (CAP) is one of the most common types of conditions primary care providers encounter in the United States. It is also the most common infectious cause of death. CAP accounts for nearly 4.5 million doctor visits annually and is the second most common cause of hospitalizations.

Risk factors for contracting CAP include:

• Older age: risk increases as you grow older, especially for those 65 years and older
• Chronic respiratory disease: higher risk patients include those who smoke or have smoked, have COPD, bronchiectasis, asthma or other illnesses
• Chronic diseases such as diabetes, congestive heart failure or stroke
• Other immuno-compromising conditions, such as asplenia and HIV

How can you protect yourself from community acquired pneumonia?

Get vaccinated! The pneumococcal vaccination can help prevent this illness. The vaccine should be routine for those 65 and older. Generally, the vaccine is not recommended for healthy adults younger than 65—unless they are immuno-compromised. Check with your primary care provider to ensure your vaccination is up to date.

What types of vaccine do you need?

The following information will help you prepare to speak with your doctor. Pneumovax PPSV23 vaccine is recommended for adults 65 and older. It is typically administered every 10 years for patients who do not have any significant immuno-compromising conditions. The Pneumovax vaccine generally protects you against more than 50 percent of the causes of pneumococcal disease. Streptococcus pneumoniae, the leading bacterial cause of pneumonia worldwide, is part of Pneumovax PPSV23’s immunity.

The Prevnar PCV13 vaccine contains protection from 13 other types of pneumonia-causing bacteria. Currently, medical guidelines have been updated to include this additional vaccine for those 65 and over on a case-by-case basis only, because the incidence of pneumonia caused by these bacteria is actually very low.

Consult your doctor about these vaccines.

HOUSE CALL MEDICAL PRACTICE LLC
808-726-5062 | Housecallmed@gmail.com
www.housecallmedhawaii.com
The medical information in this article does not replace advice from your doctor or other professional healthcare provider.

Community-acquired pneumonia (CAP) is one of the most common types of conditions primary care providers encounter in the United States. It is also the most common infectious cause of death. CAP accounts for nearly 4.5 million doctor visits annually and is the second most common cause of hospitalizations.
Smooth Out Those Hard Knots!

Chronological age does not always reflect the biological age of a person. One way to look and feel much younger than your driver’s license reveals is to stay mentally, socially and physically active.

Functional mobility keeps seniors strong, active and independent for as long as possible. Functional fitness is the physical capacity to perform normal everyday activities safely and independently without undue fatigue. But 43 percent of people over 65 have functional limitations due to inactivity.

The good news is that early detection of physical weakness and appropriate changes in physical activity habits can reverse the path toward disability. Immobility is preventable and reversible through proper physical activity and exercise levels.

Lack of physical activity can lead to dry, tight, hard fascia, which can cause chronic pain. Fascia is the connective tissue in our bodies. Keeping fascia in good condition requires consistent movement, which can help facilitate the healthy flow of lymphatic fluids throughout the body, keeping the body free of inflammation and pain by providing hydration of the tissues.

Self-myofascial release (MFR) using a hard cylindrical roller is one method of training the fascia. When we put pressure on our tissues, old inflammatory wastes are purged and fresh, new fluid flows in when the pressure is released. This hydrates the fascia, making it more pliable and resilient to injury.

Smooth out those hard knots, returning the fascia to its normal fluid and adaptable self with myofascial release.

FRAN PATOSKIE
Certified Trainer and Fascianation Method Practitioner
808-349-5598 | franpatoskie@gmail.com

Fascianator class locations:

Wainani Wellness Center
1144 10th Ave., Ste. 302, Honolulu, HI 96816
Wednesdays at 5pm

The Pacific Club
1451 Queen Emma St., Honolulu, HI 96813
Mondays at 1:30pm

Honolulu Christian Church (faith-based class)
2207 Oahu Ave., Honolulu, HI 96822
Mondays and Thursdays at 5:15pm

Chronological age does not always reflect the biological age of a person. One way to look and feel much younger than your driver’s license reveals is to stay mentally, socially and physically active. Functional mobility keeps seniors strong, active and independent for as long as possible.
Are You Golf-Ready?

Golf is a popular sports activity. Unlike most sports, it can be played throughout the golden years, if you can stay in shape and avoid injury. The American Physical Therapy Association says that older golfers often forget that while their passion for the game remains high, their bodies have aged. As we age, we lose flexibility, muscle mass and strength. Because the golf swing’s extreme bending and twisting movements are not natural for the body, senior golfers are at a greater risk of injury. Correct body mechanics on or off the course (lifting golf bags, etc.) play a larger role in preventing injuries. Warm-up exercises before starting a game are essential to prevent injury and continuing with these exercises during the game will help muscles recover faster and maintain muscular balance. Keeping yourself in shape with year-round conditioning, balance, strength, endurance and flexibility training ensures an injury-free game. Try these stretches:

Anterior Shoulder Stretch:
Increases range of motion (ROM). Standing, hold your golf club behind your back with palms outward. Raise the club upwards until a stretch is felt in the front of your shoulders and chest. Hold 20 to 30 seconds. Do 2 to 3 sets.

Trunk Extension:
Increases trunk ROM and prepares muscles for your golf swing (reduces back injury.) Stand holding your golf club with both hands (palms outward), resting the club on the small of your back. Bend backwards slowly. Hold for 2 seconds and return. Repeat 5 to 10 times.

Trunk Rotation:
Stand in the golf posture with your club behind your neck on your shoulders and grasp each end. Slowly and with control, rotate your upper body back, simulating a golf swing. Stretch the trunk region. Repeat 10 times.

Wrist Stretches:
Increase flexibility. Start with one arm held outward horizontally, elbows straight, palm down. Use your other hand to bend your wrist downward. Hold it for 20 to 30 seconds. Then turn your palm upward and repeat. Do 2 to 3 sets per wrist.

Moon Physical Therapy LLC
Aquatic, Land-based and Manual Therapy and Cardiopulmonary Rehab Programs
320 Ward Avenue, Ste. 107, Honolulu
808-597-1005 | www.moonpt.com

Golf is a popular sports activity. Unlike most sports, it can be played throughout the golden years, if you can stay in shape and avoid injury. The American Physical Therapy Association says that older golfers often forget that while their passion for the game remains high, their bodies have aged. As we age, we lose…
Helpful Hints for Organizing Your Space

Organizing and de-cluttering your home can be daunting. Conflicting emotions are sure to arise, so first, prepare yourself mentally. When you sense these feelings bubbling up, remind yourself that this is normal. Start thinking about enlisting a support team: a trusted family member, friend or professional to help you step by step through the process. Here are some initial helpful hints:

◆ Clear Pathways. Cluttered or disorganized floor spaces or stairs are major safety concerns. De-clutter walkways first so you can ensure ease of movement throughout your home.

◆ Use Clear Containers. Clear containers allow you to easily see what’s stored where. In the kitchen, OXO Pop containers designed for people with arthritis open easily and seal in freshness.

◆ Maximize Vertical Space. Over-the-door storage racks and wall hooks help turn an ordinary wall or door into efficient storage space. These items are particularly useful if you’ve already downsized to a smaller space and are still needing homes for some of your belongings.

◆ Optimize Closet Organization. An organized closet makes getting dressed much easier. Organize your pantry for more effective meal preparation. The freedomRail® closet system provides a sturdy, flexible and economical solution to pantry, closet and storage area organization.

ALOHA ORGANIZERS
4348 Waialae Ave., Ste. 939, Honolulu, HI 96816
808-347-7480

Organizing and de-cluttering your home can be daunting. Conflicting emotions are sure to arise, so first, prepare yourself mentally. When you sense these feelings bubbling up, remind yourself that this is normal. Start thinking about enlisting a support team: a trusted family member, friend or professional to help you step by step through the process.
Shopping for the Best Online Shipping

Seniors with family and friends on the mainland know what high shipping costs can do to a budget. Hawai‘i small business owners hurt even more. They pay to ship in supplies and inventory, and high shipping costs prevent them from competing with big box stores and online retailers.
Supporting our local economy keeps our neighborhood stores open. But families and seniors on fixed incomes are forced to look for the lowest prices, so here are some tips when looking for the best shipping costs.

If you can’t find what you need locally, visit webstores that will ship via the United States Postal Service. USPS is our fairest, lowest cost shipper. Retailers who really want our Hawai‘i business may also offer UPS standard air, which runs a bit higher and takes at least as long to get here. However, UPS also offers retailers an economy service that only ships to “48 contiguous states.” So, search for shipping options before your browse a site to avoid disappointment at checkout.

SHIPPING TIPS
■ Rule No.1: “Free shipping” never applies to Hawai‘i. Even Amazon.com Prime charges a membership fee and then still adds a shipping premium to many “free shipping” items.
■ Avoid “UPS Ground” shipping to Hawai‘i. This means your goods will come via an expediter on a container ship that may take six weeks to arrive!
■ Don’t buy from online sites that require “special quotes for International shipping” after you have input your payment information. If you got there from an ad, send feedback to Google.
■ Don’t waste your time trying to buy pieces of furniture or other heavy items from mainland outlets. Shipping costs may run more than the item you want! By the way, most online furniture stores are owned by Wayfair, whose shipping policies are unfavorable for Hawai‘i. Buy new or used furniture locally. Buy locally when you can, be smart when buying online and when you get the chance, ask our state legislators and members of Congress to support the Post Office and prevent us from getting cut off from family, friends and business on the mainland.

HONU MEDIA, LLC
Freelance Writing Services
Katherine Kama‘ema‘e Smith
808-268-0787

Seniors with family and friends on the mainland know what high shipping costs can do to a budget. Hawai‘i small business owners hurt even more. They pay to ship in supplies and inventory, and high shipping costs prevent them from competing with big box stores and online retailers.
Mellow Friends

Mellow Friends, a group of karaoke enthusiasts, visited 11 senior centers and assisted living facilities starting in 2011. Melvin Watarai, the founder of this volunteer ensemble, had the karaoke equipment and a format for the singers to perform solo songs, duets and group sing-alongs with the seniors. Three years ago, Gary Shimabukuro took the helm, adding more equipment and four more locations, increasing their total number of monthly visits to 15.

(L–R, sitting) Simon Sanidad, Mel Watarai, Gary Shimabukuro, Al Sakihara, (standing) Roy Hamasaki, Woody Batula, Mae Fujimoto, Clarence Kane, Jean Yamanaka, Jennie Wolfe, Yvonne Watarai and Florence Matsukado.

One of the locations that Mellow Friends visits is Manoa Cottage Kaimuki. Executive Director and Administrator Calvin Hara says, “The music of Mellow Friends provides comfort and local style to our residents. The songs of yesteryear reach into the residents’ memories as they reminisce and enjoy social stimulation with others.”

Mellow Friends volunteers are multi-talented seniors who dance hula and sing a variety of songs in different languages. Seniors look forward to their monthly visits to sing along loud and proud.

For the last four years at the annual Generations Senior Karaoke Contest at the Mayor’s Craft & Country Fair, Simon Sanidad and Al Sakihara have provided Gary valuable assistance.

MELLOW FRIENDS
Gary Shimabukuro | gsjx2@gmail.com

Mellow Friends, a group of karaoke enthusiasts, visited 11 senior centers and assisted living facilities starting in 2011. Melvin Watarai, the founder of this volunteer ensemble, had the karaoke equipment and a format for the singers to perform solo songs, duets and group sing-alongs with the seniors. Three years ago, Gary Shimabukuro took the helm,…
Maui Sunset Lilikoi Bars

There’s nothing better than sharing a perfect, tropical sunset with friends and family. The only thing that can enhance the experience further is sharing a favorite dessert. Here’s mine!

INGREDIENTS

Crust

1 cup butter (softened)
1/2 cup powdered sugar
2 cups all-purpose flour

Filling

1-1/4 cup white sugar
1 tsp. baking powder
1/4 cup all-purpose flour (to help set)
4 eggs (slightly beaten)
1/3 cup fresh lilikoi juice without seeds (use a citrus juicer) or packaged lilikoi juice purchased online from Amazon.com or at an island grocer in Hawai‘i

INSTRUCTIONS

Crust

Preheat the oven to 350°F/175°C. Prepare the crust using a medium bowl. Blend together all of the crust ingredients. Mix with a wooden spoon or a mixer on low until it has a crumbly texture.

Using your hands, press the uncooked crust evenly throughout an ungreased 9-by-13-inch pan.

Bake 20 minutes until firm and golden. Timing should be just about right for the lilikoi filling after the crust is baked.

Filling

In another bowl, whisk together the white sugar and all-purpose flour. Add the four slightly beaten eggs and whisk until smooth. Add in the lilikoi juice, then whisk again together.

Once the crust is baked, pour the filling over the crust and return it to the oven for an additional 20 minutes. Then remove and let it sit to cool.

The bars will firm up as they cool completely, then you may cut the bars. (Optional: sprinkle 1-1/2 tablespoons of powdered sugar on top before cutting.)

Serve loosely on a platter and enjoy.

Serves: 30 2-by-2-inch bars

Total time: approximately 55 minutes

There’s nothing better than sharing a perfect, tropical sunset with friends and family. The only thing that can enhance the experience further is sharing a favorite dessert. Here’s mine for Maui Sunset Lilikoi Bars.
How to Join the Flexible Workforce
I have often written to you about imagining your future — daring to dream and following your own internal journey as you think about the many opportunities for work in the year ahead.

FIRST THINGS FIRST — YOU! Your first step in exploring your future is to take an internal journey in order to make a decision to work for pay, for fun or for the good of others. Part-time and other ways of working flexibly are bountiful. Many offer unique advantages to mature workers over that old classic — the 9-to-5 job.

Think of this new time, with its many new ways to work, as the time that change and innovation are opening financial and social opportunities for those of us who need or wish to continue working over our much longer lifetimes. Think you’re alone in this new quest? Think again, as older workers form more than 30 percent of the flexible workforce; the number is growing daily.

Where do you find flexible work in Hawai‘i?

Google “temporary staffing agencies in Hawai‘i.”

Or, search for opportunities my way and Google product or service areas that interest you. I am a writer and find many options by Googling “opportunities for writers and editors in Hawai‘i and beyond.”

Join LinkedIn. For example, through my 1,100 people connections on LinkedIn, I have been able to link with people who are working remotely — here, there and everywhere. For me, the most appealing way to work is remotely from my lānai in Hawaii Kai.

Of course, you need to have relevant market skills in order to secure new opportunities of interest to you, as well as to clients and customers.

Adding basic skills to your experience is the easiest way to prepare. How easy is it? Well, I learned many necessary technical user skills from my 16-year-old granddaughter! In exchange, I helped her to develop the confidence and skills to drive a car!

Unfortunately, unrealistic fears block many mature workers from new learning experiences. Here are two sources that have helped me overcome the reluctance to reinvent myself. AARP and OSHER (www.osher.socialsciences.hawaii.edu/) offer ideas, connections and referrals to suitable skill building programs throughout Hawai‘i. Step up. Find renewed purpose through some form of work. You’ll be glad you did!

NEW WORKFORCE HAWAII
Carleen MacKay
916-316-0143 | carleenmackayhi@gmail.com
www.newworkforcehawaii.com

Contact Carleen via her website and receive New Ways to Work, a free PDF book co-written with Phyllis Horner.
our first step in exploring your future is to take an internal journey in order to make a decision to work for pay, for fun or for the good of others. Part-time and other ways of working flexibly are bountiful. Many offer unique advantages to mature workers over that old classic — the 9-to-5 job.
US Commissaries Open to 3M More Vets
On Jan. 1, 2020, 15,000-plus veterans in Hawai‘i — a “high cost area”— became eligible to shop in military stores. Commissaries have low prices and no state tax. Commissaries are like big box stores — some brands may be missing, but they carry almost everything you need. (Note that you will pay an additional fee if you use a credit card, so use cash if you can.)

How do I receive this benefit?

Disabled and other eligible veterans can just use their veteran health card to get in. The commissaries scan your card and they are gearing up inventory for the influx of new customers.

Caregivers who are primary caregivers for a wounded/injured veteran and are registered with the Department of Veterans Affairs caregiver program. You will see a memo posted to VA.gov for use to access front gates.

You will also have to show your driver’s license. In the near future, the VA will transition all to a caregivers ID card for base access.

How do I receive a veteran health card?

Call 1–877–222–8387 before 4 pm Hawai‘i time. They can access your DD 214 (discharge papers). You will then be asked numerous questions, but because you called them, the information is secure.

If your records were destroyed in the 1973 fire in St. Louis, it will take longer. A form will be sent to you to have Archives assist.

In person, you can visit either of two locations:

459 Patterson Road, Spark Matsunaga VA Medical Center at Tripler. Call 800–214–1306 for information/directions/room number.

91-2135 Ft. Weaver Road, Leeward Community Based Outpatient Clinic in room 501. 808–312–6800

Enjoy all the commissary has to offer; shopping with Veteran Health Card is just one more opportunity your VA card gives you.
On Jan. 1, 2020, 15,000-plus veterans in Hawai‘i — a “high cost area”— became eligible to shop in military stores. Commissaries have low prices and no state tax. Commissaries are like big box stores — some brands may be missing, but they carry almost everything you need. (Note that you will pay an additional fee…
Honorees Take a Stand Against Falls

(L–R, standing) Stan Michaels, Chris Pa, Percy Ihara, Michael Dowell, Peter Reyes, (seated) Tito Villanueva and Phoebe Hwang (DrPH, owner-operator, Omniworks).

More than 9,950 injuries from falls occur annually among seniors statewide. Each year, the Hawai‘i Fall Prevention Consortium (HFPC) identifies individuals with passionate dedication to reducing the number and severity of injuries from falls among seniors and honors their efforts to promote fall prevention initiatives in the state.

The HFPC presented its Annual Fall Prevention Awards for Outstanding Community Service at the end of 2019 to: Chris Pa, activities director at Leeward YMCA; Peter Reyes, program director at Catholic Charities Hawai‘i (CCH); Percy Ihara, owner/publisher of Generations Magazine (GM); and Tito Villanueva, Kauai Operations Manager for American Medical Response (AMR).

Chris Pa’s leadership has enabled many kūpuna to actively attend tai chi classes and events at Leeward YMCA. “Chris is truly a community treasure,” said Ileina Ferrier, master trainer for the Tai Chi for Health Institute.

Peter Reyes became a master trainer for Matter of Balance at CCH. “Peter is a great trainer who truly believes in the importance of reducing the fear of falling and of preventing falls,” said Diane Terada, division administrator at CHC Community & Senior Services.

Percy Ihara is one of the great forces in senior well-being and understanding through GM, said Michael Dowell, chair of the HFPC and owner of Ohana Stairlifts. “Percy is amazing in his continual energy and drive to improve the lives of all of Hawai‘i’s kūpuna.”

Tito Villanueva is the inspiration and driving force behind the growth and success of Kauai’s Home Safety Program for Seniors and has also provided mentoring and support for other programs as the AMR operations manager. “His dedication is astounding,” said Stanley Michaels, senior fall prevention coordinator at the DOH.

In addition, Phoebe Hwang, DrPH, was honored for her outstanding contract work for the HFPC. “Phoebe is truly amazing,” said Michaels.

EMERGENCY MEDICAL SERVICES & INJURY PREVENTION PROGRAM
808-733-9202 | stanley.michaels@doh.hawaii.gov
www.health.hawaii.gov/injuryprevention

A complete summary of the fall prevention campaign, special videos for seniors and/or their care-givers, and a recap of accomplishments is online at www.nogethurt.hawaii.gov.

More than 9,950 injuries from falls occur annually among seniors statewide. Each year, the Hawai‘i Fall Prevention Consortium (HFPC) identifies individuals with passionate dedication to reducing the number and severity of injuries from falls among seniors and honors their efforts to promote fall prevention initiatives in the state.
2020 Census Forms Will Be Available Online
Every 10 years, the U.S. government embarks on the herculean task of counting every person in the country. An accurate decennial census count is important in order to allocate more than $675 billion in federal funds annually for community programs and services, such as healthcare services for the elderly, education programs, housing and community development, and job training. For example, in federal Fiscal Year 2016, Hawai‘i received over $3.6 billion from 55 different federal programs, including nearly $1.5 billion in Medicaid funding.

Starting in March 2020, people will receive postcards alerting them that the census will begin on April 1, Census Day. Unlike past census events, the 2020 census may be completed online. Between March 12 and 20, the majority of people will receive a letter advising them that they may complete the census survey online. However, about 20 to 25 percent of the population will still receive a paper survey due to demographic characteristics and internet connectivity in their area.

The 2020 census general questions will be:

How many people were living or staying in this house, apartment or mobile home on April 1, 2020?

Were there any additional people staying here on April 1, 2020 that you did not include in Question 1?

Is this a house, apartment or mobile home?

What is your telephone number?

Please provide information for each person living here. If there is someone living here who pays the rent or owns this residence, start by listing him or her as Person 1. If the owner or the person who pays the rent does not live here, start by listing any adult living here as Person 1.

Name, Sex, Age

Is Person 1 of Hispanic, Latino, or Spanish origin?

What is Person 1’s race?

It will not contain a citizenship question.

If you are not able to complete the census by April 1, you will get several reminder mailings through April. Thereafter, through August, census enumerators will conduct door-todoor interviews to collect information from those who have not completed the questionnaire.

COMMON CAUSE HAWAII
P.O. Box 2240, Honoulu, HI 96804
808-275-6275 | www.commoncause.org

The decennial census is a huge endeavor to ensure a fair, accurate and complete count. The U.S. Census Bureau is looking to hire enumerators and other positions throughout Hawai‘i. Consider being a census worker. Applicants must: 1) have a valid email address; 2) be a U.S. citizen; 3) be 18 years of age or older. Apply now at www.2020census.gov/jobs.
Every 10 years, the U.S. government embarks on the herculean task of counting every person in the country. An accurate decennial census count is important in order to allocate more than $675 billion in federal funds annually for community programs and services, such as healthcare services for the elderly, education programs, housing and community development,…
Elder Abuse: Senior Advocates & Your Rights
Senior advocates understand personal rights, elder abuse, consumer rights, the legislative process and how programs are funded. They also see that agencies correctly implement laws and draw attention to the ones needing changes. This article focuses on personal rights and elder abuse law. Effective advocates begin by reading the laws and understanding what rights they protect. Hawai‘i law defines six kinds of abuse: physical, psychological, sexual, caregiver neglect, financial exploitation and self-neglect.

“Capacity” means the ability to understand and appreciate the nature and consequences of making decisions concerning one’s person or to communicate these decisions.

“Caregiver” means any person who has knowingly and willingly assumed the care, supervision or physical control of, or who has a legal or contractual duty to care for the health, safety and welfare of a vulnerable adult.

“Caregiver neglect” means the failure of a caregiver to exercise that degree of care for a vulnerable adult that a reasonable person with the responsibility of a caregiver would exercise within the scope of assumed, legal or contractual duties:

(1) Assist with personal hygiene

(2) Protect the vulnerable adult from abandonment

(3) Provide, in a timely manner, necessary food, shelter or clothing

(4) Provide, in a timely manner, necessary healthcare, access to healthcare, medication, psychological and physical care, or supervision

(5) Protect the vulnerable adult from dangerous, harmful or detrimental drugs, except those provided to the vulnerable adult pursuant to the direction or prescription of a practitioner

(6) Protect the vulnerable adult from health and safety hazards

(7) Protect the vulnerable adult from abuse by third parties

“Financial exploitation” means the wrongful taking, withholding, appropriation or use of a vulnerable adult’s money, real property or personal property, including but not limited to:

(1) The breach of a fiduciary duty, such as the misuse of a power of attorney or guardianship privileges, resulting in the unauthorized appropriation, sale, or transfer of property

(2) The unauthorized taking of personal assets

(3) The misappropriation or misuse of moneys belonging to the vulnerable adult

(4) Failure to effectively use a vulnerable adult’s income and assets for the necessities required for his or her support and maintenance It’s the government’s job to ensure that these kinds of abuse do not happen.

KOKUA COUNCIL
20 S. Vineyard Blvd., Honolulu, HI 96813
facebook.com/KokuaCouncil/
Senior advocates understand personal rights, elder abuse, consumer rights, the legislative process and how programs are funded. They also see that agencies correctly implement laws and draw attention to the ones needing changes. This article focuses on personal rights and elder abuse law.