Category: August – September 2013

  • A New & Innovative Dental Office

    An innovative concept in dentistry has emerged in Kaimuki. This dental office focuses on patient comfort, relaxation, reduction of dental fear, and is paired with coordinated specialty treatment.

    This practice is breaking the mold of the traditional dental office our parents grew up with. The office has both specialists and general dentists together in the same office. This facilitates the ideal communication and coordination of treatment between practitioners. The specialties currently offered are endodontics (root canals) and orthodontics (braces), along with general dentistry.

    I created this office with the patient’s perspective in mind. Having a great fear of the dentist as a child, I decided that as a dentist I would find a way for patients to be more comfortable during treatment. In 2001 I created the Dental Day Spa of Hawaii. The Dental Day Spa of Hawaii’s second phase is The Specialty Group. This expands the pampered patient philosophy to a comprehensive dental approach.

    Surprisingly, many patients are still fearful of the dentist, and go out of their way to avoid dental treatment. Patient relaxation is emphasized through many amenities, such as soothing massage during dental procedures by a licensed massage therapist. Aroma therapy is also used to calm fear and anxiety.

    Patients can also watch movies at the dentist office. Imagine being able to enjoy your dental procedure with a movie and a massage. For more information on The Specialty Group office, visit www.ddsspecialty.com.


     

    Wynn H. Okuda, DMD, Inc.
    Cosmetic, Implant and Restorative Dentistry
    3660 Waialae Ave., Suite 315, Honolulu, Hawai‘i 96816
    808-734-1099 | www.cosmeticdentistryhawaii.com

    An innovative concept in dentistry has emerged in Kaimuki. This dental office focuses on patient comfort, relaxation, reduction of dental fear, and is paired with coordinated specialty treatment. This practice is breaking the mold of the traditional dental office our parents grew up with. The office has both specialists and general dentists together in the…

  • Al Harrington Discusses His Years … And Yours

    Al Harrington Discusses His Years … And Yours

    At 77 years young, Al Harrington has seemingly lived the life of the American Dream—entertainer, actor, healer and educator.

    Yet, after experiencing cancer and diabetes, Al was compelled to build the healing spirit in Hawai‘i. For him, that meant illustrating how new and old methods of healing can work well together. Most practitioners — whether traditional or modern — would say that health is about balance. At the Waianae Comprehensive Health Center, Al works with the staff to incorporate body, breath, spirit and nature into good health. And most recently he’s partnered with AlohaCare, using his teaching skills to educate seniors on how to get the most out of their Medicare benefits. 

    Here, we catch up with Al to learn how his diverse life experiences and successes have led him to servicing others. His story begins in American Samoa …

    01 Al Harrington and Diamond Head - Generations Magazine - August - September 2013
    Cover & Feature Story Photography is provided by AlohaCare, Inc.

    Up until the age of three, Al was raised in American Samoa by his maternal grandmother until his mother, Lela Su’a Paia, sent for him to join her in Honolulu where she was working as a nurse. Lela would eventually marry Roy Milbur Harrington, who Al says treated him like his own son; so much so, that Al eventually adopted his step father’s last name as his own.

    “I grew up in Halawa Housing,” says Al. “Life wasn’t always easy back then, but I was very fortunate. The Lord gifted me with natural academic and athletic abilities and I was able attend Punahou School on a scholarship.” Al helped his team capture the State championship, and became the first high school All-American from Hawai‘i. His athletics and scholastic talents helped him land a scholarship at Stanford University, where he graduated with a degree in history.

    After Stanford, Al got married, returned to Hawai‘i, taught history and coached at Punahou School. “Money was tight,” says Al. “My wife (at that time) and I were going to have twins and I didn’t even have enough money to pay the hospital bill where they were born!” The need for extra income became Al’s entry into the entertainment business. While teaching at Punahou, Al moonlighted as a performer at a luau in Waikiki.

    02 Al Harrington as Ben Kokua - Generations Magazine - August - September 2013
    Al Harrington as Ben Kokua from Hawaii Five-0

    During one of those performances, Hawai‘i Five-O casting director, Ted Thorpe, who worked for Leonard Freeman, creator of Hawai‘i Five-O was in the audience. That was when Al was recruited and landed the role of Detective Ben Kokua in the original Hawai‘i Five-O. Life for Al would never be the same.

    Next, Al moved on to headline the “Al Harrington Show” in Waikiki for more than 20 years. Affectionately known as “The South Pacific Man,” Al’s popularity in the ‘70’s and ‘80’s made him a household name. He, along with other entertainers such as Don Ho, Dick Jenson, Danny Kaleikini, and Moe Keale (Uncle of Brother Iz) all helped define Hawai‘i’s entertainment industry, promoting Polynesian-style song and dance to tourists from around the world.

    After the Al Harrington Show ended in 1992, Al moved to Utah and later to Los Angeles where he enjoyed a successful movie career, acting as a Native American Indian in a number of films, including a starring role in Disney’s White Fang 2.

    03 Al Harrington and Hawaii Five-0 - Generations Magazine - August - September 2013
    Al Harrington (first from the left) on the set with the
    cast of Hawai‘i Five-0.

    In 2005, Al returned to Hawai‘i where he has continued his role as educator, actor, entertainer and healer.

    GM: You’ve certainly lived a life full of adventure and unexpected turns. How is life as a senior treating you?

    AH: You know, the term ‘senior’ is really misleading and I don’t refer to myself or others in that way. People think of seniors as folks who have one foot in the grave; and that pretty soon, life as you know it is going to be “all pau.” But, nothing could be further from the truth! The whole concept of growing older is really a concept of positive growth, coming alive, coming into your own — being content with yourself. As you age you develop the wisdom, experiences and tools to help navigate through life’s ups and downs.

    GM: Most people know you as ‘Al Harrington’ the entertainer and actor, but tell me about your role as an educator.

    AH: I’ve always considered myself an educator, first and foremost. Education is really the crux of everything we do, even on the football field. I’ve had some of my most fulfilling moments in life as a teacher. When I was teaching at Punahou, I had some pretty smart kids in my class. Heck, some were probably even smarter than me! I had to figure out a way to help engage them in the learning process and to teach them the best lesson of all — never stop learning. I’ve had some wonderful teachers in my life that have taught me that life is a process and that process never ends.

    GM: How is your life as an educator helping others today?

    AH: Simplification is education. That’s what education is supposed to do. A good teacher will take a seemingly complicated topic and make it easy to understand. Many people who are approaching Medicare eligibility find it can be difficult to understand Medicare — there’s Parts A, B, C and D and many rules and regulations. Somehow, we’re supposed to know what to do and when. Just receiving that 2-inch-thick Medicare book in the mail is enough to make your head spin!

    Taking care of our health by getting regular health checkups and screenings with the right health insurance coverage in place at reasonable costs is crucial for us at this time in our life.  So, understanding Medicare benefits pays in many ways.

    04 Al Harrington and Ladies - Generations Magazine - August - September 2013

    GM: Is that why you’ve become the spokesperson for AlohaCare?

    AH: Yes! Partnering with AlohaCare has allowed me to share my message with my generation. When I was living in Los Angeles, I was diagnosed with prostate cancer. At that point, I was ready to just give up and check out of life. It was all very overwhelming. But I was blessed. I had someone in my life that helped me through the process. She met with my doctors and worked with them to figure out what kind of treatment I needed and what kind of health coverage I had. The combination of my employer coverage and Medicare made all the difference in making sure I had all the benefits I needed for a full recovery.

    The whole process of health care can get complicated and can prevent people from getting help. My message is this — don’t wait until the unthinkable happens because when it does you won’t be able to think straight! Find a reliable source like Social Security, Medicare and your current or former insurance plan to give you the facts. Then, make your decisions based on those facts.

    GM: How has partnering with AlohaCare allowed you to share your message?

    AH: I’m a regular guest on a weekly radio show that provides seniors with important information on Medicare. It’s hosted by Martha Khlopin who is a Medicare expert. AlohaCare also has a team who conducts Medicare educational workshops for employers. Medicare is an important benefit that people like me who are still working at 65 or older can learn more about. I’ve worked all my life and continue to work. Many Medicare eligible workers don’t know you can continue to receive health insurance coverage from your employer and have Medicare as well.

    Many of us are not aware that if you are age 65 or older, work for a company that has less than 20 employees, you may need to enroll in Medicare Part B or you may be subject to a penalty. You should talk to your Human Resources Benefits manager for more information. Having the right health coverage is extremely important especially if you have an unexpected health crisis.
    There are so many seniors out there who need to know this. Years ago, when I was teaching at Punahou, one of the biggest rewards was when a student would get that look on their face and say, “Oh, I get it!” I guess you could say for me, I’ve come full circle. Today, one of the biggest rewards I get is when Martha and I meet with seniors and after sharing my story and help-
    ing them to understand Medicare, they get that same look and say, “Oh, I get it!”

    GM: What other advice do you want to share with others?

    AH: Age is not indicative of energy or mental competency. Everyone should live life with a purpose. Now is the time when we can really make meaningful contributions within our community. As my friend and fellow senior Andy Rodrigues (owner of Andy’s Sandwiches and Smoothies in Manoa) says, “We can’t let our blessings ferment!” Even as we get older, we have to use our blessings to bless others. For me, that blessing is the gift of sharing vital knowledge to help our community.” As ku¯puna, it is our responsibility — our kuleana — to guide our young generation to see life is worth living and that there are many means
    of support to help guide them along the way.

    And that is what I love about working with AlohaCare. It is their all-encompassing care for keiki, the elderly and those who are struggling financially.

    Not only do they want the people of Hawai‘i to have access to good health care but they also want them to be educated about good nutrition and exercise.

    05 Al Harrington and Kids - Generations Magazine - August - September 2013

    In addition to his work with AlohaCare, Al continues to make guest appearances on Hawai‘i Five-O and is an active board member of the (SCHAA) Sovereign Councils of the Hawaiian Homelands Assembly, the Boys and Girls Club of Hawai‘i’s NFL Youth Education Town (YET) Hawai‘i in Nanakuli, and the Hawai‘i Health Foundation.

    AL HARRINGTON: Medicare In Your Working Years And Beyond

    06 Al Harrington and Lady - Generations Magazine - August - September 2013This summer Al has been on a mission to help employers understand how to talk to their employees about Medicare. As the population ages and works long past the traditional age of retirement, employers will need to address concerns and provide information about Medicare for their employees.

    Al works with a team from AlohaCare. The team conducts educational workshops on how Medicare coordinates with employer health coverage. Here are some of the common questions from participants:

    I just turned 65. I am still working and have health insurance coverage through my employer. Do I need to contact Medicare?

    Everyone approaching 65 or older and still working should understand how their employer’s insurance coverage works with Medicare. There are specific rules for companies that employ less than 20 employees that may require enrollment in Medicare–Part B (coverage for doctor visits, labs). So before age 65, talk to your benefits manager, Social Security and Medicare.

    What do you qualify for when you’re eligible?

    Generally, people who qualify due to age start Medicare Part A (hospital coverage) at age 65. It is premium-free for most people. But, if you are still working and are covered by an employer plan, you may be able to opt-out and delay enrollment in Part B and Part D (prescription drug coverage). Your decision will depend on how your employer health coverage works with Medicare and whether both the employer medical and prescription drug coverage is “creditable,” or as good as Medicare’s.

    How do you get a Medicare card?

    For those who have chosen to receive Social Security benefits prior to age 65, you should get a Medicare card in the mail about three months before your birthday with enrollment information.

    If you decided to delay enrollment when you turned 65, contact Social Security before you lose your existing coverage. You can also visit their website at www.ssa.gov to enroll online.

    At 77 years young, Al Harrington has seemingly lived the life of the American Dream—entertainer, actor, healer and educator. Yet, after experiencing cancer and diabetes, Al was compelled to build the healing spirit in Hawai‘i. For him, that meant illustrating how new and old methods of healing can work well together.

  • Do I Need Long-Term Care Insurance?

    If you never experience chronic illness or an accident resulting in extended care, you won’t need long-term care insurance (LTCI). But, if either were to happen to you today, a nursing home in Hawai‘I could cost you $100,000 – $120,000/year and could last up to 3 years. People age 65 and older with Alzheimer’s survive an average of 4 to 8 years after diagnosis. If you have to use money you were earmarking to retire on to pay for care in a facility or at home, where does it leave your family’s financial future? If you don’t have money or run out of money, you will be dependent on children to be your caregivers or plan on an extended stay at a Medicaid eligible care home not of your own choice. Either way, it’s not pretty picture. On the other hand, LTCI transfers the cost of paid care providers from yourself to an insurance company for a fraction of the actual cost and it offers you choices.

    What are my chances of needing some form of LTCI?

    The chances of needing LTCI are high. The Department of Health estimates 7 in 10 people will need some form of LTCI. If it happens to you, odds don’t matter.

    What is the current cost of LTCI in Hawai‘i? What is the projection in 10 – 20 years?

    The current cost of a nursing home stay in Hawai‘i is approximately $100,000 – $120,000 per year. Assuming a 5% annual rise in the cost of care, the cost in 10 years would be $162,800 – $195,500 per year. In 20 years the cost would be $265,300 – $318,400 per year.

    Why are premiums expensive? Can you compare dollar for dollar versus cents on the dollar?

    Assuming an LTCI policy offered to Federal Employees, a 50 year old may be paying an LTCI annual premium of $3,000. For this money, the insurance company promises to pay up to $328,500 towards the cost of care. The choice is simple, $3,000/year to the insurance company or $328,500 out of pocket for the cost of care. If the insured paid premiums for 25 years, the combined cost over time would be $75,000. For this money, the insurance company’s 5% inflation rider would grow the promise to pay up to $1,112,400. Like health insurance, LTCI premiums are subject to increases in the future. However, my experience with LTCI premium increases over the past 25 years is that paying for LTCI is still pennies on the dollar compared to paying for care out-of-pocket.

    Is it realistic today for my kids to take care of me?

    For many, depending on the kids to be caretakers, is not realistic. Studies show that 59% of unpaid caregivers are currently employed, 70% are married, and 62% are women. Long-term caregiving is hard work; there are consequences physically, psychologically, economically and relationally.

    How do I keep my LTCI premiums affordable?

    Interestingly, it is possible to design a plan that is affordable to many people. Making LTCI affordable is made possible by considering plan type (traditional or hybrid), plan design and creative planning for premium funding.

    __________________________________

    Michael W. K. Yee at (808) 952-1222 ext. 1240

    Michael W K Yee, CFP®, CFS®, CRPC®, is a Financial Advisor and CERTIFIED FINANCIAL PLANNER practitioner™ with Ameriprise Financial Services, Inc. in Honolulu, HI. He specializes in fee-based financial planning and asset management strategies and has been in practice for 25 years. To contact him, michael.w.yee@ampf.com, 808.952.1222 ext 1240, 1585 Kapiolani Blvd., Suite 1100 Honolulu, Hawai‘i 96814.
    Advisor is licensed/registered to do business with U.S. residents only in the states of Honolulu, Hawai‘i.
    1 The Money Across Generations IISM study was commissioned by Ameriprise Financial, Inc. and conducted by telephone by GfK in December 2011 among 1,006 affluent baby boomers (those with $100,000 or more in investable assets); 300 parents of baby boomers; and 300 children of baby boomers at least 18 years old. The margin of error is +/- three percentage points for the affluent boomers segment and +/- six percentage points for the parents and children of boomers segments.
    2 United States Department of Labor, Wage and Hour Division, Family and Medical Leave Act http://www.dol.gov/whd/fmla/
    Ameriprise Financial and its representatives do not provide tax or legal advice. Consult with your tax advisor or attorney regarding specific tax issues.
    Brokerage, investment and financial advisory services are made available through Ameriprise Financial Services, Inc. Member FINRA and SIPC.
    ©2012 Ameriprise Financial, Inc. All rights reserved.

    If you never experience chronic illness or an accident resulting in extended care, you won’t need long-term care insurance (LTCI). But, if either were to happen to you today, a nursing home in Hawai‘I could cost you $100,000 – $120,000/year and could last up to 3 years. People age 65 and older with Alzheimer’s survive…

  • Proper Hydration for Health

    Staying hydrated everyday is the key to staying and feeling healthy. Our bodies have an intricate system of keeping fluids and electrolytes in balance. Due to changes in the body as we age, such as a decrease in total body water as well as a decreased sense of Generations - 2013-08-09 - Proper Hydration - Image 01thirst, this regulation system may no longer function properly, making dehydration more common. Dehydration especially in the elderly can lead to hospitalization, infection, loss of cognitive function and even death if not treated immediately. Symptoms of dehydration include dry mouth, no urine or very concentrated (dark yellow color) sunken eyes, lethargy, low blood pressure, rapid heart rate and dry skin.

    The requirement is 48–64 oz of fluid per day (almost 2 liters). For those who fear incontinence, consider things like undergarments or pelvic floor exercises. Don’t limit your intake because of it. Try to drink throughout the day (4 oz. Every 20 minutes).

    Fluid may come from fruits and vegetables, or soups and smoothies. Alcohol and caffeine don’t count because they have a dehydrating effect and should be avoided or limited.

    A good way to keep track of your intake is to get a 2–3 liter bottle to pour from so you can see how you drank by the end of each day. A pitcher of water with lemon, lime or orange slices, grapes and fresh mint is a nice refreshing drink. Remember, the more you drink the more water your body wants. Hydration is important to your health. Stay strong and drink up!


     

    Join Diane online at www.shapingup808.com, or call 808-221-3905; email shapingup@hawaii.rr.com.

    Staying hydrated everyday is the key to staying and feeling healthy. Our bodies have an intricate system of keeping fluids and electrolytes in balance. Due to changes in the body as we age, such as a decrease in total body water as well as a decreased sense of thirst, this regulation system may no longer…

  • What to Ask When Seeking a Care Home

    Choosing a caregiver or nursing home for a family member is one of the most difficult decisions in life. It is a stressful, consuming task that is often made worse by the fact that a loved one has suffered a medical crisis. You may face great pressure to arrange care in a very short period of time.

    However, the Office of the State Long-Term Care Ombudsman suggests that you take the time to ask questions — and a lot of them. Below are some inquiries you should make to determine whether a caregiver’s services will meet your family’s needs and desires.

    Questions To Ask Caregivers

    • How long have you been a caregiver?
    • Prior to starting your own business, where else did you work (hospital, nursing home, case manager, etc.)?
    • Do you like your job? Why?
    • Do you have another outside job?
    • When you’re gone, who is the substitute caregiver? Can I meet that person? What’s their background?
    • Who lives in the house? Family? Other residents?
    • What’s a resident’s typical day? When do they eat? What do they sleep?
    • What kind of activities do you offer (exercise, gardening, church, outings)?
    • Can I see your past Organized Health Care Arrangement (OHCA) annual surveys? (OHCA is a clinically integrated care setting where individuals typically receive health care from more than one health care provider. Members of an OHCA may agree to abide by the terms of a joint notice of privacy practices and to share Protected Health Information (PHI) as necessary to carry out treatment, payment, or operations relating to the OHCA.)
    • What have you been cited on in the past (deficiencies)?
    • What are you most proud of?
    • Are there open visiting hours?
    • Do you encourage family support?
    • Have you ever met or worked with the Long-Term Care Ombudsman?
    • What do you think this job is all about?
    • What would past residents say about you?
    • Do you have any references I can talk to?

    Living in the community is supposed to be less a “medical’ model and more a “psycho-social model.” What does that mean and does that describe your home?

    Questions To Ask Yourself

    • How home-like does the place appear to you?
    • What do you see? What do you smell?
    • Do the residents look happy?
    • How does the staff interact with the residents?
    • Does it feel like a family?
    • Are the residents well cared for? Safe?
    • Would I want to live here?

    For more questions about care homes and other related facilities, please call the State Long-Term Care Ombudsman:

    Executive Office on Aging No. 1 Capitol District
    250 South Hotel St., Suite 406, Honolulu
    (808) 586-7268
    www.Hawaii.gov/health/eoa/LTCO.html

    Choosing a caregiver or nursing home for a family member is one of the most difficult decisions in life. It is a stressful, consuming task that is often made worse by the fact that a loved one has suffered a medical crisis. You may face great pressure to arrange care in a very short period…

  • 25th Annual Talk Story Festival

    Around the world, every culture has it’s own way of sharing information and stories. In the Islands, we know it as ‘talk story.’ These informal conversations are about slowing down and taking the time to share ideas, stories, history and opinions with the people around you. The upcoming annual Talk Story Festival aims to keep the conversation going with hopes of inspiring and connecting us all.

    The Department of Parks and Recreation invites you to two free nights to the 25th Annual Talk Story Festival, Hawai‘i’s oldest and largest storytelling celebration. Some of Hawai‘i’s best storytellers and mainland guests are featured. Nine storytellers each night, 20 minutes each, with dramatic lighting and gifted sign language interpreters. Video of these performances is projected beside the stage. Gates open at 5 p.m. Big crowds are expected, so come early both nights!

    *SP0oOoKY STORIES

    Friday, October 18, 6 p.m.– 9:30 p.m.

    * THINK DEEP TALES

    Saturday, October 19, 6 p.m.– 9:30 p.m.

    (Touring O‘ahu, neighbor islands and public libraries the following week.)

    Ala Wai Golf Course Clubhouse Ballroom

    Hawai‘i Tellers will include:

    ‘Tita’ Kathy Collins (Maui), Yasu Ishida (Japan), Dan Kelin II (Honolulu Theater for Youth), Sandra MacLees (Big Island), James McCarthy (guitar man), Shain Miller (Ong King), Kilohana Silve (hula & story), Jeff Gere (hosts both nights).

    Mainland Guests:

    Lyn Ford (Ohio) & Kuniko Yamamoto (Japan)

    For more information, contact Jeff Gere at 808-768-3032, jgere@honolulu.gov. and visit www.honoluluparks.com.

    Around the world, every culture has it’s own way of sharing information and stories. In the Islands, we know it as ‘talk story.’ These informal conversations are about slowing down and taking the time to share ideas, stories, history and opinions with the people around you. The upcoming annual Talk Story Festival aims to keep…

  • Medicare? Are You There Yet?

    Remember the familiar line chanted by children being driven somewhere, “Are we there yet?”

    As I visit companies to conduct Medicare preretiree seminars, I hear employees nearing the age of Medicare eligibility, quietly asking each other something similar —“Are You There Yet?”

    Most can hardly believe they are reaching their 65th birthday and will soon qualify for Medicare.

    About 17,000 people in Hawai‘i are expected to turn 65 next year. Many may still be working and need to understand how Medicare will coordinate with their employer health coverage. Others want to learn more about valuable benefits, like FREE preventive screenings. Here are some rules:

    STOP — Determine when you will first become eligible for benefits. You can use the Medicare Eligibility Tool at www.medicare.gov. This will help you avoid late enrollment penalties.

    LOOK — You should get your Medicare card in the mail a few months before your 65th birthday. Contact Social Security and Medicare if you do not receive your card. You can reach Social Security at 800-772-1213 or Medicare at 800-633-4227.

    LISTEN — Learn more about your options by attending Medicare workshops during the Medicare Annual Open Enrollment Period, Oct. 15th through Dec. 7th. You can also call or meet with a licensed agent for more information.

    So ask for directions if you need to, sit back and relax. You are almost there!


    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.

    Remember the familiar line chanted by children being driven somewhere, “Are we there yet?” As I visit companies to conduct Medicare preretiree seminars, I hear employees nearing the age of Medicare eligibility, quietly asking each other something similar —“Are You There Yet?” Most can hardly believe they are reaching their 65th birthday and will soon…

  • Honoring End-of-Life Choices

    Our community is facing a crisis, most recently evidenced by the Karen Okada case. The local news recently exposed this crisis, reporting that Ms. Okada made a living will in 1998 where she stated that she did not want her life to be “artificially prolonged” at “end of life.” The Queen’s Medical Center clinicians diagnosed Ms. Okada as being in a persistent end-of-life vegetative state, and that the feeding tube should be removed in accordance with her wishes. Ms. Okada’s family, however, felt differently and did not want the feeding tube removed. This case ended up in court, making this very private family matter public. The crisis lies in the fact that many people, such as the Okada family, are not prepared for the end-of-life process. Unfortunately, as a result, patients’ dying wishes are often not upheld and many family members experience anxiety, depression and regret during and after the loved one’s death.

    Statistics reveal that only about 25 percent of adults ever make an end-of-life decision. Consequently, many family members suffer from post traumatic stress because they feel as though they were responsible for making the end-of-life decision for their loved one. Some experience conflict with other family members as ideas about care differ, while others suffer because they were not clear as to what their loved one’s wishes were about end of life.

    For those clients who do document their decisions, only about 30 percent of advance directives are honored by family members and medical facilities.

    While filing an Advance Health Care Directive in your medical chart is recommended, the medical community and legal community must ensure that patients and clients will receive:

    • dignity, respect and quality care
    • comfort and peace of mind that their choices will be honored
    • help though the end-of-life process, with the least amount of stress and anxiety as possible

    It is time for our community to come together and offer an Advance Care Planning system where:

    • information is shared so that clients can make informed decisions
    • choices are discussed with loved ones, care providers and legal advisors
    • decisions are documented and stored so that they are easily retrievable when necessary
    • plans are viewed as a process and revisited from time to time

    Statistics from communities that have adopted this type of planning are positive. Close to 90 percent of the patients made an Advance Health Care Directive, and 86 percent of the directives were honored by family and medical facilities.

    Encourage our community leaders — medical, legal and financial professionals, business leaders, educators, the political and spiritual leaders, and non-profit organizations—to work together to create a uniform advance care planning process for all of Hawaii.

    Our community is facing a crisis, most recently evidenced by the Karen Okada case. The local news recently exposed this crisis, reporting that Ms. Okada made a living will in 1998 where she stated that she did not want her life to be “artificially prolonged” at “end of life.” The Queen’s Medical Center clinicians diagnosed…

  • Shingles

    Generations - 2013-08-09 - Shingles - Image 01Shingles also known as Herpes Zoster causes a painful rash that usually is located on one side of the body. Shingles is caused by the varicellazoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can enter the nervous system and lie dormant for years. Eventually it may reactivate and travel along nerve pathways to the skin causing shingles. Shingles tends to occur in seniors, especially during periods of low immunity or high stress.

    Is it Contagious?

    A person with shingles can pass the varicellazoster virus to anyone who isn’t immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, not shingles. Chickenpox can be dangerous for some groups of people such as pregnant women, newborn babies, and persons with weak immune systems.

    What are the signs and symptoms of shingles?

    • Pain, burning, tingling and numbness
    • Fluid-filled tiny blisters that break open and crust
    • Itching
    • Headache, fatigue, fever are less common

    What are the potential complications?

    • Post-herpetic neuralgia or pain that continues long after the blisters have cleared
    • Vision loss in or around the eyes
    • Inflammation of the brain (encephalitis), facial paralysis, hearing or balance problems
    • Skin infections

    What treatment options are available?

    Antiviral drugs such as Valcylovir (Valtrex), Famciclovir (Famvir) or Acyclovir (Zovirax) can speed up healing and reduce complications. To reduce the pain, anticonvulsants such as gabapentin or tricyclic antidepressants may be prescribed. Numbing agents such a lidocaine skin patch also reduce the pain.

    How can a person prevent shingles?

    The Food and Drug Administration has approved the use of the varicella-zoster vaccine (Zostavax) for adults age 50 and older. It is a one-time vaccination. In scientific studies, the vaccine reduces the risk of developing shingles by about 50 percent. It will reduce the course and severity of the disease as well as reduce the risk of post-herpetic neuralgia. Since the vaccine contains live virus it should not be given to people who have weakened immune systems.

    Shingles also known as Herpes Zoster causes a painful rash that usually is located on one side of the body. Shingles is caused by the varicellazoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can enter the nervous system and lie dormant for years. Eventually it may reactivate…

  • When to Place a Loved One

    Making the decision to place a loved one into long-term care can be difficult for families. It wasn’t too long after Maria’s husband had fallen outside of their home did she realize it was time to discuss his long-term care plans with the family.

    Maria’s family found it difficult to come to agreement on the details, and the children felt guilty about placing their father into an “institution,” causing them to prolong the decision. As an alternative, the children agreed to share the responsibility of caring for him. Yet, the demands of care giving were stressful on those who balanced a full-time job and their own families. The children felt burnt out and decided they could no longer accommodate the responsibilities of care giving.

    So, when is the right time to place a loved one? Typically, a physician or facility will make a recommendation for placement if the individual has medical needs and requires 24-hour care.

    One of the newest long-term care programs started by the Department of Human Services (DHS) is the Community Care Foster Family Home Program. Homes throughout our community are licensed by the DHS to operate as Adult Foster Homes that provide residents with 24-7 medical care and supervision by certified caregivers. Each home is required to work alongside a licensed case management agency that provides residents with care coordination and face-to-face contact by a registered nurse or licensed social worker. For more information about the Adult Foster Care Program, please visit http://humanservices.hawaii.gov/ssd/home/adult-services.


     

    Nightingale Case Management, Inc. has been a part of the CCFFH Program for over 12 years. For a free assessment and consultation, please contact: (808) 484-2205, nightingalecmi@hotmail.com, or visit www.nightingalecmi.com

    Making the decision to place a loved one into long-term care can be difficult for families. It wasn’t too long after Maria’s husband had fallen outside of their home did she realize it was time to discuss his long-term care plans with the family. Maria’s family found it difficult to come to agreement on the…

  • August – September 2013

    August – September 2013

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    Al Harrington: Discusses His Years . . . And Yours