Category: October – November 2013

  • Demanding Good Government

    Forty years ago, the Watergate scandal outraged Americans and diminished the public’s trust in government. Demonstrations were held nationwide demanding that a more honest, open government be held accountable to the public, thussparring the good government movement.

    “Good government” is used to describe the ideal corruption-free government that is transparent, responsive to the public rather than private interests, robust with citizen participation, and where public officials are held accountable for their actions.

    Common Cause Hawaii has been a leading ‘good government’ voice advocating for improved process-related measures that affect our democracy. For the last 40, it has advocated for campaign finance reform, voting modernization, and stronger transparency and ethics in the Legislature. It considers process-related issues and improvements as universal issues that impact all of our social and economic policies.

    Today, one good government issue provokes the public with as much force as Watergate did: the 2010 U.S. Supreme Court’s decision on Citizens United, which opened the floodgates of special interest money from corporations, unions and wealthy individuals into “Super PACs” (political action committees that do not coordinate their efforts with candidates) seeking to influence our elections.

    As a result of Citizens United, Mainland corporate spending on national campaigns ran into the billions in 2012. Locally, the 2012 elections data reflected that 16 Super PACs spent $4,801,069.06 on Hawai’i campaigns. The 315 Hawai’i candidates who ran for State and County offices spent $13,404,231.01. The 16 Super PACs managed to spend 26 percent of the entire pool of money spent on Hawai’i elections. According to the Campaign Spending Commission, Hawai’i also attracted a significant amount of “outside” money from Mainland donors: 24 of the 61 registered non-candidate committees received 100 percent of their funding from outside sources.

    Citizens United reminded Americans how fragile our democracy is, and the strides we must take to strengthen it.

    Communities across the country are advancing resolutions through their city councils and state legislatures that declare support for a constitutional amendment to overturn Citizens United, challenge corporate power, and eliminate unlimited campaign spending.

    As part of our effort to limit special interest money’s influence in politics, in 2012, Common Cause Hawaii introduced two state legislative resolutions (HCR 5 and HR 5) and one Honolulu County resolution (Resolution 12-207), all of which passed. In the 2013 legislative session, Common Cause Hawaii successfully advocated for HB1147 (now Act 112), which would require Super PACs to list their top three donors in political ads.

    Our work extends beyond legislative activities. We are currently coaching high school students on key good government issues: money in politics, transparency and ethics. Additionally, we are planning a series of workshops to involve mobileapplication (apps) developers in creating apps to share Campaign Spending data in attractive and convenient ways.

    With the prevalence of social media, a new wave of citizens are in tune with how special interest money influences public policy, and can quickly raise awareness to questionable issues and actions. Through our advocacy and outreach, we develop new activist leaders and equip them to make informed decisions and participate meaningfully in the law-making and electoral process.

    Together, we can present a unified voice demanding higher standards for government ethics and transparency, and firmly say: money has no place in politics.

    Forty years ago, the Watergate scandal outraged Americans and diminished the public’s trust in government. Demonstrations were held nationwide demanding that a more honest, open government be held accountable to the public, thussparring the good government movement. “Good government” is used to describe the ideal corruption-free government that is transparent, responsive to the public rather…

  • Caregiving, Near or Far

    My mother fell and hurt her knee. She’s 86 years old. I am thousands of miles away. My sister lives in the same town as my mother which makes her, by default, my mother’s caregiver. I feel guilty. That is not uncommon for siblings who are not able to provide assistance to parents who live in another town — or on another continent. There are situations where it is impossible to be the primary caregiver, whether you want to or not.

    As seniors, we want to do the best we can to be self-sufficient and to take care of ourselves. But sooner or later [hopefully later] we will have to depend on others to look after our well-being. This is a message to the next generation. Think about who is going to be your caregiver. If you can count on your children, fine. But remember, there are professionals standing by who can help support the entire family. But if you have seen the headlines lately, you realize there is a looming crisis. There will be more people who need assistance than there are people available to offer it. These are important things to think about as we age. As we have said many times in the past, sooner or later you will be a caregiver or one receiving care. We are fortunate that Generations Magazine provides a great deal of resources to help us all with our specific family needs. In fact, the cover story of this issue, Living A New Normal, highlights the importance of caregiving and offers some insights and additional community resources.

    And, just remember, that although you may not always be able to be by a loved one’s side, a simple phone call to check in or sending some photos of grandkids can go a long way in making someone feel loved.


    The Elderhood Project airs on KHON2 Friday Morning news at 5:45a.m. and Thursday at 5p.m.

    My mother fell and hurt her knee. She’s 86 years old. I am thousands of miles away. My sister lives in the same town as my mother which makes her, by default, my mother’s caregiver. I feel guilty. That is not uncommon for siblings who are not able to provide assistance to parents who live…

  • Your Health, Your Home, Your Choice!

    It’s only natural to want to stay at home. So being informed about good caregivers and their services can enrich your home experience by making everyday tasks a little easier and safer. The services you need depends on your and health strategies and type of support, as well as your financial and insurance situation.

    Ask the home care agency how they ensure safe, qualified, professional service:

    Q. What types of screenings are performed before hiring a caregiver?

    A. For your safety and health benefits, be sure the caregiver has been pre-screened properly and is qualified. Here is a checklist to help guide a wise decision:

    □ Federal and State Criminal Background Checks

    □ Drug Screening (ten panel)

    □ Sex Offender Check (all 50 states)

    □ Medical Disciplinary Screening

    □ Employment and Education Verification

    □ Professional and Personal Reference Checks

    □ Office of the Inspector General (OIG)

    □ Social Security Check

    □ Adult / Child Protective Services Screening

    □ DMV Motor Vehicle Report

    Q. Are caregivers bonded and insured through the Home Care Agency?

    A. The agency should provide you proof of current professional liability, general liability, workers’compensation and temporary disability insurance.

    Q. Who is the caregiver employed by?

    A. Caregivers should be employees of the agency and not an independent contractor. If they work more than 20 hours a week on a regular basis they are eligible for health care under the Prepaid Health Care Act.

    Never compromise on quality and safety!


    HiHealthCare, 745 Fort Street, Honolulu, HI 96813
    Main (808) 534-7815 | Fax (808) 356-5014
    info@hihealthcarehawaii.com | hihealthcarehawaii.com

    It’s only natural to want to stay at home. So being informed about good caregivers and their services can enrich your home experience by making everyday tasks a little easier and safer. The services you need depends on your and health strategies and type of support, as well as your financial and insurance situation. Ask…

  • Retirees Have Confidence Yet Lack Finances

    Just five years after the onset of the financial crisis, Americans’ confidence about retirement is rising with the strengthening economy. According to the New Retirement Mindscape® 2013 City Pulse index, two in five (42%) Americans feel on track for retirement. This is more than last year (37%), and more than any other year since the index began in 2010.

    Yet, the lack of action people are taking to prepare financially for retirement has remained relatively unchanged over the past few years. While nearly three in four (72%) have taken some action to prepare for retirement, this number is smaller than in 2011 and 2010 when the economic recovery was still unstable.

    The annual New Retirement Mindscape City Pulse index examines the 30 U.S. Metropolitan areas. The index serves as a barometer for national and local retirement trends.

    According to the index, nearly half (45%) of Americans think that healthcare expenses during retirement will be one of the most challenging financial issues. Likewise, two-thirds (68%) of Americans express concern about the pending changes due to the Affordable Care Act, and half (51%) of those concerned say that their top worry is that they will end up paying more for healthcare.

    Of the 30 largest U.S. metro areas, San Francisco–Oakland–San Jose (#1), Detroit (#2) and Hartford-New Haven (#3) were the most confident and prepared. There are a few things that set these cities apart. If you’re preparing for retirement, take note of the following factors:

    • Contribute to retirement accounts beyond a workplace-sponsored plan. More residents than average in the top three cities contribute to IRAs or other personal investment accounts (other than or in addition to workplace-sponsored plans). Making regular financial contributions to these types of accounts and maintaining a diversified portfolio will likely make you feel more confident about life after you leave the workforce. You may also have more control over your personal accounts as you do in an employer-sponsored plan, and withdrawals typically carry fewer penalties — though it’s important to avoid withdrawing from you retirement savings accounts if possible.
    • Maintain positive feelings about retirement. Although the financial market fluctuates, you have control over how you respond to its ups and downs. Respondents in two of the top three cities were far more likely than the national average to say that thinking about retirement makes them feel empowered. Thinking positively about the future — and acting on those feelings by taking proactive steps to prepare — is key to helping build retirement confidence.
    • Consider working with a financial professional. Residents in two of the three most retirement-ready cities were more likely to work with a financial advisor. The national survey results uncovered that only one in four (23%) Americans say they have determined the amount of money they need to save for retirement and even fewer (11%) report having a written financial plan. A financial advisor can help you define and work toward your retirement goals.

    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.

    Just five years after the onset of the financial crisis, Americans’ confidence about retirement is rising with the strengthening economy. According to the New Retirement Mindscape® 2013 City Pulse index, two in five (42%) Americans feel on track for retirement. This is more than last year (37%), and more than any other year since the…

  • Secret Money for Senior Veterans

    Many Veterans believe that they have to have suffered an in-service disability to qualify for monetary benefits from the Veterans Administration. This is a common misconception. Depending on health, income and assets, many senior Veterans (and their dependent or surviving spouses) can qualify for not only basic “Improved Pensions” based on low income, but also supplemental benefits of up to $2,053 per month as of 2013. The supplemental benefits are called “Housebound Benefits” and “Aid & Attendance Benefits.”

    In order to qualify for any of these pension benefits, the Veteran (or surviving spouse, based on the Veteran’s military service record), must satisfy the following general criteria:

    • The Veteran must have served at least 90 days of active duty.
    • At least one day out of the 90 days of active duty must have been during war time (there are defined dates for the beginning and end of World War II, the Korean War and the Vietnam Conflict; and the Gulf War, which began on August 2, 1990, is not concluded yet, and its ending date will be set by Presidential Proclamation at the appropriate time).
    • The Veteran must have received a discharge other than dishonorable.
    • The claimant and household must have limited income and assets.
    • The claimant must have a permanent and total disability at the time of application (note that a surviving spouse can qualify for a basic low income pension without being disabled, but the Veteran must be disabled—although the disability does not have to be related to war time or military service).
    • The disability must have been caused without the willful misconduct of the claimant and must not have been due to the abuse of alcohol or drugs.

    As the name implies, Housebound Benefits are payable where the claimant is substantially confined to his or her home because of permanent disability. In order to qualify for Aid & Attendance benefits, the claimant must:

    • Require the aid of another person in order to perform personal functions required for everyday living (such as bathing, feeding, dressing, toileting, transferring from bed to a wheelchair, or dealing with incontinence) OR
    • Be bedridden, in that he or she must remain in bed apart from any prescribed course of convalescence or treatment OR
    • Be a patient in a nursing home due to mental or physical capacity OR
    • Be blind or have very poor vision.

    Applying for these supplemental benefits is not a quick or simple process, and if you decide to apply, you may want to enlist the help of a Veterans’ assistance organization or a specially-trained individual. Note that whoever assists with the application cannot charge a fee for that service. However, other services by the individual or organization may be chargeable.


    Scott Makuakane, Attorney at Law
    Specializing in estate planning and trust law.

    Watch Scott’s TV show, Malama Kupuna
    Sundays at 8:30pm on KWHE, Oceanic channel 11

    www.est8planning.com
    O‘ahu: 808-587-8227, Maui: 808-891-8881
    Email: maku@est8planning.com

    Many Veterans believe that they have to have suffered an in-service disability to qualify for monetary benefits from the Veterans Administration. This is a common misconception. Depending on health, income and assets, many senior Veterans (and their dependent or surviving spouses) can qualify for not only basic “Improved Pensions” based on low income, but also…

  • Share a Tip with Your Favorite Senior

    While the Baby Boom era is behind us, its effects live on. The number of people reaching the autumn season of life is higher than ever. In fact, the World Health Organization reports that there are around 600 million people aged 60 and older living in the world today. That number is expected to double by 2025 — a short 12 years from now — and is expected to reach about 2 billion by 2050.

    In the United States, 10,000 people reach retirement age every single day.

    Younger people often turn to their elders for advice, as older people have the life experience and reflection that younger people lack. But given the fast-paced changes the world now experiences, with new technologies becoming outdated in a matter of years or even months, there may be some helpful insights you can share with your elders.

    For example, if you know someone who is nearing retirement age, tell them about www.socialsecurity.gov. They may not be aware of the helpful and easy-to-use tools available to them. It’s no exaggeration to say that even someone who does not use the Internet on a regular basis can easily plan their retirement or even complete their retirement application online in a matter of minutes — much less time than it would take to drive to a local Social Security office.

    The best starting place for anyone thinking about retirement is Social Security’s Retirement Estimator. Use it to get an instant, personalized estimate of future retirement benefits in a matter of minutes. Spend a few more minutes plugging in different information, such as different projected future wages and different retirement dates, to help make a wise decision on the best retirement date. The Retirement Estimator is available at www.socialsecurity.gov/estimator.

    Then there’s the online retirement benefit application. In as little as 15 minutes, a person can apply for Social Security benefits and submit their application online. In most cases, once one submits the application, there is nothing more to do but wait for the first payment. It’s really that simple. And, if one decides they’d like to doublecheck some information before submitting the application, that’s fine too. The application can be paused and then restarted at any time during the process. It’s all available at www.socialsecurity.gov/applyonline.

    It makes sense to go to our elders for advice and guidance. But in this technology-driven world, we may be able to offer a little advice to the sages as well. A good bet is to tell the older adults in your life about www.socialsecurity.gov.


    For other information and locations near you:

    1-800-772-1213 (toll free) | 1-800-325-0778 (TTY)
    www.socialsecurity.gov

    Generations Magazine -Share a Tip with Your Favorite Senior - Image 01

    While the Baby Boom era is behind us, its effects live on. The number of people reaching the autumn season of life is higher than ever. In fact, the World Health Organization reports that there are around 600 million people aged 60 and older living in the world today. That number is expected to double…

  • Cataract Corrections

    What is a cataract?

    The eye’s lens is mostly made up of water and protein, but as we age, some of that protein in the lens begins to clump together, resulting in cloudy patches of vision. This is called a cataract.

    What does a cataract do to my vision?

    As the cataract grows, vision worsens. Cataracts usually develop slowly and are painless, though the symptoms are troubling, and ultimately can lead to blindness if not removed.

    When should you worry about cataracts?

    Cataracts affect nearly 22 million Americans age 40 and older. According to the American Academy of Ophthalmology more than half of all Americans have cataracts by age 80. Adults get cataracts usually due to aging, exposure to sunlight and can also be affected by smoking, improper nutrition, systemic diseases, injury to the eye or certain medications.

    Symptoms include:

    • Blurred, foggy or cloudy vision; a sense of film over your eyes
    • Blues and greens seem faded
    • Difficulty reading small print
    • Double vision
    • Seeing halos around lights at night
    • Are there new ways to correct cataracts?

    Laser cataract surgery is a simple and relatively painless procedure that is done on an out-patient basis. Cataract removal is the most frequently performed surgery in the U.S. and nine out of 10 patients who have cataract surgery regain between 20/20 and 20/40 vision. New bladeless, computer-controlled laser refractive cataract surgery, LenSx®, offers greater accuracy and precision than previous methods.


    Jenkins Eye Care | 808-591-9911
    615 Pi‘ikoi St. Suite 205, Honolulu, Hawai‘i 96814
    www.jenkinseyecare.com | Twitter: @jenkinseyecare
    Facebook.com/jenkinseyecare | YouTube: Jenkinseyecare

    What is a cataract? The eye’s lens is mostly made up of water and protein, but as we age, some of that protein in the lens begins to clump together, resulting in cloudy patches of vision. This is called a cataract. What does a cataract do to my vision? As the cataract grows, vision worsens.…

  • Don’t Miss a Beat with Online News

    Generations Magazine - Don’t Miss a Beat with Online News - Image 01A couple years ago, University of Hawai‘i journalism professor Bev Keever had her students undertake a very basic reporting exercise: request misconduct reports filed with the Legislature by Hawai‘i’s four county police agencies.

    It turned out to be anything but simple. But Keever, a former Vietnam War correspondent, finally obtained what turned out to be vague summaries, sorely lacking in detail, and only for the Honolulu Police Department dating back to 2000.

    By the time Keever got the records, her class of blossoming reporters was long gone. So she brought the three-inch stack of photocopies to Honolulu Civil Beat, a relatively new arrival on the media scene here.

    Keever’s groundwork became a five-part investigative series in Civil Beat. “In the Name of the Law” explored the public policy decisions that have kept police disciplinary records off limits to the public in Hawai‘i since the mid-1990s, when an earlier crop of UH journalism students fought — and won — a Supreme Court victory opening misconduct files. Their victory was short-lived; the police union convinced political allies in the Legislature to exempt police records from disclosure.

    I’ll let you read all about the politically charged situation that spanned three governors and many legislative sessions. You can find it at www.civilbeat.com under Special Reports.

    But the project that took more than six months to pull together illustrates just who we are. Started by eBay founder Pierre Omidyar and his business partner, Randy Ching, in May 2010, Civil Beat is the only independent news organization in Hawai‘i dedicated to public affairs journalism. We don’t cover sports, entertainment or lifestyle features unless they involve some aspect of public policy. Taxpayer money is always a big issue for us, as is raising questions of possible wrongdoing or lack or government transparency.

    We’ve provided in-depth coverage of controversial issues, from the Honolulu rail project to the debate over genetically engineered crops. Earlier this year, another multi-part special report examined the history of the Ala Wai Canal, its flawed design and environmental problems — and its murky future.

    We believe a vibrant news organization is vital to democracy and we can make a difference in the lives of people and public policy through solid, smart, watchdog journalism. In fact, legislators and other elected officials circulate our stories and quote from our coverage.

    One of our main goals is to foster civil discussions through our website, a virtual “civic square” where people can gather to understand, debate and discover the issues. We welcome community voices and invite you join us online.

    And we’ve won a slew of journalism awards for our work, including being named the Best News Site in Hawai’i for three years in a row by the Society of Professional Journalists.

    In September, we teamed up with The Huffington Post to launch HuffPost Hawaii, which brings news to Hawai’i while sharing our local issues with a global community. Visit us at www.huffingtonpost.com/Hawaii or email hawaiiblogs@huffingtonpost.com.

    A couple years ago, University of Hawai‘i journalism professor Bev Keever had her students undertake a very basic reporting exercise: request misconduct reports filed with the Legislature by Hawai‘i’s four county police agencies. It turned out to be anything but simple. But Keever, a former Vietnam War correspondent, finally obtained what turned out to be…

  • Fall Prevention

    There I was, the Hawai’i State Fall Prevention Coordinator, fallen, spread eagled, with a dent in my car door in the shape of my own forehead. It happened so fast, one second of inattention and I was flat on the ground. And to make matters worse, I had just left the quarterly meeting of the Hawai’i Fall Prevention Consortium.

    First, it’s important to know that falls are the most common fatal unintentional injuries in our state. Second, falls are the leading cause of nonfatal injuries among Hawai’i residents with more than 21,000 emergency room visits per year. That’s more than two falls every single hour. That’s a lot of pain, misery and money. And the majority of the fallers are 65 years or older. One single moment of inattention and, in my case, stupidity, and I fell. However, this fall (like most others) was preventable.

    I use the word “stupidity” because I should know better. Someone called my name, I turned to respond, and continued to walk without looking where I was going as I tripped on a curb and ran my forehead straight into my car door. Had my forehead come in contact with anything other than the soft spot in the side door of my car …say six inches to the left where the steel pillar and door hinges are, I would have been severely injured. I was just lucky.

    At 72 years of age, and with lousy balance, I cannot afford to make these mistakes. I know that we all have friends who have tripped, fallen, collided with their dog, slipped in their bathtub or in some other way fallen and severely injured themselves. We are all old enough to know better … we must stop being inattentive especially while walking. While walking, walk and watch where you put your feet. If you want to chat with a friend while walking make sure you are on a level path with no obstructions. Don’t stop walking, as it is one of the best things we can do to stay active and strong. Just be careful and don’t forget to raise your head and look several feet ahead now and then so that you can respond to obstacles or a change in terrain, grade and, yes, as with my case … curbs.

    Four simple tips:

    You can prevent falls and stay independent by taking these simple precautions.

    1) Medication — Some medications cause dizziness,vwhich can lead to falls. Be proactive andvmake an appointment with your doctor or pharmacistvtoday to review your medications, includingvany over-the-counter drugs and supplements.

    2) Exercise — Balance and strength are essential to preventing falls. Be active and do simple movements — walk, garden, yoga, swim, dance, tai chi — every day to prevent a fall.

    3) Vision — Maintaining good vision helps with balance and safety. Be proactive and have your eyes and eyewear checked at least once a year.

    4) Remove Hazards — Make your home safer by removing fall hazards. Keep pathways clear and the floor free of objects. For a home safety checklist, visit www.nogethurt.hawaii.gov.

    Hawai‘i State Department of Health offices:

    Oahu: 1250 Punchbowl St., Honolulu
    Ph: (808) 586-4400 | Fax: (808) 586-4444
    health.hawaii.gov

    Hilo: 75 Aupuni St., #201, Hilo
    Phone: (808) 974-6006 | Fax: (808) 974-6000

    Kona: 79-1015 Haukapila St., Kealakekua
    Ph: (808) 322-4880 | Fax: (808) 322-1504

    Waimea: 67-5189 Kamamalu St., Kamuela
    Ph: (808) 887-8114 | Fax: (808) 887-8118

    MAUI: 54 South High St., Rm. #301, Wailuku,
    Ph: (808) 984-8200

    Kauai: 3040 Umi St., Lihue, HI 96766
    Ph: (808) 241-3614

    Generations Magazine - Fall Prevention - Image 01

    There I was, the Hawai’i State Fall Prevention Coordinator, fallen, spread eagled, with a dent in my car door in the shape of my own forehead. It happened so fast, one second of inattention and I was flat on the ground. And to make matters worse, I had just left the quarterly meeting of the…

  • Caregiver Burnout

    In a 2012, 15 percent of Hawai‘i’s population was 65 years and older. This statistic continues to increase; and as part of our culture in Hawai‘I to care for our loved ones, many families have assumed the role of caregiver. Being a caregiver can include providing supervision, assisting in meal preparation, doctor’s visits, medications, and more. It is common for those providing care to struggle with managing a full-time job, raising a family and the demands of being a caregiver.

    The term “caregiver burnout” refers to the physical, emotional and mental exhaustion frequently experienced by caregivers. According the American Heart Association, signs and symptoms of caregiver burnout can include:

    • depression
    • changes in appetite
    • change in sleep patterns
    • difficulty concentrating

    It is important to recognize these symptoms and take the necessary steps to seek help from family, friends or a medical professional.

    Families may also want to consider exploring alternative options for care. For instance, The Community Care Foster Home Program is a long-term care program where qualified adults can receive medical care and supervision in licensed Adult Foster Homes without the excessive cost. For more information about the Adult Foster Home Program, please visit www.humanservices.hawaii.gov.


    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.nightingalecasemanagement.com.

    In a 2012, 15 percent of Hawai‘i’s population was 65 years and older. This statistic continues to increase; and as part of our culture in Hawai‘I to care for our loved ones, many families have assumed the role of caregiver. Being a caregiver can include providing supervision, assisting in meal preparation, doctor’s visits, medications, and…

  • Estate Planning: Preventing the Fight

    You kids, don’t fight when I’m gone. These were always my Mom’s words as she left to go grocery shopping, and left my brothers and me home alone. I remember, as soon as we’d heard the car leave the garage, we would start fighting over something.

    Now as an adult, I notice that the same experience happens among adult children when their parents leave for the last time. While parents are with us, we tend to behave and get along. And once our parents die, many of us begin to argue and fight.

    This is sad for me to see time and again … As children not only lose a parent, but also their relationships with their siblings. None of my clients want their children to fight — especially after they’re gone. In fact, this is one of the main reasons why people set up estate plans. And estate planning attorneys can advise parents how to minimize the risk of jealousy, rivalry and infighting between their children. Sometimes we must continue to parent beyond the grave.

    Here are five estate planning suggestions to minimize fighting:

    • Don’t give your children the same asset, give them different things
    • Make it as equal as possible
    • Don’t leave decision-making up to them — you are the parent and these are your assets … you make the call
    • Meet with the family and explain the estate plan
    • Clearly explain your reasoning behind your decisions and share the “why” behind each gift

    Stephen B. Yim, Attorney at Law | 2054 S. Beretania St., Hon. | (808) 524-0251 | stephenyimestateplanning.com

    You kids, don’t fight when I’m gone. These were always my Mom’s words as she left to go grocery shopping, and left my brothers and me home alone. I remember, as soon as we’d heard the car leave the garage, we would start fighting over something. Now as an adult, I notice that the same…

  • Caring for Yourself: Kidney Disease Update

    Generations Magazine - Caring for Yourself: Kidney Disease Update - Image 01What would you do if you were told you might be sick, or might become sick, even though you feel fine, have no symptoms of which you are aware, and think that you are generally in “good health?” Would you bother to do anything at all under those circumstances? Would you tend to think that you will deal with a potential health problem if and when you begin to notice some symptoms? After all, we’re all generally pretty busy, and dealing with something that “might” become an issue could easily be filed in the “Someday, Maybe” file.

     

    A New Study is Published

    Unfortunately, for many Americans this scenario is, or will become, a reality — and many of us are unaware that a problem may exist. According to a new analysis published in the American Journal of Kidney Disease, nearly six of ten Americans will develop kidney disease in their lifetime. That’s not a misprint; a new study completed by a team of researchers at Johns Hopkins University determined that the lifetime risk of moderate kidney disease for Americans is 59.1 percent. That is substantially higher than the lifetime risk of having a heart attack, diabetes or invasive cancer (which are significant illnesses in their own right). According to the analysis, “Chronic kidney disease (CKD) is rising in prevalence, increasingly expensive, and associated with a high degree of morbidity and mortality.” (Am J Kidney Dis. 2013;62(2):245)

    For those of us living in Hawai‘i, the prospect of a similar lifetime risk is even more daunting. While the Johns Hopkins University study did not make a state-by-state breakdown, it is generally known that Hawai‘i has a higher incidence of Chronic Kidney Disease than is found on the Mainland. At least in part, that is because CKD is not an equal opportunity disease. For reasons that are not yet clear, certain ethnic groups have a higher incidence of the disease than do other ethnic groups, including (in no particular order) Hawaiians and other Pacific Islanders, Asians, including Filipinos, Japanese, Chinese and others, African Americans and Latinos. Given the ethnic composition of our local population, it is reasonable to expect that the lifetime risk of CKD for people living in the Islands will be even higher than reported for the nation as a whole as represented in the Johns Hopkins University study.

    The new analysis, the first of its kind for kidney disease, also called attention to the very high risk that women have of developing moderate kidney disease, in part because moderate kidney disease risk increases dramatically starting at age 60. Women have a tendency to outlive men, making kidney disease a particular concern of women who might expect a long life.

    Additionally, diabetes and high blood pressure are the leading causes and risk factors, yet many people don’t link these with kidney disease. Even those with diabetes and high blood pressure aren’t always tested for kidney disease. High blood pressure can cause kidney disease, and in turn kidney disease can cause high blood pressure, so there is a cyclical relationship.

    What You Can Do to Safeguard Your Kidney Health

    Clearly, Chronic Kidney Disease is a serious, high-risk problem. Fortunately, having a problem and dealing with a problem are not necessarily the same thing. In the case of Chronic Kidney Disease, for many people — even those who may be in the early stages of the disease—there are things that can be done to help.

    A good first step you may want to take is to learn whether or not you may have kidney disease, even if you “feel fine” and consider yourself to be “in good health.” According to the National Kidney Foundation, the awareness level of most people is really low. It is estimated that fewer than 50 percent of people with advanced kidney disease (stage 4) are aware of their disease. It’s safe to say that most of us who may be in the early stages of kidney disease are also unaware of our true health condition. As a result of this latest study, the foundation is now calling on healthcare professionals and adults at risk to take action. People at risk for kidney disease should have an annual screening. Those who are generally considered to be at risk include people with diabetes, high blood pressure, and those over 60 year of age or with a family history of kidney failure.

    Your family physician can order simple urine and blood tests to check for the disease. A urine test is for albumin — a protein — which indicates early kidney damage. The blood test measures kidney function. Filtration of less than 60 indicates kidney disease — less than half the filtration capacity of healthy adults.

    Early detection allows early intervention, which can help prevent progression of the disease and the risk of complications, such as heart disease and stroke. Early detection can also improve patient safety in terms of appropriate medication use for those with reduced kidney function.

    Other things an adult can do to reduce the risk of kidney disease include the following:

    • Control blood pressure and blood sugar
    • Maintain proper weight through healthy diet and regular exercise
    • Quit smoking
    • Avoid excessive use of pain medication that can harm the kidneys, such as ibuprofen.

    Once kidney disease is advanced — when urine tests for kidney damage show large amounts of protein in the urine and blood tests measuring kidney function are less than 30 — a nephrologist can provide the expert care that is needed.

    At this stage, diet is critical and the help of a clinical dietician is helpful.

    Be proactive. Don’t wait until you don’t feel quite right to take the tests. And, if you have any of the risk factors mentioned in this article, check with your family doctor. Early detection will enable you to have a better quality of life and hold the disease in check.

    Let Us Help You and Your Caregiver

    For all of us, having better awareness of our health and nutrition is key to living an enriching lifestyle. At the National Kidney Foundation of Hawai‘i we try to make this easy. Our website, Facebook page and eNewsletters are filled with information that will keep you up to date. We encourage people to join the Willie K. Challenge, which encourages us all to eat better and exercise. Our programs department regularly holds public health and kidney screening events that inform people and measure a person’s kidney-related health.

    If you are a patient, family member or a caregiver, we offer support groups to help you cope with the lifestyle surrounding kidney disease. Members meet to discuss important treatment issues, learn from the experience of others and become active in managing kidney disease.

    Caregivers and patients may also want to participate in our Peer Mentoring program, where those who have dealt with the challenges of chronic kidney disease address your questions and concerns.

    Our K.I.W.I. program is open to patients and caregivers who want to learn about lifestyle issues such as nutrition and exercise, how to shop for kidney-friendly foods and prepare meals for kidney patients.

    To join a program, become a volunteer or simply keep in touch, call Jeff at 589-5976 or email jeff@kidneyhi.org.

    For more information, visit the National Kidney Foundation of Hawai‘i at www.kidneyhi.org, or the national website at www.kidney.org.

    Generations Magazine - Caring for Yourself: Kidney Disease Update - Image 02

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