Category: Date

  • Caregiver Legislation On The Table

    Family members, partners and close friends are an important source of support for older people who need help taking care of themselves at home. In Hawai‘i, these caregivers provide most of the care for loved ones who need help with activities such as bathing, dressing and transportation. Many caregivers also perform complex tasks such as providing wound care, managing medications and operating medical equipment.

    But despite the importance of caregivers in the day-to-day care of our ku¯puna, they are often left out of discussions involving a patient’s care while in the hospital. And when loved ones are discharged from the hospital, caregivers often receive little or no instruction on how to help prevent readmission.

    To address this issue, AARP Hawaii is urging passage of a bill in the 2014 state Legislature that would allow patients to designate a caregiver as part of their medical record — or that hospitals voluntarily adopt this practice. The bill requires hospitals to notify and meet with the designated caregiver to discuss the patient’s plan of care prior to discharge or transfer to another facility. It also requires hospitals to instruct caregivers in how to care for loved ones after they are discharged.

    “This bill will have the two-pronged effect of supporting family caregivers and keeping health care costs in check,” says Steve Tam, AARP Hawaii director of advocacy. “It enables caregiv- ers to support their loved ones at home and in the community, and discourages costly and unnecessary hospital readmissions.”

    The federal Centers for Medicare & Medicaid Services (CMS) estimates that $17 billion in Medicare funding is spent each year on unnecessary hospital readmissions. The bill is intended to reduce readmissions by engaging caregivers more intentionally in the care of their loved ones. It also comes as hospitals across the country are seeking to avoid admission penalties under the federal Affordable Care Act.

    In Hawai‘i, family caregivers already play a critical role in the care of our elderly and disabled populations. On any given day an estimated 247,000 residents provide unpaid care valued at a staggering $1.9 billion annually, according to 2009 data. Caregivers are often members of the individual’s immediate family, but friends and other community members also serve as caregivers.

    AARP is dedicated to helping Hawai‘i’s caregivers by providing the tools, information and support they need to care for their loved ones and themselves. For information on the status of this legislation, or to get involved as an advocacy volunteer, contact Steve Tam at 808-545-6005.

    For information on resources for caregivers available online, visit the AARP Caregiving Resource Center at www.aarp.org/caregiving.


    AARP Hawai‘i state office: 808-545-6024 | Toll-Free: 866-295-7282 | aarp.org/hi | facebook.com/AARPHawaii twitter.com/AARPHawaii

    Family members, partners and close friends are an important source of support for older people who need help taking care of themselves at home. In Hawai‘i, these caregivers provide most of the care for loved ones who need help with activities such as bathing, dressing and transportation. Many caregivers also perform complex tasks such as…

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    Generations - 2014-02 - Web Navigation - Image 01

    Main navigation menu: Use these topics to navigate to the various pages in our site. As you run the cursor over the word, it’ll become bold. These topics will always exist on every page. Throughout the homepage, there are also various other buttons that’ll take you to any one of these topics. Home is the…

  • Healthy New Year’s Resolutions

    Every one of us, regardless of our age, can make plans and set goals. Each new year is a new beginning … a time to start fresh and hopefully get it right.

    Write down what you would like to see happen in the year ahead. It’s a way to solidify your dreams and desires, and move into the new year with an upbeat, positive attitude.

    The top New Year’s resolution is to lose weight and live a healthier lifestyle. We all start with good intentions and then seem to fall back into bad habits. Experts say it takes 21 days for a new activity to become a habit and six months for it to become part of our personality. It doesn’t happen over night, so be persistent and patient. Obsessing over the occasional slip won’t help you achieve your goal. Do the best you can each day and take one day at a time. The key is to start small and set realistic goals for yourself.

    Here is a list of things you can start doing today to feel better and move toward a healthier lifestyle in 2014.

    • Start each day with a 8 oz. glass of water. Water has many benefits. It carries nutrients to our cells, flushes the kidneys, lubricates joints and prevents constipation. The goal is to work up to 1 to 2 liters a day.
    • Eat more fruits and vegetables. Start by adding a salad to your daily diet or making yourself a green smoothie. Fruits and vegetables protect your body from disease and help fight cancer cells. The goal is 3 to 5 servings a day.
    • Eat a handful (1 oz.) of raw nuts every day. Walnuts, macadamia nuts, almonds. Healthy proteins and fats are important for preserving muscle and brain function.
    • Move your joints every day. Moving helps keep and improve function. Start at your neck, look left to right and then up and down. Go to the shoulders, arms out to the side, palms up and make small to large circles from the shoulder joint. Go both directions. Same with the wrist. Work your way down the body.
    • Try not to sit for longer than 15 minutes. Sitting for long periods slows the metabolism and can raise insulin and cholesterol levels. Taking a 10-minute walk every 2 hours can improve your health dramatically.
    • Practice taking deep breaths. Breathe in through the nose and out the mouth. This clears the lungs of toxins, increases energy, calms the mind and allows you to think more clearly.
    • Educate yourself on staying healthy. For example, Dr Oz came out with an updated version of YOU: The Owners Manual. It contains a lot of great info on health and longevity.

    Remember empowerment comes from doing!


     

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

    Every one of us, regardless of our age, can make plans and set goals. Each new year is a new beginning … a time to start fresh and hopefully get it right. Write down what you would like to see happen in the year ahead. It’s a way to solidify your dreams and desires, and…

  • The First Thing

    At the National Kidney Foundation of Hawaii we are often asked about Chronic Kidney Disease (CKD) and what a person should do to find out how if he or she has the disease.

    There is good reason for concern. According to recent research, the lifetime risk of having moderate kidney disease for Americans is nearly 60 percent. Moreover, CKD is often called a “silent killer” because people can have the disease without exhibiting any apparent symptoms until the disease is in late stages.

    CKD is a disease in which the kidneys are unable to filter blood as well as they should. The effect is to have waste products build up in the body and lead to further health problems, including cardiovascular disease, among other things. The disease is usually irreversible and can lead to kidney failure over time if it is not treated. However, if CKD is detected early, treatment with medication and lifestyle changes may slow down the progress of the disease or even prevent kidney failure altogether. There is no cure for CKD, and the only treatment options for kidney failure are dialysis or a kidney transplant.

    So what’s the first thing someone should do if they want to know whether they might have Chronic Kidney Disease? Since early stages of the disease do not typically involve symptoms that a person can “feel” perhaps the first thing to do is have yourself screened for CKD. Your personal physician can order a simple blood test and/or urinalysis that will provide good indications of your kidney health. You might also attend a free screening offered by the National Kidney Foundation of Hawaii, which is designed to provide basic information that might warrant a visit with your doctor. Also, you may want to visit www. kidneyhi.org about an upcoming screening currently scheduled for March 14 at the Ala Moana Hotel as part of World Kidney Week.

    Screening is particularly important for people who have high blood pressure or diabetes, as these two conditions are the leading cause of CKD. Additionally, you may be at greater risk if members of your family have a history of kidney failure or if you are over the age of 60 (although CKD can strike people at any age). Certain ethnic groups have a higher incidence of CKD, including Hawaiians and other Pacific Islanders, Asians, African Americans and Hispanics, although no ethnic group is immune.

    First Thing: Learning the truth by getting a simple screening will enable you to make changes that just may save your life.

    __________________________________

    National Kidney Foundation of Hawai‘i
    808-589-5976 | jeff@kidneyhi.org
    www.kidneyhi.org | www.kidney.org

    Generations - 2014-02 - The First Thing - Image 01

    1 Epidemiology. 2007 July; 18(4): 501–506. doi: 10.1097/EDE.0b013e3180646338
    2 AKA Framingham Offspring Study
    3 http://www.kidney.org/news/monthly/phosphorus.cfm?homestatic=PhosphorusInfographic?homeslider=Phosphorus
    4 Food and Nutrition Board, Institute

    At the National Kidney Foundation of Hawaii we are often asked about Chronic Kidney Disease (CKD) and what a person should do to find out how if he or she has the disease. There is good reason for concern. According to recent research, the lifetime risk of having moderate kidney disease for Americans is nearly…

  • February – March 2014

    February – March 2014

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    Cover Story: Off Air: Who is Frank B. Shaner?

  • Finding Funds for Long-Term Care

    Preparing for aging and care is not easy and many do not anticipate the costs associated with long-term care. Some of us assume that relatives will be able to provide care, however this doesn’t always pan out. Those who are not prepared for long-term care costs are left wondering how they will afford their care or the care of a loved one. Whether assisted living, in-home care or a nursing home is the type of long-term care needed, the costs can be overwhelming. Nursing homes on O‘ahu can charge $6,000 to $10,000 per month. This is why it is important for families to explore all of their options.

    For example, a program called the Community Care Foster Family Home Program under the State of Hawai‘i offers long-term care in licensed adult foster homes within the community. The cost for this program ranges from $3,000 to $5,500 per month. This is half the cost of a nursing home. Moreover, Medicaid covers the cost for care and services under the program for those who qualify.

    For more information, visit online at humanservices.hawaii.gov/ssd/home/adult-services, scroll down and click on the Adult Foster Care Program tab.


    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.

    Generations Magazine - Finding Funds for Long-Term Care - Image 01

    Generations Magazine - Finding Funds for Long-Term Care - Image 02

    Preparing for aging and care is not easy and many do not anticipate the costs associated with long-term care. Some of us assume that relatives will be able to provide care, however this doesn’t always pan out. Those who are not prepared for long-term care costs are left wondering how they will afford their care…

  • Start a New Tradition with Social Security

    Generations Magazine - Start a New Tradition with Social Security - Image 01The holiday season has arrived — a time of year that is steeped in tradition. We’d like to suggest that you start a new tradition. It actually starts with breaking the old tradition of trudging to an office when you need to do business with Social Security.

    Sometimes traditions evolve. Many of the things your parents or grandparents did in a Social Security office you can now do online. For example, if you’re not yet receiving benefits, you can request your Social Security Statement or use the Retirement Estimator to get an accurate picture of what your future benefits will be. You can read or listen to our publications, find out whether you qualify for benefits — even apply for Social Security disability, retirement and spouses benefits online from the comfort of home.

    You also can go online to get a replacement Medicare card or appeal a medical decision made about your disability claim. You can do all this and more at www.socialsecurity.gov.

    Set up an online account to:

    • receive your benefit verification letter
    • review benefits
    • view earnings record
    • change your address or phone number
    • start or change your direct deposit
    • check your information

    Join the millions of people and start a new tradition: forego the holiday traffic to the office by going to www.socialsecurity.gov.


    For other information and locations near you:

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

    The holiday season has arrived — a time of year that is steeped in tradition. We’d like to suggest that you start a new tradition. It actually starts with breaking the old tradition of trudging to an office when you need to do business with Social Security. Sometimes traditions evolve. Many of the things your…

  • Lotteries & Sweepstakes: You’re Not That Lucky

    Generations - 2014-12-01 - Lotteries and Sweetstakes - Image 01When Betty Lau (victim’s name changed) of Kaimuki opened her mail, she could not believe how lucky she was to find out that she won the $3-million Australian Lottery. The official looking letter explained that an unnamed company bought her a ticket as a promotional program and the enclosed Gold Credit Card from VISA contained the prize money. With the plastic card in hand, Betty felt confident this lottery was legitimate. Betty then read that the card had to be activated with a payment in order for her to gain access to the funds she had won. She was told, however, that any funds she paid would be put right back on the credit card. However, after making payment after payment, she received yet another notice that there was one more fee she had to pay in order for her to get access to the money. She had the feeling of playing a slot machine that kept showing “bar” “bar” cherry”— one more spin (or, in this case, payment) and she would win big. For the next three months, Betty sent more than $150,000 in an attempt to activate the card. It was only when she went through her entire savings account that she was forced to stop pursuing this fantasy.

    Unfortunately, the Elder Abuse Unit at the Prosecutor’s Office and the Honolulu Police Department are seeing the above scene being played out repeatedly in Hawai‘i. Letters, emails, and telephone calls are being received by seniors in increasing numbers. Each giving news that is too good to be true.

    These notices are official looking with impressive wording and says the victim must pay a small fee to receive their winnings. Some include credit cards, like in Betty’s case, while others include a real looking check. The victim is told to cash the check and send the money to another party to pay for the transaction/processing fees. The bank cashes the check without verifying it is real (because they are customer friendly after all). The victim then sends the money to the third party. When the bank discovers that the check was fake, they make the victim pay the cash back and threatens to call the police on the victim for passing a bad check.

    These scams have some things in common. Firstly, the notices state that the victim must act soon or the monies won will be put back into some sort of “general lottery fund.” Secondly, the letters advise the victims to not tell anyone they won so that they do not become victims of fraud. And finally, each of these letters ask for an advanced payment of fees in order to access the winnings.

    How can you prevent this from happening to you?

    Watch the news for information about recent scams.

    Review your bank statements for any unauthorized withdraws.

    Never rush into sending money to strangers. Talk to family, friends or financial advisors before taking action.

    Do not fill out contest entry forms. The entries are made into lists that can be bought by scam artists who can then contact you with accurate information you provided for the contest.

    And, finally, realize you are not that lucky to have won a contest you never entered.


     

    To Report Suspected Elder Abuse, call:
    Adult Protective Services
    808.832.5115
    ElderAbuse@honolulu.gov
    or visit www.ElderJusticeHonolulu.com.
    All reports are confidential.

    When Betty Lau (victim’s name changed) of Kaimuki opened her mail, she could not believe how lucky she was to find out that she won the $3-million Australian Lottery. The official looking letter explained that an unnamed company bought her a ticket as a promotional program and the enclosed Gold Credit Card from VISA contained…

  • Home Equity Into Retirement Income

    The long-struggling housing market is finally showing signs of recovery, giving many homeowners more equity in their properties. This is prompting more pre-retirees to consider if, and how, home equity can be turned into a source of cash to help fund their retirement.

    Home equity represents one of the biggest assets for many Americans. However, there are risks in assuming that your home’s equity will be a guaranteed source of income in retirement. For starters, home equity, like any investment, is subject to the fluctuations of the market and may have tax consequences. Also, you will always need a place to live, so you can’t assume that the full value of a home is at your disposal. Remember that the primary function of your home is to provide a roof over your head, and using equity to fund retirement requires careful planning. Here are three primary options:

    • Home Equity Lines of Credit (HELOC): A HELOCS (second mortgage) is a reasonable option for an employed individual, but it may be less practical for someone in retirement. HELOCs need to be repaid, and using the proceeds from a home equity loan to help fund retirement often means taking on interest costs in order to generate that income. It’s important to note that an individual puts a lien on their home by taking a HELOC, and risks losing it should he or she fail to repay under the terms of the loan.
    • Reverse Mortgage: A popular alternative is a reverse mortgage. This allows a homeowner to tap into the home equity while still occupying it. A reverse mortgage provides payment to homeowners for the bulk of the value of their homes via a lump sum, a line of credit or periodic payments. In essence, this is a loan to the homeowner paid back when the house is sold at some future date. However, interest accrues throughout the duration of the loan and upfront fees apply, so it can be expensive.

    A standard reverse mortgage, also called a Home Equity Conversion Mortgage, charges a 2 percent mortgage insurance premium on the full value of the home. The government now offers a lower cost “Saver” loan with a mortgage insurance premium of just 0.01 percent of the home’s value, but applying a higher interest rate. Over time, the combination of fees and interest charges can significantly deplete the value of the home’s equity.

    Reverse mortgage applicants must be at least 62 years old. The older a retiree is, the more he or she can receive from the home’s equity. Understanding the complicated terms of a reverse mortgage before signing on the dotted line is crucial.

    Selling & Downsizing: The other way to tap a home’s equity is to sell it. Many retirees are ready to “downsize” or to buy or rent a smaller residence. If the market is right, they can sell their existing home, buy a new place and have equity leftover to add to their retirement nest egg.


     

    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.

    The long-struggling housing market is finally showing signs of recovery, giving many homeowners more equity in their properties. This is prompting more pre-retirees to consider if, and how, home equity can be turned into a source of cash to help fund their retirement. Home equity represents one of the biggest assets for many Americans. However,…

  • Cataracts: Serious But Treatable

    Generations - 2014-12-01 - Cataracts - Image 01Cataracts affect more than 24 million Americans, with nearly 115,000 of them right here in Hawai‘i. A cataract is when the normally clear lens of the eye starts to become cloudy, which blocks and distorts light necessary for the retina to process images.

    The disease occurs naturally as we age, but some risk factors include exposure to ultraviolet light, diet, smoking, diabetes, use of some steroid medications and serious eye injuries. Cataracts usually worsen over time and can lead to blindness if left untreated.

    Signs of cataracts include blurred vision, sensitivity to light, fading or yellowing of colors, poor night vision, sensitivity to glare and seeing a halo around bright lights. People at risk should get regular eye exams and be aware of the symptoms, especially if you are over the age of 40.

    There are various methods available to correct cataracts, but the general procedure involves removing the clouded lens of the eye and replacing it with an artificial lens implant. Surgery is typically outpatient with very little pain or discomfort. Modern cataract surgery can often be upgraded to include vision correction to reduce dependence on glasses and contacts for those with vision impairments near, far and in between.


     

    Hawaiian Eye Center
    O‘ahu: 606 Kilani Ave., Wahiawa | 808-621-8448
    Big Island: 1178-A Kinoole Street, Hilo | 808-969-1419
    Toll Free 1-888-621-2020 | www.HawaiianEye.com

    Cataracts affect more than 24 million Americans, with nearly 115,000 of them right here in Hawai‘i. A cataract is when the normally clear lens of the eye starts to become cloudy, which blocks and distorts light necessary for the retina to process images. The disease occurs naturally as we age, but some risk factors include…

  • Is Physician-Assisted Suicide Legal in Hawaii?

    A large, well-funded national organization has been taking out print ads and airing TV commercials that claim that doctors in Hawai‘i are providing lethal doses of medication to individuals who desire “aid in dying.” According to the ads and commercials, this is perfectly legal because of a newly discovered loophole inHawai‘i law.

    As it turns out, however, the ads and commercials ignore what Hawai‘i’s chief law enforcement officer, attorney general David Louie, has said about this topic. In an opinion letter dated December 8, 2011, Louie addresses:

    • whether section 453-1 of the Hawai‘i Revised Statutes (the supposed newly discovered loophole) authorizes a physician to assist a terminally ill patient with dying
    • whether any criminal laws prohibit “aid in dying”

    Louie opines that the loophole being touted in favor of physician-assisted suicide simply allows doctors to prescribe unconventional “remedial agents or measures” (i.e. medication or treatment intended to make the patient better — or at least to provide pain relief and comfort), not cause the patient’s death. In the attorney general’s view, the law clearly does not allow doctors to prescribe lethal doses of medication.

    As to the second question, Louie opines that physician-assisted suicide would constitute the crime of manslaughter. However, proving that the crime had been committed would involve convincing a jury that the physician intended for the patient to commit suicide, and that the lethal medication prescribed by the physician accomplished its intended task. As we all know, proving that a crime has been committed is not necessarily an easy task. But the fact that a crime is difficult to prove does not mean that no crime was committed. Obviously, any physician who follows interpretation of Hawai‘i law urged in the current advertising blitz could be in for serious trouble.

    So don’t be fooled by the commercials and ads. Our existing hospice and palliative care (alleviating pain) physicians and services do a wonderful job of assisting the terminally ill and their families face death. There are legitimate and compassionate ways of dealing with end of life issues that do not involve suicide or raise the prospect of euthanasia.

    For more information, or if you would like a copy of the Attorney General’s opinion, email info@est8planning.com.


     

    Scott Makuakane, Counselor at Law
    Focusing exclusively on estate planning and trust law.
    Watch Scott’s TV show, Malama Kupuna
    Sundays at 8:30 p.m. on KWHE, Oceanic channel 11
    www.est8planning.com
    O‘ahu: 808-587-8227
    Email: maku@est8planning.com

    A large, well-funded national organization has been taking out print ads and airing TV commercials that claim that doctors in Hawai‘i are providing lethal doses of medication to individuals who desire “aid in dying.” According to the ads and commercials, this is perfectly legal because of a newly discovered loophole inHawai‘i law. As it turns…

  • All-in-One Services Help Seniors Stay Home

    It is no secret that the number of individuals over the age of 60 is increasing exponentially. Without massive changes to operations, there will be no way to effectively meet the needs of seniors in the future. This we know. What may not be so evident are the strides forward that the Hawai‘i State Executive Office on Aging and the Area Agencies on Aging (AAA) in Hawai‘i are making in “getting ahead” of the population boom.

    About 18 months ago, the Maui County Office on Aging (MCOA) implemented a new assessment protocol that each AAA in Hawai‘i will eventually use. (Kaua‘i began the use of the new tool a year ago). And let me warn you, it is a long assessment. So, why implement an assessment that could be construed as cumbersome and downright bothersome for frail seniors?

    The answer lies in what seniors and family caregivers end up receiving from the assessment. Imagine a senior who needs assistance in order to remain safely at home. Maybe the senior and family identify a few services that would allow him/her continued independence. Rather than having to call numerous agencies and participate in separate assessments, the AAA can conduct one assessment that provides a comprehensive view of how to help keep that senior at home.

    I like to think of the assessment as a traffic light. MCOA used to only determine the red and the green lights. We could easily identify when seniors were in the “red” and required immediate in-home assistance. We could also determine functions for which the senior required no assistance — the “green” areas. The new assessment process allows us now to identify the “yellow” at-risk areas as well. These are the areas that do not yet require intervention but that could eventually undermine the senior’s desire to remain independent at home.

    By identifying the at-risk areas, MCOA can assist families in taking a proactive approach. We no longer simply authorize necessary services, but we help the individual and family plan to avert the need for services in the future.

    So, yes, we spend a few hours getting to know the senior and family caregiver. But the time is well spent. We identify not only needs, but also areas of strength and potential areas of risk. Seniors receive a comprehensive support plan designed to meet current needs, improve function when possible, and prevent further decline.

    This proactive approach, combined with evidence-based health promotion activities, is critical to the future success of the aging network. We know the amount of funding we receive will not keep pace with the aging population. Therefore, we must engage in coordinated planning efforts that maximize health and independence in a preemptive manner and be able to meet the needs of at-risk seniors for years to come.


    Maui County Office On Aging
    J. Walter Cameron Center
    95 Mahalani Street, Rm. 20, Wailuku
    808-270-7774 | F: 808-270-7935
    Toll Free in Hawai‘i 808-643-2372 | www.co.maui.hi.us

    It is no secret that the number of individuals over the age of 60 is increasing exponentially. Without massive changes to operations, there will be no way to effectively meet the needs of seniors in the future. This we know. What may not be so evident are the strides forward that the Hawai‘i State Executive…