Aloha! When we hear the words “kūpuna care,” it can bring forth many thoughts, perhaps of taking care of a parent, grandparent, neighbor or friend. For me, “kūpuna care” has also meant a career of three decades working in senior care communities in California and Hawai‘i. As a licensed administrator, I’ve been there in the continuum of care: independent living, assisted living, memory care and skilled nursing. I strived, with other staff members, to provide the highest quality of care and services.
Family caregiving
Like many baby boomers, I have also been a family caregiver. From Mom to an uncle, it has been a journey of applying working knowledge of quality of care, regulations, psycho-social needs, Alzheimer’s disease and other dementia types, finding caregivers for home care and end-of-life care, and discovering the true grit of a team of first-time family caregivers.
As I age, and kūpuna in my family age, we share with each other our inter-generational experiences of growing up in Hawai‘i nei, working for a living and raising a family. And, as we retire into the sunset, we reflect on the contributions our ancestors made so we could, hopefully, have a better life.
Showing love by being present
In the year 1987, at the first skilled nursing facility I worked at in Sacramento, CA, I met two sisters who drove from the Bay Area to Sacramento to see their issei mother every weekend. Their mother was in advanced dementia, but just their presence showed undeniable love for their mom. I observed them talking to her with reminiscences of childhood days, raising families, work, then retirement.
In Hawai‘i we simply “talk story.” Talking story is such a relaxing way of communicating. Talking story reflects the “hanabata days” of being a “runny-nosed” kid. Remember when…? What neighborhood…? What high school…? You know so-and-so…? All these are ways of sharing. Even though a senior may repeat these stories, it is aloha to listen and share with them, bringing love and comfort. This is just one aspect of senior care and, for me, my most treasured memory as a caregiver of Mom and Uncle.
Aloha! When we hear the words “kūpuna care,” it can bring forth many thoughts, perhaps of taking care of a parent, grandparent, neighbor or friend. For me, “kūpuna care” has also meant a career of three decades working in senior care communities in California and Hawai‘i. As a licensed administrator, I’ve been there in the…
Deciding when is the right time to find senior care for your kupuna can be an intimidating task. You want to provide the best care possible for them, but how do you know if it’s the right time; where do you start? First, understand and identify the level of care your senior needs to conduct day-to-day activities and care for themselves. Identifying your senior’s needs early in your search will help you understand the options available. Keep in mind that the level of care can change over time as conditions change.
There are two main categories for long-term care solutions for seniors: senior communities and residential care homes. In senior communities, kūpuna live together in an apartment-like setting and interact with one another through daily, scheduled activities. They dine with other residents. In residential care homes, three to five seniors are cared for in a home-like setting. Residents get more individualized attention and all of their needs are taken care of.
Finding great healthcare for your loved ones is hard to do on your own. Each year, we see hundreds of seniors in Hawai‘i finding themselves incapable of living independently at home.
How do we get Mom and/or Dad out of the home when they don’t see the need, even though they have fallen multiple times?
After a fall, your senior is feeling fearful and may be resistant to change. During gentle conversations over time, explain that finding care comes from a place of love and wanting them to live a safe and healthy life.
What about dementia care?
Questions to ask a care home or facility about a patient’s dementia care include:
• Is the staff experienced in working with residents with dementia/Alzheimer’s?
• What approaches are used to diffuse a situation with an agitated dementia/Alzheimer’s resident?
• What kind of activities are available to help stimulate a resident’s mind and body?
• Are they open to working with the resident’s geriatric team and family?
Deciding when is the right time to find senior care for your kupuna can be an intimidating task. You want to provide the best care possible for them, but how do you know if it’s the right time; where do you start? First, understand and identify the level of care your senior needs to conduct…
Volunteer honoree delegates throughout the state were celebrated on Friday, June 5th, at Cafe Julia, Honolulu, with the directors of each Hawai‘i county for the Executive Office on Aging (they are also known as the AAAs).Volunteer honoree delegates (L–R top) Roger Caires (Kaua‘i), Robert Ferolano (Hawai‘i Island), Donald Jensen (Maui), Alan Kumalae (O‘ahu), (middle): Pat Simpson (Kaua‘i), Janet Murakami (Hawai‘i Island), Katsuko Enoki (Maui), Yolanda Morreira (O‘ahu); (bottom) AAA directors Nalani Aki, (O‘ahu County), Deborah Stone-Walls (Maui County), Kealoha Takahashi (Kaua‘i County), Kimo Alameda (Hawai‘i County).
An Introduction by Terri Byers, Director of Executive Office on Aging
Mahalo to Generations Magazine for the opportunity to introduce myself to you. When I was appointed director of the state Executive Office on Aging (EOA) by Gov. David Ige earlier this year, I joined a fantastic team of professionals and volunteers dedicated to honoring our kupuna. The office is funded primarily by grants under the Older Americans Act, state appropriations and other federal grants. EOA has a staff of 25, assisted by volunteers from the Long Term Care Ombudsman program, the Senior Medicare Patrol and the Hawai‘i State Health Insurance Program.
We work with all four county Area Agencies on Aging (AAAs) via local Aging and Disability Resource Centers (ADRC) to enable older adults to live in their own homes for as long as possible. Connecting them to direly needed support and services can be a complex process.
Alternatives to institutional care are called home and community based services. In Hawai‘i, these supports are made available through DHS, Quest Integration (QI), EOA’s Kupuna Care and Older Americans Act services provided through your county’s AAA. EOA provides training and technical assistance to the AAAs so they can meet federal guidelines for a fully functioning ADRC.
A Driving Need for Change
Section 2402(a) of the Affordable Care Act requires the U.S. Department of Health (DOH) and the Hawai‘i Human Services (HHS) create regulations that:
Respond to beneficiary needs and choices;
Provide strategies to maximize independence, including client-employed providers; and
Provide support and coordination necessary for “individualized, self-directed, community-supported life.”
We use ADRC as a mechanism to comply with these federal requirements, and we are actively seeking new private and nonprofit partnerships to help us serve the needs of older adults and family caregivers. Read on and find out what’s going on in your county. You will see why I am excited about the future of aging in Hawai‘i. To become involved with EOA planning activities, please call our office at 808-586-0100.
COUNTY OF HAWAI’I
by C. Kimo Alameda, HI County Executive Director, Office on Aging
Kupuna Care (KC) program provides funds to “… help frail and vulnerable older persons lead independent, meaningful and dignified lives in their own homes and communities.” Services for Seniors and the Hawai‘i County Office of Aging (HCOA) has increased the number of seniors receiving Kupuna Care funding in Hawai‘i County by creating a unique case management and transition approach, that doubles the impact of the state’s fiscal investment while ensuring seniors are safe, happy and living in their homes with their families for as long as they choose.
Services for Seniors Office Team, (L–R) Kim Takehiro-Jack, Michelle Yamasaki and Tessie Hernando
Of 273 KC-funded seniors receiving case management from Services for Seniors in 2014, 77 percent were able to stay in their homes at an average cost of $1,200 per month. This is an astonishingly low figure when average monthly costs at Hilo’s Life Care Center run $12,405, Okutsu VA at $11,200 and Foster Home Care or a Care Home between $3,000 and $5,000. Services for Seniors reduced out-of-pocket costs through its “least restrictive placement” approach to transition planning that involves the development of lasting informal partnerships for seniors at every level.
After a Kupuna Care consumer receives three to six months of case management and wrap services, Services for Seniors staff works diligently to replace formal services with community and volunteer supports. These supports are provided by caregivers in the family, friends, faith-based members and/or community volunteers willing to be a part of the consumer’s caregiving team. Transition to informal supports reduces the use of Kupuna Care funds, which then enables other eligible seniors to participate in the program. This system also reduces the number of consumers on a wait list, allowing Services for Seniors to help a larger number deserving elders age in place with dignity.
For every Kupuna Care dollar HCOA and Services for Seniors spends, the State of Hawai‘i and its taxpayers save either $2 to $3 in foster care home costs, or $10 to $12 in long-term residential costs. By listening to our kupuna and connecting them to their circle of support, Services for Seniors creates successful relationships that benefit the whole community.
Active Seniors Give Back Through RSVP
Hawai‘i County’s Elderly Activities Division is one of the most active senior entities in the state, serving over 12,000 older adults. One of its prized programs is the Retired & Senior Volunteer Program (RSVP) that places close to 1,700 Hawai‘i Island seniors in over 150 volunteer stations. This year, RSVP celebrates 42 years and will accumulate 130,000 hours of service — a value of $1.3 million given back to the community. RSVP also gives our active seniors meaningful volunteer work that enables them to engage with their community as well as live independently in their own homes.
You never know whom you might run into as you walk the halls of Hawai‘i County’s Aging and Disabilities Resource Center. How would you like to chat with a guy who was inducted into the Volleyball Hall of Fame?
Pete Velasco, RSVP Volunteer
Hall of famer and Olympic volleyball legend Pedro “Pete” Velasco is an RSVP volunteer who spends several hours a week answering the phone and welcoming walk-in clients at Hawai‘i County’s Nutrition (HCN) program — one of many duty stations available to RSVP volunteers aged 55 and older. Pete’s wife, Adelle, oversees the Keaau HCN program. “She introduced me to RSVP,” says Pete. “I answer phones, and I help make connections between people.”
Pete Velasco and Tom Haine, 1966 USVBA National Champioships
Connections between people and leadership is what led Pete to the pinnacle of volleyball — first as part of the Outrigger Team that won tournaments across the nation in the ‘50s. He played on the United States National teams at the 1963 and 1967 Pan American Games. In 1964, he was elected captain of the USA Olympic volleyball team for the Tokyo games, where volleyball was first recognized as an Olympic sport. He returned to the Olympics in Mexico City in 1968.
Pete has a great recipe for life: “I live by seven words — commitment, dedication, and sacrifice. If you do these three things, God is bound to give you success. But to maintain success you need the next two words — creativity and innovation. And to perpetuate the success you need the final two words — humility and compatibility.” Pete is truly a humble man. “At my point in life, I give from the heart. You don’t owe me anything, because I already received when I gave to you.”
Pete is still winning points, answering telephone requestsat the ADRC office, and finding out the answers.
Giving is what RSVP is all about. Pete says, “I love what I do. The RSVP program helps me to share my aloha with those I can help.”
Join RSVP and share your aloha with those you can help. RSVP volunteers come from all walks of life: homemakers, landscapers, postal workers, salespersons and coffee growers all bring their successes and wisdom to their volunteer work. If you are over 55 and can commit to several hours a week, please call 808-961-8730 or visit our office at Kamana Senior Center, 127 Kamana St. in Hilo. And contact our ADRC office for information on our various programs and services.
by Deborah Stone-Walls, Maui County Executive on Aging
Maui County Office on Aging (MCOA) is an office filled with activity. Since implementing standardized tools and procedures of the Aging and Disability Resource Center (ADRC), new referrals to MCOA have increased as much as 400 percent a month. While the numbers of seniors and individuals with disabilities requesting assistance has increased, the available funding to serve the seniors of Maui, Moloka‘i, and Lana‘i has remained mostly static. Therefore, MCOA finds it necessary to look for opportunities to creatively solve the issue of how to meet the increasing need without the luxury of an increase in funding.
A major way that MCOA is working to find solutions is to greatly increase emphasis on helping seniors, family caregivers and individuals with disabilities improve their overall health. Two “evidence-based” (proven to create expected outcomes) healthy-aging programs now available on Maui are Better Choices, Better Health (BCBH) and Enhance®Fitness (EF).
Lana and Jose Queding of Keokea, Maui, attended a six-week Better Choices Better Health training class that “Gave us back our life,” according to Lana. Many seniors can benefit by learning how to manage their chronic disease and enjoy a better quality of life.
BCBH includes a Chronic Disease Self-Management Program (for those with a long-term health conditions, such as diabetes, arthritis, heart disease, obesity, high blood pressure and many others). The six-week workshop covers how to deal with pain, fatigue and frustration, and teaches action planning, in addition to ways to improve fitness and manage medications.
Another BCBH workshop is the Diabetes Self- Management Program (for those who are prediabetic or suffer from diabetes). Both workshops provide the necessary self-management tools that reduce symptoms and promote better health and overall enjoyment of life. The once-a-week class for people with diabetes meets for six weeks, building awareness for healthy choices, and creating good habits that allow participants to bring themselves into better control and increased overall health. Family members may attend to reinforce and support healthy choices. Jose and Lana Quedding from Keokea in Upcounty Maui are enjoying their retirement with the improved quality of life that came from attending our program.
These dynamic, interactive and fun workshops are offerred to seniors on Maui, Moloka‘i and Lana‘i. Evidence shows that program participants experience positive outcomes, such as improved health behaviors, positive changes in health, increased confidence, better communication with health providers, fewer visits to physicians, expanded support networks, more energy and less fatigue. Participants experience a better quality of life when they are no longer totally controlled by their chronic disease.
MCOA is also excited to continue work with community partners by offering Enhance®Fitness, a nationwide, evidence-based physical activity program for seniors. The program has been nationally recognized by the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Administration on Aging and the National Council on Aging. More importantly, folks on Maui who have participated in Enhance®Fitness report that they are noticeably stronger and more physically fit! Many have been astounded that physically, they now can do more than they have in years. Even small increases in strength, flexibility and balance can make household chores and errands much easier.
Leona Medeiros and Rodger Mellema have fun in Kihei’s Enhance®Fitness class. The “stepping-over-object” exercise improves balance as students lift one foot off the ground while balancing on the other leg for a short time
Enhance®Fitness is a fun, one-hour, interactive class offered three times a week at various locations on Maui and Lana‘i. MCOA is in the initial stages of planning for Enhance®Fitness implementation on Moloka‘i.
The program challenges active, older adults, as well as individuals who are unfit or near-frail, with exercises and activities geared to every level of fitness. Participants “work out” standing, seated or in their wheelchairs — each as they are able. Every class is like four classes in one: aerobics, balance, strength training and stretching. No special or expensive equipment is needed, and soft wrist and ankle weights are provided.
Enhance®Fitness instructors are specially trained. Individual participant progress is followed with fitness checks at enrollment and every four months thereafter. Exercises are safe and may be modified according to participant ability. The class also affords social interaction and reinforcement among persons who have a common desire to get healthier. Enhance®Fitness classes are a great way to get stronger, have more energy and maintain independence.
For further information on all Maui County Office of Aging programs and services, please call Monday through Friday 7:45 am to 4:30 pm:
by Nalani Aki, County Executive on Aging, City & County of Honolulu, Elderly Affairs Division
For O‘ahu elders over 60 and people with disabilities of any age, obtaining information and referral assistance starts with the Elderly Affairs Division, ADRC “one-stop” Senior Helpline: 808-768-7700. Trained community service aids assess needs and refer callers to service providers in Honolulu County, and conduct assessments for frail elders 60 and older who may qualify for publicly funded services. For example, a homebound elder in need of meals would be assessed and connected to local agencies that provide meal service.
My job is to oversee Honolulu’s Aging and Disabled Resource Center (ADRC), a component of the Elderly Affairs Division. Each month, our helpline connects answers hundreds of calls regarding long term service and supports on O‘ahu.
We understand that transportation is a challenge for many people, so ADRC is a helpline to we connect older adults and people with disabilities to the agencies that can help them. Aids answer questions Monday through Friday from 7:45 am to 4:30 pm except holidays. Many call to ask what programs are available and how to qualify; those interested in specific services may be in directly referred to a service provider. In addition to connecting O‘ahu elderly and people with disabilities to specific government and community agencies, a community service aid will also arrange to visit potential clients to verify assessment information and help them create a support plan. Many seniors wish to continue to live in their own homes, but need assistance with meals, transportation or other services. A support plan may include state or federally funded services, identifies members of support, such as family members, friends and neighbors, volunteers or paid professionals. It is a plan that covers all options for assistance — formal and informal.
A warm “aloha” from our O‘ahu EAD Staff: front row (L–R): Sandy Esaki, Kaimanaonalani Makekau, Andrea Golden, Remy Rueda, Carol Makainai, (middle row) Ryan Gallardo, Pablo Venenciano, Melanie Hite, Kelly Yoshimoto, Sharra Feliciano, Matu Marrero, Lenny Fabro, Jade Kauwe-Lopez, (back row) Robyn Meyer, Joel Nakamura, Alex Blackwell, Daleena Castaneda, Roger Clemente, Carolyn Tellio, Craig Yamaguchi. Not pictured: Carlton Sagara.
Some seniors say the hardest step is admitting that they need help and picking up the phone to ask for help. Our aids will guide you to community services that make sense and connect you to publically funded services you qualify for. ADRC also supports a website packed with information. Family members and caregivers use it most. During the next year, we plan to enhance the site for easier navigation. We are still evolving. It has taken a lot of time and effort to roll out our “onestop” helpline and ADRC services to such a large audience of seniors and people with disabilities. Agencies and community programs are changing and improving their services, too. We ask for your understanding as we continue to meet the challenge of guiding everyone to the best options to meet their specific needs.
O‘ahu’s Retired and Senior Volunteer Program (RSVP) is the volunteer end of help and assistance. RSVP engages people age 55 and over in a diverse range of volunteer activities offered by more than 25 “volunteer stations” (nonprofit or government agencies who deliver services to the elderly, as well as providing other community needs). Project Director Lenny Fabro heads this very successful island-wide program.
RSVP is federally funded under the Corporation for National and Community Services (CNCS). In 1972, it was initiated on O‘ahu by Helping Hands Hawaii. Since 2010, the City/County of Honolulu, under the Elderly Affairs Division (EAD), sponsors RSVP O‘ahu. Currently, over 200 RSVP O‘ahu volunteers contribute over 14,000 hours. “Two hundred more volunteers are needed,” says Fabro.
Carl Nakamura preparing to load his truck with meals. Carl’s duty station is “shuttling” and distributing meals outside the Honolulu area. Other volunteers will meet Carl in Wahiawa and deliver the meals to seniors.
“We make it easy for citizens to volunteer,” Fabro continues. “Persons over 55 who can commit time each week may enroll by calling 808-768-7700, or by filling out the online form at www.elderlyaffairs.com/site/460/rsvp.aspx or on Facebook at www.facebook.com/RSVPOahu. We also reach out with presentations at fairs, community gatherings and organization meetings. We invite volunteers to an orientation that explains all the many types of volunteer opportunities available. The beauty of RSVP is flexibility. Volunteers pick what they want to do based on their skills and tastes. If they want to help on Mondays delivering a meal to a senior, and on another day help with blood donors, they can do it. If an activity does not suit them, they may switch to another more compatible assignment.”
Some of the volunteer stations now available are: Hawai’i Literacy, The Next Step Shelter, Office for Social Ministry, Blood Bank of Hawai‘i, Lanakila Meals on Wheels, State Executive Office on Aging, HCAP Head Start and several elementary schools providing tutoring and mentoring. One important volunteer opportunity is with the EAD. Volunteers assist with important independent living services, such as transportation, companionship and telephone reassurance, to homebound elders. Another station that assists with independent living services is the Waikiki Friendly Neighbors program.
Fabro encourages people 55 and over, to apply their knowledge, skills, and experiences to volunteer and help meet community needs. If you have some time to commit, sign up and check out the many ways you can help our O‘ahu community.
by Kealoha Takahashi, Executive on Aging, County of Kaua‘i Agency on Elderly Affairs, Office of Community Assistance
Elders on Kaua‘i are just a phone call away from our Agency on Elderly Affairs. Our receptionist will answer requests for information, and process requests for assistance by taking the caller’s name and address and making an appointment for visit and needs assessment from a Community Service Assistant. Our goal is to be sure elders know what federal, state, county and community services are available to them, and to refer them to agencies and care providers who can deliver those services. Funding is limited and helping those who live alone is top priority.
In April, at the 2015 Mayors’ Day of Recognition for National Service, Kaua‘i Foster Grandparents Program and RSVP volunteers presented William Arakai, Kaua‘i District superintendent, with a cartful of school supplies for Kapa‘a Elementary School.
While most people call us, we also assist elders who email us, visit our office or submit questions on our website. Last year, we processed over 4,000 requests for information and referrals.
Friendly Agency on Elderly Affairs staff help Kaua‘I seniors “Live well and age well.”
Kaua‘i County is part of a nationwide Area Agency on Aging program, which was created by the Older Americans Act. It mandates that we provide elders access to health, transportation, information and referral services in our community. To be sure that all elders have access to us, we reach out to the community with presentations and workshops, too. We follow our elder clients as they age, and send caseworkers to do annual assessments.
It is important for seniors on Kaua‘I to know that services are available to them and to their families. Never believe that you have nowhere to turn.
That goes for caregivers, too. Plan ahead for the time when your loved one will need more help than you can give. Find out what services are available to you now and in the future. Don’t wait until you are exhausted and stressed out before you call for assistance with your loved one. We have information about daycare for elders and respite services for worn out caregivers that can help them manage better and maintain their own mental and physical health. Call us — we can help.
Kaua‘i RSVP Volunteer Opportunities
The Corporation for National Community Services (CNCS) grants funds to Kaua‘i County that help pay for Community Service staff salaries. Actually coordinating and delivering services takes the work of a full community. On Kaua‘i, over 350 volunteers donate their time to assist 24 different organizations that deliver services to the elderly. All skills can be used to help others. If you want to learn new skill, we will teach you. All you need is to be active, age 55 or older, and able to commit to several hours a week to help the elderly. To volunteer, call 808-241-4479.
Foster Grandparents Program
Another statewide program that CNCS funds is Foster Grandparents. This program teams elders with school children who don’t have grandparents. Educational research shows that kids who spend time with grandparents perform better in school. Undivided attention, unconditional friendship and mentoring from elders can create a positive framework for the child at school and play.
Healthy Aging Program on Kaua‘i
It’s never too late to get healthy! We encourage seniors to participate in our newest programs for healthy aging. Doctors have proven that exercise and careful management of chronic disease can keep body, heart and mind healthy as we age, and improve quality of life.
Enhance®Fitness classes are very popular with seniors, because exercises are modified to each senior’s ability. Here, participants do upper body strength training while seated.
Enhance®Fitness
We currently run nine Enhance®Fitness classes at seven different sites on Kaua‘i. Instructors monitor students’ progress and record increased flexibility, balance, overall strength and endurance. Fitness also improves attitude. Just the social interaction of attending class is a happy benefit for elders who spend most of their time at home.
Diabetes Self-Management Workshop
This important program meets once a week for six weeks. It helps diabetic seniors make better choices. We currently have a two-hour-a-week Diabetes Self-Management workshop that helps diabetics keep their “numbers” under control, become more active and generally feel better.
For more information on Healthy Aging workshops on Kaua‘i, please call or visit us oline.
AAA – Area Agencies on Aging ADRC – Aging & Disability Resource Center AEA – Agency on Elderly Affairs (County of Kaua‘i) BCBH – Better Choices, Better Health CNCS – Corporation for National & Comm. Services DHS – Department of Human Services DOH – Department of Health EAD – Elderly Affairs Division (County of O‘ahu) EF – Enhance®Fitness EOA – Executive Office on Aging HCEAD – Hawai‘i County’s Elderly Activities Division HCN – Hawai‘i County’s Nutrition HCOA – Hawai‘i County Office of Aging HHS – Hawai‘i Department of Human Services KC – Ku¯puna Care MCOA – Maui County Office of Aging QI – Quest Integration RSVP – Retired & Senior Volunteer Program
In a state with a high cost of living — where one in five residents will be 65 or older by 2032 — island residents are worried about paying for long-term care. In Hawai‘i, costs range from $17,500 for one year of adult day care to about $126,000 for private nursing home care — more than twice the median household income.
In a recent AARP survey, most members expressed little confidence they could afford the cost of nursing home care, and half doubted they could even afford less expensive care in their own homes. That could mean additional pressure on family caregivers in the future, the number of whom is projected to decline as the number of residents requiring some form of care increases over the next 20 years.
To address these concerns, AARP Hawai‘i is making long-term care a priority issue in the 2013 legislative session. Our goals include:
Support for Kupuna Care — AARP supports an appropriation of $9 million for Kupuna Care from the base budget. Kupuna Care is a state-funded program designed to meet the needs of frail older adults who cannot live at home without help from family or formal services.
Support for the Aging and Disability Resource Center (ADRC) — AARP supports an appropriation of $1.8 million for continued implementation and state-wide expansion of ADRCs. ADRCs are designed to help eliminate confusion by providing a “one-stop shop” for residents looking for long-term care services. A recent AARP report ranked Hawai‘i 41st in the nation in the ability to access long-term care through an ADRC.
Investigate the Cost of a Public Long-Term Care Insurance Program — AARP supports the study of the cost and feasibility of a limited mandatory public long-term care program, as recommended by the Hawai‘i Long-Term Care Commission. The study would identify eligibility requirements, benefit amounts, benefit period, and premium payments.
To find out more about the long-term care challenges facing Hawai‘i, or to get involved as a volunteer advocate, call 808-545-6005.
Pension Tax Posse II
AARP Hawai’i’s Top Legislative Priority in 2013 In a state with a high cost of living — where one in five residents will be 65 or older by 2032 — island residents are worried about paying for long-term care. In Hawai‘i, costs range from $17,500 for one year of adult day care to about $126,000 for private nursing home…
“We need to face our challenges together, and build a Hawai‘i for all ages.”
As Neil Abercrombie marched into the governorship of Hawai‘i, he carried with him a manifesto — A New Day In Hawai‘i. One of the plan’s key points was to enhance the quality of life for older adults — even to ambitiously turn age into an asset.
Now that it’s been just about 365 “new” days (or one year), since Abercrombie assumed office, Generations Magazine sat down with the governor to see whether, indeed, a new day is dawning for seniors in Hawai‘i.
GM: What is the fire in your belly that motivates you to want to help seniors and make it a significant part of your administration’s goals?
NA: I grew up during the Depression in Buffalo, New York, a city with many ethnic and religious divides. I often got into fights to defend me and others for having the “wrong” background. It was also during a time when women faced open discrimination. I witnessed the injustice of working women, such as my mother Vera, who received lower pay and benefits simply because of their gender. Through this and other childhood incidents, my mother taught me the importance of fairness, equality and of standing up for what was right. I was taught that big kids shouldn’t pick on little ones, I believed it and believe it now.
When I was first elected to public office, my mother reminded me of how she was treated unfairly and to always fight for those who can’t fight for themselves. In these times, the most vulnerable are often our seniors.
Prior to the 2010 elections, I knew we were facing the most trying time in the history of the State of Hawai‘i. I felt the responsible thing to do was to utilize my relationships in Congress and the White House and my decades of legislative experience to address important social issues, such as aging, in these difficult times as Governor.
GM: Set the stage for us …what is the status of our retirees and elders in Hawai‘i?
NA: First off, I want to say nearly ninety-five percent of people over 60 are active, engaged and want to contribute. In that way, our ku¯puna are a tremendous economic and social asset. However, we often view aging through a deficit or sick-care lens. My administration is changing that viewpoint. We’re partnering with senior advocacy groups to redefine social attitudes about aging.
For example, this year our Executive Office on Aging joined the United States Administration on Aging in proclaiming the month of May as “Older Americans Month” in Hawai‘i. The recognition celebrates the role older Americans play in steering the course of our history and recognizes them for their valuable insights and wisdom. We honored seniors by showcasing them as “treasured resources,” united by historical experiences and strengthened by diversity.
We understand that older Americans are now living healthier, longer and richer lives. We look forward to the many accomplishments they will offer our local communities in the future.
GM: Besides creating awareness, what are you doing to help seniors stay integrated into the whole of society?
NA: Seniors who want to work or volunteer, should be able to. It is part of government’s job to make sure that they have a chance to do so. It’s part of our plan to create a “silver wave” of opportunities for active older adults. Through incentives and partnerships we are encouraging non-profits and businesses to create flexible paid and volunteer opportunities for seniors. We also recognize model employers who bring in retirees to serve as mentors and trainers.
Senior Corps is one great example of the“silver wave” at work. The program taps the skills, talents and experience of individuals age 55 and better to meet a wide range of community needs through three programs: RSVP, Foster Grandparents and Senior Companions.
RSVP connects volunteers with service opportunities in their communities that match their skills and availability. Volunteers conduct safety patrols for local police departments, participate in environmental projects, provide intensive educational services to children and adults and respond to natural disasters, among other activities. Foster Grandparents serve one-on-one as tutors and mentors to young people with special needs. Senior Companions help homebound seniors and other adults maintain independence in their own homes. I encourage seniors to inquire about these volunteer opportunities at the Hawai‘i Aging and Disability Resource Center (643-2372). For an update on the RSVP Program, click here.
Also, Kapi‘olani Community College’s Kūpuna Education Center offers assistance in comprehensive life planning and upgrading skills, including lifelong and/or intergenerational learning opportunities for older adults.
GM: For seniors who are less active, or need more assistance, how is your administration helping?
NA: One of the most important public challenges of our time is to ensure that our rapidly aging population of retirees and elders can live productive and dignified lives.
Currently, the state helps the most frail and vulnerable older adults through Medicaid’s QUEST Expanded Access Program (QExA). The program covers health services for nearly 39,000 Hawai‘i resident who are aged, blind and disabled (ABD). However, Hawai‘i’s Medicaid plans are plagued with rising health care costs and a growing senior population. Medicaid is on a path to exceed our ability to pay and is at risk of failing those who need it the most.
In view of that, I will continue to lobby the federal government for federal matching provisions to support the Medicaid program. My administration is also planning to attack the skyrocketing costs of health care statewide, including a greater focus on prevention, quality and on programs that demonstrate their cost savings.
The silver lining in all of this is that states all across the country are encountering similar fiscal challenges, and the Obama Administration and Congress are aware of this and looking for ways to help. With my strong ties to the White House and to Congress, I am working to move Hawai‘i to the front of the line for these opportunities.
GM: Will existing services for seniors, especially through Ku¯puna Care funding, be increased to support the growing number of seniors?
NA: For seniors who are not eligible for Medicaid, our administration will continue to provide Kūpuna Care, which is a publicly-funded service that provides services such as meals, bathing, companion and assisted transportation to people needing help with daily living.
More importantly, however, is that state and county governments are currently transforming our service delivery system. We want families to have better access to and assistance with navigating our long-term supports and services.
For example, through the Aging and Disability Resource Centers in each county, we will provide information and referrals in a very person-centered manner. We hope to empower families and caregivers to make informed decisions about their options. The goal is to streamline access to the public and privately funded services and support, such as counseling, case management and programs such as the before mentioned Ku¯puna Care and QUEST Expanded Access.
GM: As you know, many adult children take care on their aging parents. Although most wouldn’t have it any other way, caring for our elderly parents and grandparents can be difficult. How does the state support those who embrace it as their duty?
NA: I understand how difficult caregiving can be. My mother-in-law was incapacitated for almost seven years. I saw every variety of care facility and workforce caliber. Only the professional dedication of health care personnel enabled my wife and me to get through the ordeal with her.
Despite government’s best efforts over the years to provide all of our kūpuna care, our efforts are falling way short of the mark. Too many older adults and their families are without the support and resources they need, forcing them to turn to more expensive and less desirable living situations. For seniors who are alone and impoverished, the situation is even worse.
Out of this crisis, we have found opportunities. Hawai‘i is a very adaptable and resourceful place. As such, Hawai‘i is the nation’s leader in intergenerational households. Grandparents are routinely involved in raising grandchildren. And adult children oftentimes care for their aging parents. These family caregivers are the backbone of our system of support and services for older adults. They care for our kūpuna in a way the government can’t — emotionally and fiscally.
Family caregivers allow people to grow older in their own homes and communities, without requiring a huge and expensive new government program. In fact, the estimated economic value that family caregivers provide is about $2 billion, which is more than government can afford to spend on care and why it’s so important to help family caregivers in areas such as respite, care coordination, and education and training.
GM: Do you have a ‘A New Day In Hawai‘i’ legacy that you would like to leave behind?
NA: For the senior and aging component of A New Day In Hawai‘i, I hope to develop a Hawai‘i Center of Excellence on Aging. This is something that can continue to grow in years to come after I leave office.
I’d like to see our university system, community colleges, the private business sector and non-profits come together to obtain funding for major research and cutting-edge projects around the subject of aging. We already have outstanding experts and programs at Kapi‘olani Community College, the University of Hawai‘i at Mānoa and community-based programs throughout the Islands. These can be coordinated to develop training programs, career paths in gerontology, and new advancements that can benefit people in Hawai‘i and can be exported around the world, particularly in China, Japan and Korea, which are rapidly aging. There is no reason why Hawai‘i cannot be a world leader in this field.
GM: This was just year one of your governorship … you have three more years to see your plan come to fruition. Do you have a parting message for our readers?
NA: Well, last but not least, I do believe government has a responsibility to build a streamlined system of supports and services for families. I note, however, that the care of Hawai‘i’s kūpuna is a shared responsibility. No one entity can do this alone. From philanthropic organizations to the for-profit sector, from government to non-profits, from individuals and families to clubs and associations, we all have resources — monetary, in-kind, volunteer, ideas, time — to contribute to care for our kūpuna and to create the society that we want to live in.
We need to face our challenges together, and build a Hawai‘i for all ages.
Every place on Earth, whether it be a large metropolitan city in Asia or an isolated Island community like Hawai‘i, has a culture that was created over time by the inhabitants of that place. That’s why all of us who live in these Islands must never forget that we owe much to the generations who came before and to the older people in our community. They helped to educate us, form our ideas about brotherhood and establish the spirit of Aloha that pervades our home. I extend to all of our seniors my most heartfelt appreciation for their past contributions and wish them all the very best.
GM: What do you have planned for retirement once your term is over?
NA: I’ll help wherever and whenever I can, but I’m not looking for any other job. This run for Governor was the culmination of a lifetime of public service. This is the last public office I will hold. In retirement I plan to walk my dog Kanoa every day, read and spend more time with my wife, Dr. Nancie Caraway.
“We need to face our challenges together, and build a Hawai‘i for all ages.” As Neil Abercrombie marched into the governorship of Hawai‘i, he carried with him a manifesto — A New Day In Hawai‘i. One of the plan’s key points was to enhance the quality of life for older adults — even to ambitiously turn age into an…
Aloha! When we hear the words “kūpuna care,” it can bring forth many thoughts, perhaps of taking care of a parent, grandparent, neighbor or friend. For me, “kūpuna care” has also meant a career of three decades working in senior care communities in California and Hawai‘i. As a licensed administrator, I’ve been there in the continuum of care: independent living, assisted living, memory care and skilled nursing. I strived, with other staff members, to provide the highest quality of care and services.
Showing love by being present
Kupuna Care (KC) program provides funds to “… help frail and vulnerable older persons lead independent, meaningful and dignified lives in their own homes and communities.” Services for Seniors and the Hawai‘i County Office of Aging (HCOA) has increased the number of seniors receiving Kupuna Care funding in Hawai‘i County by creating a unique case management and transition approach, that doubles the impact of the state’s fiscal investment while ensuring seniors are safe, happy and living in their homes with their families for as long as they choose.
After a Kupuna Care consumer receives three to six months of case management and wrap services, Services for Seniors staff works diligently to replace formal services with community and volunteer supports. These supports are provided by caregivers in the family, friends, faith-based members and/or community volunteers willing to be a part of the consumer’s caregiving team. Transition to informal supports reduces the use of Kupuna Care funds, which then enables other eligible seniors to participate in the program. This system also reduces the number of consumers on a wait list, allowing Services for Seniors to help a larger number deserving elders age in place with dignity.
Maui County Office on Aging (MCOA) is an office filled with activity. Since implementing standardized tools and procedures of the Aging and Disability Resource Center (ADRC), new referrals to MCOA have increased as much as 400 percent a month. While the numbers of seniors and individuals with disabilities requesting assistance has increased, the available funding to serve the seniors of Maui, Moloka‘i, and Lana‘i has remained mostly static. Therefore, MCOA finds it necessary to look for opportunities to creatively solve the issue of how to meet the increasing need without the luxury of an increase in funding.
A major way that MCOA is working to find solutions is to greatly increase emphasis on helping seniors, family caregivers and individuals with disabilities improve their overall health. Two “evidence-based” (proven to create expected outcomes) healthy-aging programs now available on Maui are Better Choices, Better Health (BCBH) and Enhance®Fitness (EF).
Enhance®Fitness instructors are specially trained. Individual participant progress is followed with fitness checks at enrollment and every four months thereafter. Exercises are safe and may be modified according to participant ability. The class also affords social interaction and reinforcement among persons who have a common desire to get healthier. Enhance®Fitness classes are a great way to get stronger, have more energy and maintain independence.
For O‘ahu elders over 60 and people with disabilities of any age, obtaining information and referral assistance starts with the Elderly Affairs Division, ADRC “one-stop” Senior Helpline: 808-768-7700. Trained community service aids assess needs and refer callers to service providers in Honolulu County, and conduct assessments for frail elders 60 and older who may qualify for publicly funded services. For example, a homebound elder in need of meals would be assessed and connected to local agencies that provide meal service.
O‘ahu’s Retired and Senior Volunteer Program (RSVP) is the volunteer end of help and assistance. RSVP engages people age 55 and over in a diverse range of volunteer activities offered by more than 25 “volunteer stations” (nonprofit or government agencies who deliver services to the elderly, as well as providing other community needs). Project Director Lenny Fabro heads this very successful island-wide program.
Some of the volunteer stations now available are: Hawai’i Literacy, The Next Step Shelter, Office for Social Ministry, Blood Bank of Hawai‘i, Lanakila Meals on Wheels, State Executive Office on Aging, HCAP Head Start and several elementary schools providing tutoring and mentoring. One important volunteer opportunity is with the EAD. Volunteers assist with important independent living services, such as transportation, companionship and telephone reassurance, to homebound elders. Another station that assists with independent living services is the Waikiki Friendly Neighbors program.
Elders on Kaua‘i are just a phone call away from our Agency on Elderly Affairs. Our receptionist will answer requests for information, and process requests for assistance by taking the caller’s name and address and making an appointment for visit and needs assessment from a Community Service Assistant. Our goal is to be sure elders know what federal, state, county and community services are available to them, and to refer them to agencies and care providers who can deliver those services. Funding is limited and helping those who live alone is top priority.
That goes for caregivers, too. Plan ahead for the time when your loved one will need more help than you can give. Find out what services are available to you now and in the future. Don’t wait until you are exhausted and stressed out before you call for assistance with your loved one. We have information about daycare for elders and respite services for worn out caregivers that can help them manage better and maintain their own mental and physical health. Call us — we can help.
GM: This was just year one of your governorship … you have three more years to see your plan come to fruition. Do you have a parting message for our readers?