Cara had to face it — after 7 years, she couldn’t care for Dad at home any more. He needed 24/7 supervision and care and she was worn out. After calls to five facility managers, and getting no answers she collapsed in tears. Cora needed help right now…

Cara’s story replays every day. Caregivers get beyond the limit of their own strength without even realizing it. Their loved one may not qualify for skilled nursing, but is already well beyond the care limit of assisted living.

Some seniors are much happier in a small care facility that can provide increased care options when needed.

Some seniors are much happier in a small care facility that can provide increased care options when needed.

Hawai‘i has two more levels of care between Assisted and Skilled nursing: Adult Residential Care Homes (ARCH) which offers 24/7 supervision for safety and care for clients under the direction of a facility RN. An additional level of care is provided by Intermediate Care Facilities (ICF), with 24/7 care below the level of skilled nursing, but each client’s care is managed by an independent RN case manager, required by Hawaii State Department of Health. Case managers may cost an extra $500–$800 per month. Long-term care costs top out at skilled nursing facilities (SNF), which cost about $10,000/month in Hawai‘i.

Some large care facilities offer independent living and all levels of care in different branches of their complex. A change in a person’s care level would mean moving to another section of the property, away from familiar clients, personnel and surroundings. Clients who choose smaller, friendly care homes without options for increased care services may have to move to a different facility when they require more care. When looking for placement in a small care home, one should try to find one that is licensed to provide intermediate care and has an Expanded Care License for skilled nursing care. Avoid the hassle and distress of moving when the inevitable happens.

Most of all, be looking ahead, and don’t put off transition to a care facility until you are too exhausted to make a good decision. Your loved one and you will be much better off.


Kina ‘Ole Estates: Enriched. Dependable. Senior Living
45-225 William Henry Road, Kaneohe
808-233-4455 |