Taking care of our kupuna

by Senator Will Espero
District 19

Several years ago when my mother and father came to live with me, people commented, “Oh, you’re going to take care of your parents?”  I replied, “No, they’re going to take care of me.”

Hawaii has long been at the top of the list in sociologic and gerontologic research for best places to be a senior citizen.  Our Native Hawaiian culture reveres kupuna, placing value on the wisdom acquired by them, and according them high esteem in society.  The Pacific Rim and Asian immigrants brought with them their cultural values of filial piety for the elderly, displayed through their practices of revering parents and grandparents.  Unlike the predominant nuclear families on the mainland, many Hawaii families live in extended families, where the three generations care for, educate, support, and nurture each other.

Nearly one out of five residents of Hawaii is over 60 years old.  With the growing population of aged citizens, there is, thankfully, broad responsiveness to the common needs of this section of our community.  The City and County’s Elderly Affairs Division has a comprehensive resources guide entitled, “Senior Information & Assistance Handbook.”  You can call the Elderly Affairs Division Senior Helpline at 768-7700 or visit its website at www.elderlyaffairs.com.  Kokua Kalihi Valley’s Comprehensive Family Services also publishes a helpful resource guide entitled, “Housing Options For Seniors on Oahu.”

Housing

To move or not to move, that is the question.  Does a person’s current home provide the best environment for his physical needs?  Is or will his home be in disrepair due to inability to maintain it?  Does the home have adequate security?  Does the person need help for basic daily activities?  Those seniors who choose to stay where they are may find that the home modifications they require may be expensive.  Non-slip floor covering, grab bars in the shower and tub area, lever type handles, or increasing doorway width, among others, may also be needed.  Those seniors who choose to move have a variety of choices.  They can have a live-in health aide, or go to senior centers during the day, have in-home care, or group homes.

Caregiving

The Department of Veterans Affairs, www.eldercare.gov publishes a helpful series of caregiver pamphlets.  Among the topics:  “Caring for the Caregiver”; “50 Things Every Caregiver Should Know”; “A Checklist for New Caregivers”; “Rewards of Caregiving”; “Balancing Caregiving, Family and Work”; and “5 Tips to Avoid Caregiver Burnout.” 

The level of home care assistance differs based on the condition and abilities of the person.  A Health Companion can provide accompaniment during outings, housekeeping, stand-by assistance with bathing or dressing, meal preparation, and the like.  A Home Health Aide-Basic renders personal assistance such as wheelchair transfers, turning and positioning, dressing, feeding, vital sign monitoring, toileting, and exercise to maintain range of motion.  Seniors who need medical monitoring may require a Home Health Aide – Advanced.  For example, these could include care for bedbound persons, those with catheters or enemas, or who need blood glucose or blood pressure monitoring, and similar functions.  For seniors requiring more stringent nursing care, a Licensed Nurse may be needed, for example, patients who need nasopharyngeal suctioning, NG tube feedings, IV tubes, or ventilators. 

Transportation

Disabled persons can obtain a Parking Permit at any satellite city hall.  Seniors can ride TheBus at a discount.  The Senior Annual Pass costs $30 and can be purchased at TheBus’s main office at 811 Middle Street.  The Handi-Van provides curb-to-curb service for those who may not be able to walk as far.  A number of transportation companies operate to furnish either door-to-door or curb-to-curb services at various prices depending on the distance of the trip. 

Does my parent have Alzheimer’s?

The Alzheimer’s Association, in collaboration with the Office of Hawaiian Affairs, has a hand-sized booklet “10 Signs Every Hawaiian Should Know – Is it Alzheimer’s or just signs of aging?”  that explains in an easy-to-understand way, what is normal and what is Alzheimer’s.  They can help you find the right doctor, provide information and support (591-2771 for Oahu or 242-8639 for Maui).  It’s normal to occasionally forget names or appointments , why you came into a room and what you planned to say, or where you were going or what day of the week it was, and to misplace your keys or wallet, or have a hard time balancing your checkbook. 

In contrast, an Alzheimer’s patient may forget what numbers are, where they are, how they got there or how to get back home.  He may find it hard to plan or complete everyday tasks, such as preparing a meal, place a phone call, or play a game.  He may dress inappropriately, wearing several layers of clothing on a warm day or too little clothing in cold weather.  He may put things in unusual places, such as placing an iron in the freezer or wristwatch in the sugar bowl. 

As our citizens age, all of us will be affected.  Whether you are a caregiver or an elderly person, you are not alone.  There are many resources available to help if you need assistance and guidance.