Aging Disability Issues 2020 - Hawaii State Department of Health
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Aging Disability Issues 2020
A Guide for Hawai‘i’s Legislators, Organizations & Citizens
Cover photo: Haleakala National Park Aging & Disability Issues 2020 Sunset, Kaua‘i, Hawai‘i Contributing Authors Kevin Dusenbury, BS Craig Gima, BA Cullen Hayashida, PhD John G. McDermott, LSW, ACSW, MDiv Ian Ross, BA Gary Simon Eldon Wegner, PhD Kathy Wyatt, RN, MSN, MBA, LNHA Sarah Yuan, PhD Authors of personal stories acknowledged with re- spective stories where known. Hawai‘i Family Caregiver Coalition Board of Directors Kevin Dusenbury, BS Cullen Hayashida, PhD Lyn Moku David Nakamaejo Cyndi Osajima, MPH Gary Simon Audrey Suga-Nakagawa, MPH Helen Wagner Francine Wai, MA Eldon Wegner, PhD Kathy Wyatt, RN, MSN, MBA, LNHA
TA B L E O F C O N T E N T S
&
Aging Disability Issues 2020 A Guide for Hawai‘i’s Legislators, Organizations & Citizens
Section 1
Introduction & Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Section 2
Keeping Kūpuna Healthy: Kūpuna Care; Aging & Disability Resource Centers;
Healthy Aging Partnership Program; Long-Term Care Ombudsman Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Section 3
Aid to Caregivers: Kūpuna Caregivers Program; Paid Family Leave; Caregiver Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Section 4
Alzheimer’s Disease & Related Dementias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Section 5
Affordable Prescription Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Section 6
Retirement Years: Hawai‘i Saves Program & Active Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Section 7
Conclusion: A Path Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Section 8
Information, Education & Research Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
1
About the Hawai‘i Family Caregiver Coalition, the Maui County Office On Aging, the Hawai‘i Pacific Gerontological
Society, the Disability and Communication Access Board, and St. Francis Healthcare System of Hawaii.
As caregiving touches everyone, the
mission of the Hawai‘i Family Caregiver
Coalition (HFCC) is to improve the qual-
Organized in 1979, the Hawai‘i Pacific
ity-of-life of those who give and receive
Gerontological Society (HPGS) is a not-
care by increasing community awareness
for-profit organization whose mission is
of caregiver issues through continuing
“to provide professionals and students in
advocacy, education, and training.
the field of aging with vital information,
Over the years, the Hawai‘i Family Care- workshops, networking, and scholar- St. Francis Healthcare System of Ha-
giver Coalition has supported our com- ships to enhance the gerontology work- waii is one of the largest providers of
munity by sponsoring the annual Aging force; to support the creation of needed multi-faceted care options for seniors
& Disability Issues report, Family Care- policies and programs; and to deliver ex- and caregivers in the Islands. Sponsored
giver Awareness Day at the State Capi- cellent service to the aging population in by the Sisters of St. Francis of the Neu-
tol, and the annual HFCC Members and Hawai‘i and the Pacific.” mann Communities, it is the only Catho-
Friends Luncheon. lic healthcare system in Hawai‘i.
If you are interested in pursuing this
For more information, please email Gary mission, you are invited to join the St. Francis currently offers:
Simon, President, at gsimon@aarp.org. HPGS. Please visit the HPGS online at • Care navigation services
www.hpgs.org or mail your inquiry to: • Caregiving training and support
P.O. Box 3714, Honolulu, Hawai‘i 96812. • Adult daycare
• In-home bathing & personal
care services
• Preschool
• Spiritual retreat center
• Hospice care in homes, nursing
homes, and at St. Francis Healthcare
DISABILITY AND System’s inpatient facility in
COMMUNICATION Nu‘uanu; and
The Maui County Office on Aging ACCESS BOARD • Outreach to the homeless in Waianae.
(MCOA) takes the lead role in aging
The health and wellness programs of-
issues on behalf of older persons in
fered by St. Francis Healthcare System
Maui County. The Disability and Communication Access
of Hawaii are rooted in a legacy of caring
Board (DCAB) is a governor-appointed
As the designated lead agency at the and compassion that began with St. Mar-
state agency whose mission is to promote
local level, MCOA promotes and pro- ianne Cope and the Sisters of St. Francis,
the independence and civil rights of indi-
tects the well-being of elderly indi- who came to Hawai‘i to care for those
viduals with disabilities. DCAB supports
viduals in Maui County. with Hansen’s disease in 1883.
family and caregiving programs, as well
For more information about MCOA, as universal and accessible design to al- Mailing address:
please call Deborah Stone-Walls, Di- low individuals to live in the community St. Francis Healthcare System
rector, at (808) 270-7774. MCOA’s versus institutional settings. 2226 Liliha Street, #227
mailing address is: Maui County Honolulu, Hawai‘i 96817
For more information, contact Kirby
Office on Aging, J. Walter Cameron Email: info@stfrancishawaii.org
Shaw, Executive Director, at dcab@doh.
Center, 95 Mahalani Street, Room Website: stfrancishawaii.org
hawaii.gov, or at (808) 586-8121. The
20, Wailuku, Hawai‘i 96793. Phone: (808) 547-6500
mailing address is: 1010 Richards Street,
Room 118, Honolulu, Hawai‘i 96813.
2
SECTION 1
Introduction
&
Healthcare System of Hawaii. Their sup- In addition, personal stories from care-
port is gratefully acknowledged. givers regarding the issues they face and
the significance of public policies in en-
Overview This report has eight sections:
Section 1 offers an overview of the
abling them to care for their loved ones
can be found in the report. These stories
report, as well as some general obser- demonstrate the emotional strains and
By Gary Simon, President, Hawai‘i Family vations of the political and economic rewards experienced by our beleaguered
Caregiver Coalition & Chair, Policy Advisory changes in Hawai‘i in 2020. caregivers and describe the difficulties
Board for Elder Affairs any of us could experience when faced
Sections 2 through 6 describe the pri-
T
with aging or disability. These stories
his 2020 issue of the Aging & Dis- ority issues for the Legislature in the
provide a human face to legislative issues
ability Issues report is the 15th 2020 session as designated by the major
by illustrating how they are embodied in
annual publication that offers an groups that advocate for the frail elder
the very human experiences of individu-
overview of legislative issues dealing and disabled populations and their care-
als and families.
with aging, disability, caregiving, and givers. The sections explain why these
long-term care services and supports in issues are important, and provide back- The Political Context of 2020
Hawai‘i. This report calls attention to the ground information concerning them.
An estimated 41 million family caregiv-
priority issues that deserve the earnest The six sections also discuss the specific
ers in the United States provided 34 bil-
attention of our lawmakers, advocates, bills that address these priority areas and
lion hours of unpaid care to adult loved
and the public. It is a joint project of their status at the time of this writing.
ones in 2017, according to AARP’s 2019
the Hawai‘i Family Caregiver Coalition
Section 7, the Conclusion, provides a Valuing the Invaluable report, the latest
(HFCC), the Policy Advisory Board for
brief summary and a look ahead. in an ongoing series of reports that look
Elder Affairs (PABEA), the Executive
at the contributions and needs of family
Office on Aging (EOA), the Hawai‘i Pa- Section 8 contains a listing of informa-
caregivers across the country. The report
cific Gerontological Society (HPGS), the tion, education, and research resources
estimates the approximately 34 billion
Hawai‘i Disability and Communication relevant to aging and disability issues
hours caregivers contributed in 2017
Access Board (DCAB), the Maui County that may be helpful to those seeking ad-
were worth $470 billion — more than
Office on Aging (MCOA), and St. Francis ditional information.
(Continued on next page.)
3
SECTION 1 – continued
total out-of-pocket spending on health making recommendations for a national partment of Health and Human Services
care in the U.S. that year ($366 billion), caregiving strategy. to advocate for the appointment of Debo-
and all money spent on paid caregiving in rah Stone-Walls, the Executive on Aging
The strategy will identify actions com-
2016 (also $366 billion). The report notes for the Maui County Office on Aging, to
munities, providers, government, and
that family caregivers spent an average the Family Caregiving Advisory Council.
others are taking and may take to rec-
of nearly $7,000 on caregiving expenses,
ognize and support family caregivers. It Hawai‘i’s economy is expected to con-
such as transportation and home mod-
will include: tinue positive growth in 2020, with real
ifications in 2016. Research has shown
GDP growth forecast at 1.2%. According
that family caregivers report higher rates • Promoting greater adoption of per-
to the November 2019 Blue Chip Eco-
of loneliness than their non-caregiving son- and family-centered care in all
nomic Consensus Forecasts, U.S. real
peers in mid-life and beyond.1 healthcare and long-term service and
GDP is expected to increase by 1.8%
support settings with the person and
Two Thousand Twenty is the year for in 2020. 3 Thus, more resources may be
the family caregiver at the center of
us to build upon the foundation built available to address care issues, including
care teams
over the last 30 years. Family caregiv- aiding family caregivers.
er support is now firmly established as • Assessment and service planning (in-
The Older Americans Act (OAA) con-
a national priority with the launch of cluding care transitions and coordi-
nects older adults and their caregivers to
the RAISE Family Caregiving Adviso- nation) involving care recipients and
services that help older adults age with
ry Council, which acknowledges that family caregivers
health, dignity, and independence in
everyone’s quality-of-life is positively
• Information, education, training sup- their homes and communities. In 2020,
impacted by providing support to our
ports, referral, and care coordination Congress must reauthorize this vital fed-
often emotionally, financially, and
eral program that serves every communi-
physically taxed family caregivers. Es- • Respite options
ty in the country.4 The OAA funds critical
tablished by the bipartisan RAISE Fam-
• Financial security and workplace issues.2 services that keep older adults healthy
ily Caregivers Act for which HFCC has
and independent — services like meals,
advocated, the Council is charged with The Hawai‘i Family Caregiver Coalition
job training, senior centers, caregiver
was pleased to work with the U.S. De-
4
support, transportation, health promo- program of its kind in the nation designed steadfast in ensuring that elected officials
tion, benefits enrollment, and more. to provide working family caregivers with at all levels of government are committed
financial assistance to help pay for costs to our elders and those with disabilities.
In May of 2019, Governor Jay Inslee
associated with caring for their elders.
signed into law a bill making the state of References
Washington the first in the nation to cre- The Governor and House and Senate 1
AARP. Family Caregivers Provide Billions of Hours
ate a state-run long-term care insurance leadership have committed to a package of Care Annually. https://www.aarp.org/caregiving/
benefit to help its residents afford the high of bills to make life better for our work- financial-legal/info-2019/family-caregiver-contribu-
tion-study.html. Accessed February 10, 2020.
cost of services ranging from assistance ing families. Priorities include increasing
at home to nursing home stays. The Long- the minimum wage, tax relief, reducing
2
Administration for Community Living. RAISE Family
Caregiving Advisory Council. https://acl.gov/pro-
Term Care Trust Act will provide a lifetime the cost of childcare, building affordable grams/support-caregivers/raise-family-caregiving-ad-
benefit of $36,500, indexed annually for homes, reducing homelessness, investing visory-council. Accessed February 10, 2020.
inflation. Workers will be able to access in agriculture and self-sufficiency, devel- 3
Department of Business, Economic Development &
their benefits once they have paid into oping clean energy sources, sustaining Tourism. Research & Economic Analysis. Outlook for
the program for ten years. Some may be our economy and culture, and playing our the Economy. 4th Quarter 2019 Report. http://dbedt.
hawaii.gov/economic/qser/outlook-economy/. Ac-
able to access benefits if they have worked part in preventing climate change.6 These cessed February 10, 2020.
continuously for three of the last six years. priorities require enormous funding. 4
National Association of Area Agencies on Aging.
Beginning in 2022, employees would have Older Americans Act Reauthorization 2020. https://
However, investments in critical services
just over one half of one percent deducted www.n4a.org/OAA. Accessed February 10, 2020.
for our rapidly-aging population and
from their wages to pay for the insurance. 5
AARP. Washington State Enacts Public Long-Term
those with disabilities are also priorities. Care Insurance. https://www.aarp.org/politics-society/
Benefits will be available to active employ-
The efforts of the Legislature’s Kūpuna advocacy/info-2019/washington-long-term-care-law.
ees and retirees starting in 2025.
Caucus, led by co-convenors Represen- html. Accessed February 10, 2020.
Here in Hawai‘i, Governor David Ige and tative Gregg Takayama and Senator Sha- 6
Capitol Connection. February 2020. https://gov-
the State Legislature have supported inno- ron Y. Moriwaki, will be vital. In addition, ernor.hawaii.gov/wp-content/uploads/2020/01/
2FINAL-FEB-2020-Capitol-Connection.pdf.
vations such as Kūpuna Caregivers, the first aging and disability advocates must be Accessed February 10, 2020.
5
SECTION 2
was in the EOA’s base budget, and the rest
had to be determined annually through
special budget bills. Having the Kūpuna
Care program appropriately funded in the
base budget helps provide a consistent and
stable program foundation, which is a nec-
essary condition for meeting the increasing
needs of older adults throughout the state.
Aging and Disability
Resource Centers (ADRCs)
O
lder adults, people with disabilities,
and their families are often unpre-
pared when the sudden onset of a
severe health condition or sudden decline
in function occurs. Once faced with the
need for long-term services and supports,
families find it challenging to navigate the
complexities of care systems. Aging and
Keeping Kūpuna Healthy Disability Resource Centers (ADRCs) are
designed to simplify the process of obtain-
ing information and accessing support and
By Sarah Yuan, PhD er comparable services. Kūpuna Care services. ADRCs also reduce the fragmen-
Chair, Legislative Committee services include adult daycare, assisted tation of care systems, recognizing that
Policy Advisory Board for Elder Affairs transportation attendant care, case man- the care needs of older adults and people
I
agement, chore help, homemaker/house- with disabilities are often similar. Through
n our rapidly aging society, a wide
keeping, personal care, and home-deliv- a single coordinated system, the develop-
range of services has evolved to keep
ered meals. With an annual budget of ment and implementation of ADRCs will
older people healthy and active, and
$8.73 million, the state has supported ensure access to high-quality care through
to support them so they can remain liv-
services that enable older adults to re- person-centered services, which optimizes
ing in their own home and community
main in their homes and communities, choice and independence, encourages per-
regardless of their ability level. Many of
delaying premature placement to expen- sonal responsibility, and provides support
these service programs were initiated by
sive residential care facilities. Annual so individuals and their families can make
federal and state agencies, while others
budget funding is allocated to the Execu- informed decisions.
were developed at the local level through
tive Office on Aging (EOA). The EOA then
private and public entities. Much of the Hawai‘i’s ADRCs are administered by
distributes the funds to the Area Agency
funding for these programs comes from the Executive Office on Aging (EOA) and
on Aging (AAA) in each county, which
federal and state governments, although implemented by each of the county Area
administers the program and contracts
in Hawai‘i, county governments also pro- Agencies on Aging (AAA). The develop-
for services with private non-profit and
vide funding. This section will discuss ment of Hawai‘i’s ADRCs began in 2006
for-profit agencies. The services reached
three such programs: when the EOA received a federal grant to
almost 9,000 older adults in FY19.
pilot the system and continued with the
• Kūpuna Care
As Hawai‘i’s older adult population in- support from several federal grants and
• Aging and Disability Resource creases rapidly with the most substantial the Hawai‘i State Legislature. Since 2016,
Centers (ADRC) increase being those age 85 and over, en- the ADRC system has been implemented
suring adequate and economical care in statewide, with the operation custom-
• Healthy Aging Partnership
the least restrictive environment is crucial. ized by each AAA to meet county-specific
(SB 2335/HB 1866)
Recognizing the critical role of the Kūpuna needs while adhering to a standard set of
Care program in the state’s long-term sup- functional criteria across all counties. The
Kūpuna Care port service system, the Ige Administration ADRC system offers a full range of infor-
H
awai‘i’s Kūpuna Care program requested $8.73 million in the FY20/FY21 mation on long-term support programs
was established in 1999 to pro- biennium budget for this program, which and benefits; conducts the assessment on
vide long-term services and was approved in the 2019 Legislative Ses- individuals’ needs for services to maintain
supports to frail and vulnerable adults sion. Until this year, only about half ($4.85 independent living in the community; and
age 60 and over who lack access to oth- million) of Kūpuna Care program funding (Continued on next page.)
6
balance. She learned about EnhanceFitness
from her church and friends who were pro-
gram participants. “My close friends told me
about EnhanceFitness and how they thought
the classes could help me, since they were
feeling better after a year in the classes,” she
related. Skeptical about how the program
could help her, Blanche shared this informa-
tion with her doctor, who agreed Enhance-
Fitness could be very beneficial physically,
mentally, and socially. Blanche’s first class was
in October 2013, the start of persimmon sea-
EnhanceFitness at the Makawao Hongwanji Mission son. “When I joined the program, my goal was
to heal my back and to get rid of my hunch-
Back to the Farm been picking fruit from a ladder almost daily
for decades. After her fall, Blanche was lim-
back,” she said. “I needed to do something. I
was suffering and persimmon season was go-
By Claudette Medeiros ited in what she could do physically as she ing to start.” Blanche knew she needed to do
Maui County Office on Aging was experiencing great pain and needed something to help her back: “I couldn’t be on
to wear a back, body, and neck brace. Al- the farm with my back like that—I needed to
F alling off a ladder while picking avocados
during the peak of avocado season in the
summer of 2013 was something Blanche
though she was mobile, exercise was limited.
Blanche was unable to finish avocado season
get back.” She has been diligently attending
EnhanceFitness classes three times a week at
and needed to stay away from her farm. Makawao Hongwanji Mission ever since.
Ito never thought would happen. “Falling
would cross my mind sometimes, but I never Blanche felt her back was starting to finally heal Blanche credits her participation in the exer-
thought it would happen,” she said. “Even at when she enrolled in Enhance®Fitness, an exer- cise program to getting back to her two acres
72-years-old, I could climb ladders. I didn’t cise program designed for seniors to improve of trees. “I have 70 trees to take care, two sea-
think I would fracture my back.” Blanche had cardiovascular fitness, strength, flexibility, and (Continued on next page.)
is a single point of entry for Kūpuna Care The Healthy Aging The Partnership offers two evi-
and Older Americans Act (OAA) services. dence-based programs:
In FY19, the ADRCs had nearly 53,000
Partnership Program
1. Better Choices, Better Health, a six-
contacts, representing a 50% increase in By Eldon L. Wegner, PhD week program on the self-manage-
its serving capacity from FY17. The ADRCs
T
he Healthy Aging Partnership Pro- ment of chronic disease; and
linked about 9,000 older adults to public-
ly-funded long-term services and support gram was founded in 2003 to im- 2. Enhance®Fitness, an ongoing exercise
programs and provided assessment ser- prove the health status of older program designed for older adults
vices to nearly 5,000 individuals. adults by empowering residents to make held three-times a week.
healthy decisions and engage in healthier
In the last Legislative Session, Governor lifestyles. The Partnership has received Better Choices, Better Health has had
Ige’s request to allocate $3.1 million to support from multiple funding streams, a total of 2,998 participants. The work-
EOA’s base budget for the ADRC system was including grants and state and county bud- shops complement medical-profession-
approved. It was a significant milestone for gets. It is a public-private partnership, with al recommended treatment plans. The
the ADRC system, which went from hav- largely public funding of private providers participants learn skills to help manage
ing 55% (1.7 million) of its total budget who offer the programs to the public. The their health conditions and interact with
rely on annual special appropriation, to University of Hawai‘i Public Health Pro- their health care providers. A six-month
receiving total funding in the base bud- gram successfully adapted evidence-based follow-up evaluation found that partici-
get. With sustainable funding, the ADRC health promotion and disease prevention pants had a decreased number of visits to
system will continue to grow in capacity programs for Hawai‘i’s multicultural pop- physician offices and emergency rooms,
and become fully functional according to ulation, and has conducted continuous and a cost-savings analysis estimated a
federal requirements, and be a dependable evaluation of the outcomes of the programs net saving of $655.81 per participant.
and reliable resource for long-term support until last year. Participants also reported increases in
services for Hawai‘i’s residents. (Continued on next page.)
7
SECTION 2 – continued
Back to the Farm was told EnhanceFitness participation would
need to be put on hold for at least 10 to 12
cording to Blanche, “We all need socialization;
for some, our classes are the only socialization
(Continued from page 7.) months, but because of the strength they they get. This year, she will be 79, and will keep
sons of picking fruit.” After six years of being an had built, they came back to class after on- going to the classes as long as they are offered.
EnhanceFitness participant, Blanche does not ly 6 months. These achievements have kept “It’s the only way I know I can keep healthy,”
climb ladders like she used to but she is on her Blanche motivated to keep participating in Blanche concluded. “Not only my balance and
farm almost daily. “I am now able to work on the program. “I know EnhanceFitness helped posture improved but my brain too with the
my avocado and persimmon farm,” she said. me heal, and when I see the others get stron- memory exercises. EnhanceFitness has helped
Blanche believes she has become a healthi- ger and comeback from getting hit by a bus, me regain my posture, better my body and
er person since joining the exercise program. it makes me want to continue with the pro- my mind, and keeps me healthy enough to
During the six years she has been an Enhance- gram,” said Blanche, who feels EnhanceFitness keep me working my farm.”
Fitness participant, Blanche has witnessed is the “perfect program” for her and many of
many great achievements by her classmates, her classmates, whose ages range from 60 to For more information about the Hawai‘i
such as seeing an older participant’s balance, 90-plus years. “This program is designed for Healthy Aging Partnership, please visit www.
strength, and overall health improve to the seniors like us,” she continued. “We’re all get- hawaiihealthyaging.org or call the Executive Of-
point that “they walked around Disneyworld ting older and we need to support each oth- fice on Aging at (808) 586-0100. To learn more
for a week with no help at 80 years old.” An- er.” EnhanceFitness classes have given Blanche about EnhanceFitness in Maui County, please
other classmate, “younger than me, was hit by opportunities to meet and make new friends, visit the Maui County Office on Aging online
a bus during their morning walk.” This person as well as spend time with old friends. Ac- at www.mauicountyadrc.org, or call (808) 270-
7774 or toll-free at (808) 643-ADRC.
No appropriations were passed for the
Healthy Aging Partnership Program in
the 2018-19 budget year. As a result,
the City and County of Honolulu had to
close its EnhancedFitness program sites.
Kaua‘i and Maui received county funds to
keep some of their programs open. Due to
budget restrictions, a number of trainers
were let go, and the Executive Office of
Aging suspend the program evaluation
contract with the Public Health Program
at the University of Hawai‘i. Funding for
the 2019-20 fiscal year was restored, and
the Healthy Aging Partnership is rebuild-
ing its staff and programs statewide.
strength exercise and aerobic exercise, Program has received numerous nation-
and fewer symptoms of pain, fatigue, and al awards, including the 2013 award for However, if the appropriation proposed
shortness of breath. Excellence in Multicultural Aging from in HB 1866 and SB 2335 fails to pass
the American Society on Aging. this session, the entire Healthy Ag-
The EnhancedFitness Program served ing Partnership program may end. The
1,742 persons; 65% were age 70 to 89. Legislative Support Needed health of our citizens would be negative-
After 16 weeks, participants reported ly impacted and health care costs for the
The Healthy Aging Partnership Program
fewer falls and an increased number of state would increase. Thus far, SB 2335
is one of the few state programs that im-
days of being physically active. Improve- has cleared the subject matter commit-
plements evidence-based interventions.
ments occurred in measures of physical tees and the Senate Ways and Means
Systematic evaluations of program out-
function, such as arm curls, chair stands, Committee, and HB 1866 has cleared
comes have been conducted, and docu-
and up-and-go exercise. Funding for En- the subject matter committees in the
mented evidence of cost-savings to the
hanceFitess for 575 kūpuna was estimat- House and is waiting to be heard in the
state have been provided. However, con-
ed to save $789,000 in healthcare costs. House Finance Committee. The bills need
sistent support is needed from the Legis-
Prevention programs are always cost-ef- to cross over and be heard by the other
lature. Resources are desperately needed
fective with regard to chronic disease. body in the coming weeks. We strongly
to not only continue the award-winning
Hawai‘i’s Healthy Aging Partnership program, but to allow it to expand. support maintaining these programs.
8Long-Term Care This study was done at a time when most - 21 Community Care Foster Family
residents were in nursing homes. Today’s Homes with 48 beds
Ombudsman Program residents live in many more types of facili-
- 6 Adult Residential Care Homes with
ties: adult residential care homes, assisted
By John McDermott, LSW, ACSW, MDiv 26 beds
living facilities, community care foster fam-
C
ompanion bills SB 2337 and HB ily homes, and adult residential care homes. - Total: 33 Long-Term Care facilities;
1872 supporting the Long-Term Additionally, in Hawai‘i they are spread 507 beds
Care Ombudsman Program (LT- over six different islands. The logistics are
Maui
COP) are of incredible importance. Vari- therefore more complicated than in 1995,
ations of these bills have been introduced and require greater staffing and funding. - 4 Nursing Homes with 459 beds
multiple times before without success, - 1 Assisted Living Facility with 144 beds
but with the growing numbers of Hawai‘i
seniors who need long-term care place- - 59 Community Care Foster Family
ment, it has never been more important Homes with 150 beds
than now to pass these bills. - 12 Adult Residential Care Homes
The purpose of these bills is to appropri- with 72 beds
ate funds to the LTCOP for six full-time - Total: 76 Long-Term Care facilities;
(6.0 FTE) ombudsman specialist posi- 825 beds
tions, two each on O‘ahu and Hawai‘i
Island, and one each on Kaua‘i and Maui. Hawai‘i Island
The LTCOP protects our most vulnerable - 8 Nursing Homes with 870 beds
Numbers by Island
kūpuna, who are often hidden from sight. - 1 Assisted Living Facility with 220 beds
The LTCOP should not be confused with The OAA mandates all residents “have
Adult Protective Services or the Depart- regular and timely access to the LTCOP - 125 Community Care Foster Family
ment of Health’s Office of Health Care As- services.” The Administration on Aging Homes with 339 beds
surance (the licensing agency). APS only (a part of the Administration for Com-
- 42 Adult Residential Care Homes
investigates cases of abuse or neglect. The munity Living) interprets this as “every
with 190 beds
Department of Health focuses mostly on resident, at a minimum, should be vis-
annual inspections. They also investigate ited quarterly.” Our 12,889 long-term - Total: 176 Long-Term Care facilities
complaints, but the LTCOP is uniquely care residents live in 1,727 facilities. A with 1,619 beds
there to proactively prevent problems; quarterly visit would mean 28.78 facility
O‘ahu
work with residents, family, and staff to visits per day.
make facilities better; provide support - 30 Nursing Homes with 2,830 beds
Kaua‘i
and protection to the residents; and in- - 15 Assisted Living Facilities with
vestigate complaints and address con- - 5 Nursing Homes with 333 beds
2,379 beds
cerns by visiting at least once per quarter. - 1 Assisted Living Facility with 100 beds (Continued on next page.)
Background
In 1978, the Older Americans Act (OAA)
required all states have an Office of the
Long-Term Care Ombudsman Program.
In 1979 HRS 349 was amended to con-
form with federal law.
The National Institute of Medicine’s
1995 report, Real People, Real Problems:
An Evaluation of the Long-Term Care Om-
budsman Programs of the Older Americans
Act, recommended 1 FTE ombudsman
per 2,000 residents at a minimum. Cur-
rently, Hawai‘i has 1 FTE ombudsman
per 12,889 residents; the national aver-
age is 1 ombudsman to 2,208 beds.
9SECTION 2 – continued
- 1,024 Community Care Foster Family
Homes with 2,616 beds
- 373 Adult Residential Care Homes
with 2,113 beds
- Total: 1,442 Long-Term Care facili-
ties with 9,938 LTC beds
- Grand Total: 1,727 facilities with
12,889 beds
Travel to a neighbor island from O‘ahu in-
cludes airfare, car rental, airport parking,
plus per diem. For example, on January
22, 2020, the cost was approximately $248
per trip. There is also a time factor, which
includes early arrival before departure,
picking up a rental car, driving to facilities,
and the journey back to O‘ahu, all of which
totals approximately four hours, leaving
just four hours in a day to visit residents.
liabilities. On one hand, our contractors plicants were recent retirees who knew
The time and cost involved demonstrates have made a major difference. For the about the LTCOP and wanted to help, but
that it is much more effective to have first time since 1978 when the LTCOP discovered this type of advocacy within
ombudsmen who live on the island they was established, every facility on the long-term care facilities is much more
serve. A local ombudsman would know neighbor islands received quarterly visits emotionally draining than they had ex-
the people and the community, and can by an ombudsman (monthly on Kaua‘i). pected. These contractors were all a part
be available for evening or weekend in- We resolved most of the residents’ com- of the sandwich generation. Some were
vestigations, family councils, senior fairs, plaints and learned of several systemic taking care of both parents and children
recruitment of volunteers, and working problems we need to address with the who were starting lives of their own.
with local media, county councils, and Department of Health.
After her one-year commitment, our
local Area Agencies on Aging. Finally, as
However, contractors take a long time Kaua‘i contractor quit on February 7,
neighbor island residents pay the same
to find and train, and when a contract 2020 to care for multiple family mem-
federal and state taxes as O‘ahu, they
is over, the process must start all over
should enjoy the same regular and timely
again. In this field of work, one gets bet-
access to services provided by the LTCOP.
ter over time. The cumulative experience
One FTE ombudsman for the entire of working with people in crisis is critical.
state is clearly not enough. As our young Further, with contracting, the focus of
people move away because housing and neighbor island service tends to be from a
other expenses make it too expensive Honolulu perspective. These issues make
to live here, extended ‘ohana are less it unfair to neighbor island kūpuna.
available to help and protect the kūpuna
The following is a brief review of our
who live here. Ombudsmen help fill that
2017 contractor experiences:
loss. Residents know what they tell an
ombudsman is confidential. They know After receiving permission to post the
the ombudsman will visit on a regular contracts and get the word out by various
basis, so if their situation deteriorates, email list-servers, we received only one
the ombudsman will be there to advocate application for Kaua‘i, one application for
on their behalf. Maui, one application for Hilo, and af-
ter many more months, one application
Alternatives to FTE Ombudsmen
for Kona. This was disappointing, but
Contracting not a surprise. With Hawai‘i’s high cost
of living, young people need full-time
Some propose we continue contracting
jobs with benefits. The labor market in
out these positions and not increase the
Hawai‘i is very tight, so there is a lot of
size of state government and associated
competition for workers. All of the ap-
10day. That’s not the LTCOP, which is a
commitment of one year to make week-
ly visits to talk story with residents,
listen to their concerns and problems,
then work on solutions with admin-
istration. Sometimes there is success,
but not always. Vulnerable seniors with
dementia or other limitations don’t call
for help. Many don’t have a phone or
even know what “ombudsman” means.
They must be visited at their facility
and engaged face-to-face until trust is
developed and they open up about their
concerns. There is always the fear of re-
taliation, so weekly follow-up visits to
make sure the residents are safe after
complaining is critical.
Partnerships
We have and will continue to partner
with anyone interested in protecting
our kūpuna.
bers. Her plate was full and she had to people and history through the ombuds-
move on. We contracted with the Kaua‘i man position. She was very good, but Conclusion
Agency on Elderly Affairs after receiving Waikoloa proved more expensive than she I have been doing this for 22 years, but
no applications. had budgeted and left to work full-time. I am getting ready to retire. FTEs who
Virtually every organization has had dif- will make the commitment to be there
Our Maui contractor was previously an
ficulty finding workers on the Kona side. for 25 years are needed. Our contractors,
ombudsman volunteer for seven years, so
he had no learning curve. We were happy Volunteers volunteers, and partnerships are greatly
he applied for the position and he was appreciated, but they are not substitutes
Volunteers have been proposed as a solu- for permanent FTE staff. Our senior
glad to earn some money for his work,
tion. A volunteer coordinator position was population is growing rapidly, and our
as there is no funding to reimburse vol-
created in 2001 with the support of the young residents continue to move away.
unteers for their gas mileage to facilities.
Legislature. Since then, almost 250 volun- The need for LTC ombudsman advocates
Unfortunately, he is now having some
teers have been certified. Volunteers are is growing in numbers and importance.
health issues and may need to step down.
carefully screened, provided with 20 hours Please support HB 1872 and SB 2337 so
Our Hilo contractor worked as director of of classroom training, and 8 hours of one- we can better protect our seniors who are
social services at several nursing homes, on-one on-site training. They are asked for responsible for everything we have and
so she also had adequate experience. a one-year commitment (many have given love about Hawai‘i.
However, she needed surgery on her leg years!). We all meet
after she was hired and was not able to as a group monthly
do the amount of walking required for so everyone stays on
the job. the same page and we
learn from one another
Fortunately, the Hawai‘i Island Office on
by discussing cases and
Aging connected us with a DOH public
having guest speakers.
health nurse practitioner who had just
As of this writing, we
retired after 40 years and wanted to help
have 21 wonderful vol-
the LTCOP after unexpectedly losing her
unteers, but most want
husband. However, she wants us to find
to be assigned to only
a replacement, because she is now ready
one facility, and there
to move on.
are 1,727 facilities.
We finally had an applicant from the
It is much easier to
mainland who recently retired to Waiko-
get volunteers for a
loa and wanted to get to know Hawai‘i’s
11SECTION 3
by any comparable government or private
home- and community-based care service
(excluding Kūpuna Care) or reside in a
long-term care facility. They must have im-
pairments of at least two activities of daily
living (ADL) or instrumental activities of
daily living (IADL) or a combination of
both, or significant cognitive impairment
that requires substantial supervision.
Program Funding: The KCGP was funded
at $0.6 million for the second-half year of
FY18 and $1.2 million for FY19. Act 126,
enacted in 2019, increased the appropria-
tion to $1.5 million, and it reduced program
service coverage from a maximum of $70 a
day to $210 per week per participant, with
the intent of serving more working care-
givers. In the current Legislative Session,
HB 1867 HD 1 requests a level funding of
$1.5 million. Its companion bill SB 2342
SD 1 seeks an increased appropriation of
$2 million and a further program change
Aid to duce work hours to care for an aging family
member. In 2017, with robust championing
by Senator Roz Baker and Representative
to lower the employment hour requirement
for working caregivers from 30 hours per
Caregivers
week to 20. Currently, the EOA is imple-
Gregg Takayama, our legislators passed menting a plan to increase the number of
HB 607, which was signed by Governor Ige people served by the KCGP, so additional
into law as the Kūpuna Caregivers Program eligibility changes to this new program may
Kūpuna Caregivers Program (KCGP Act 102, 7/6/2017). affect the plan and its expected results.
By Sarah Yuan, PhD The KCGP is administered by the Execu-
Chair, Legislative Committee Program Impacts: In FY19, the KCGP
tive Office on Aging (EOA), with services served 112 working caregivers. At the time
Policy Advisory Board for Elder Affairs delivered by the county Area Agencies of application, 40% of caregivers reported
E
very minute, about seven baby on Aging (AAA) and their contracted having provided care for five or more years;
boomers in the U.S. turn 65. Our service providers. half spent 40 or more hours in caregiving
local population is aging even more Purpose: The KCGP helps make long- during the past week; and 40% were sole
rapidly and also living longer than in any term care for our kūpuna more afford- caregivers. The average age of these caregiv-
other state. In 2016, 17% (about 244,000) able and provides the helping hand care- ers was 57 years old, and almost 80% lived
of Hawai‘i residents were 65 and over. By givers so desperately need. The program with the care recipients. Nearly all (92%) of
2030, when all baby boomers are 65 or old- helps working caregivers pay for adult care recipients received adult daycare ser-
er, Hawai‘i’s older adult population is pro- daycare, assisted transportation, chore vices, and 87% received case management
jected to increase to 23% (nearly 369,000). service, home-delivered meals, or other services. Other services used by 7% or more
Because the demographic make-up of our designated services. It allows caregivers of seniors were personal care, homemaker,
state is changing, we need to change the to continue to earn their retirement ben- transportation, and home-delivered meals.
way we provide care for our kūpuna. efits, helps businesses retain experienced The evaluation results reported by the EOA
When given a choice, most kūpuna prefer workers, and provides peace-of-mind to showed a significant decrease in the “objec-
aging at home. Our extended ‘ohana are the caregiver that their loved one is being tive” and “stress” burden scores from intake
often incredible caregivers, but providing cared for while they are working. to follow-up (6 – 12 months later). These
that care can create financial and emotion- positive impacts have proved to be sig-
Qualifications: Eligible caregivers must nificant among caregivers who have been
al stress. In 2019, the annual cost of home be employed at least 30 hours a week by
health care in Hawai‘i was about $10,000 caregiving for over five years or spent more
one or more employers and provide direct than 40 hours a week in caregiving. Overall,
higher than the national average (Gen- care to a care recipient who is a U.S. citizen
worth Cost of Care Survey). Our caregivers the KCG has shown to be effective in keep-
or a qualified alien 60 years of age or old- ing the working caregivers in the workforce
need assistance too. Many caregivers make er. The care recipient must not be covered
the difficult decision to leave their job or re- while reducing their caregiving burdens.
12Kūpuna Caregiver costly. Due to her mother’s
Alzheimer’s disease diag-
Program Helps nosis and her father’s de-
mentia, Rebecca made a
Caregivers & commitment to care for
her parents in her home
Community for as long as they lived
and make them as safe and
By Kevin Dusenbury as comfortable as possi-
Maui County Office on Aging ble. According to Rebec-
ca, she read every book
F or the past six and a half years, Rebecca
Armato has lovingly cared for her aging
parents. While Rebecca was working at her
she could find on how to
prepare to be a full-time
caregiver. She also pre-
previous job at Huntington Hospital in Pas-
pared a home that would
adena, California, she received a phone call
meet their needs for ag-
from her dad, Andrew, who lived in Kansas,
ing-in-place, including
who said he needed help caring for him-
carpet removal and the
self and for Rebecca’s mom, Patricia. Rebec-
addition of solid surface
ca boarded the next flight to Kansas and
flooring to make it easi-
quickly realized her parents could no lon-
er for shuffling; a stair lift;
ger live independently because the stress
wheelchair access; and se-
of caregiving was taking a significant toll on
curity gate and door locks
her father’s health. To avoid placement in a
to prevent wandering. She
long-term care facility, Rebecca moved her Patricia and Andrew Armato also “parent-proofed” the
parents from Kansas to her tiny apartment
kitchen, laundry, and oth-
in Newport Beach, California. Upon her
home. In May 2015, the Armatos embarked er areas for safety. Since her parents were
parents’ arrival, Rebecca realized she had
on their journey to Wailuku. Not knowing experiencing much of their world through
to temporarily step away from her career to
how long they had together, the first year sight and smell, Rebecca planted fruit trees,
focus on her parents’ healthcare and overall
was a bucket list of exploring Maui for the pikake, and night-blooming jasmine so there
health. After living in her apartment for al-
Three Musketeers. When it appeared her would be visuals, smells, and tastes they
most two years, Rebecca decided to make
parents’ health would allow it, Rebecca ac- could continue enjoying as their ability to
a change for the “Three Musketeers.”
cepted a position at the Pacific Cancer In- communicate verbally diminished. The Ar-
After traveling to Hawai‘i for over 35 years, stitute and hired an agency to come into matos grew up on a farm in rural Michigan,
Rebecca always dreamed of calling Maui her their home while she was at work. It was very (Continued on next page.)
Paid Family Leave In November of 2019, the Hawai‘i State family leave to 16 weeks for businesses
By Gary Simon, President, Hawai‘i Family Legislature released a legislatively-man- that employ one or more employees who
Caregiver Coalition & Chair, Policy Advisory dated report on the viability of creating a meet the hourly qualifications.
Board for Elder Affairs paid family leave program in Hawai‘i. A
We strongly encourage the Legislature
revised version of the report was released
W
hy Paid Family Leave? Demo- and the Governor to pass a strong paid
in December of 2019.2
graphic data helps identify the family leave law. Employees need sub-
problem in Hawai‘i. Forty per- The report has helped to inform legislators’ sidized time off to care for a newborn,
cent of Hawai‘i’s workforce provides care proposals in the 2020 Legislative Session. newly adopted or foster child, or an ill
for older parents, and family caregivers or disabled family member. Paid fami-
HB 2219, introduced by Representa-
provide 70% of all care for frail elderly ly leave guarantees that employees can
tives Aaron Ling Johanson and Linda
persons. Furthermore, just over 40% of cover the basic costs of living while pro-
Ichiyama, and its companion bill, SB
Hawai‘i’s workforce does not have access viding care to family members when
2491, introduced by Senator Brian
to a single day of leave from work, paid they need it most.
Taniguchi, provide family leave insur-
or unpaid.1 ance benefits and extends the period of (Continued on next page 15.)
13SECTION 3 – continued
Kūpuna Caregiver er for her 83-year-old
mother while working a
Program Helps full-time job is an intri-
cate juggling act. Accord-
(Continued from page 13.)
ing to Rebecca, “The Ku-
so having plants and flowers are what they puna Caregiver Program
remember best. provides not just financial
support, but much need-
In June 2016, Andrew passed away in his ed emotional support
daughter’s home at 89 years of age, just shy by relieving the stress of
of the Armato’s 60th wedding anniversary. worrying how I can con-
After the death of her husband, Patricia’s tinue to care for her in
Alzheimer’s worsened significantly to the my home, helping me un-
point she required constant supervision derstand I am not alone,
and care. Rebecca had no choice to resign and gaining strength from
Rebecca and Patricia Armato
from her job because she could not afford others who are going
reliable in-home care for her mom. As her mitment to her mom’s well-being. According through the same feelings and challenges
mom’s condition worsened, Rebecca expe- to Rebecca, 2019 was a life-changing year as I am. With the help to continue to send
rienced a whirlwind of emotions, including for the Armatos. my mom to daycare, I am able to keep her
despair and uncertainty. However, she per- living with me at home – which is what she
severed with her commitment to keep Patri- Leveraging her medical practice manage- wanted and what I promised her. The pro-
cia safely in her home for as long as possible. ment experience and expertise from her gram allows me to find time for me and build
career at Huntington Hospital in Physician in time to replenish myself so I can continue
Over the year, Rebecca began to suffer from Services, Rebecca secured a job as manager to get up each day and care for both of us.
caregiver burnout. She had heard about the of physician services at Maui Health System I find myself living both in her past – as the
annual Caregivers’ Conference presented in Wailuku. She now works full-time recruit- past is the best place for her to linger over
by the Maui County Office on Aging from ing and retaining physicians to live and prac- her sweet memories, where her happiness
a case manager at Maui Memorial Medical tice on Maui. still resides – and still see I have my own life
Center. In addition to registering for her and future, and am able to work, helping our
first conference, Rebecca requested care- While the new position is a great fit for Re- medical staff and recruiting new physicians
giver support services from the Office on becca professionally, there was still a need to care for our community members.”
Aging in October 2017. After the Office on for her mother’s care while she worked
Aging determined eligibility for Kūpuna during the day. As the adult day care bills Rebecca shared that she does not know if
Care services, the case manager authorized continued to grow, Rebecca continued to the lawmakers fully realize all of the lives they
person-centered services, which included struggle balancing her caregiving duties have touched through Kūpuna Care and the
adult daycare and adult daycare respite. with her new position. In July 2017, Gover- Kūpuna Caregiver Program, but she would
While the addition of these services pro- nor David Ige signed the Kūpuna Caregiver like them to know she is truly blessed and
vided great relief, the cost of in-home care Program into law, which originally permitted thankful for the assistance provided in the
over the previous few years had depleted the authorization of home- and communi- programs. If Patricia could still speak, Re-
all of Rebecca’s personal savings. Patricia ty-based services with a value of up to $70 becca knows her mom would express deep
could not contribute to care, as her Social per day for a caregiver employed at least gratitude as well, because she sees it in her
Security benefit barely covered the cost of 30 hours per week. While the Kūpuna Care- smile each morning. In addition to helping
health insurance, medication, and inconti- giver Program was amended in 2019 to limit the Armatos, care and help has enabled Re-
nence supplies. the service amount per week, the program becca to continue work that saves the lives
continues to be largely successful and ben- of Maui’s community members through phy-
To pay for the additional days of adult day- eficial to working caregivers who need the sician recruitment and retention at Maui
care not covered by Kūpuna Care, Rebecca extra assistance to remain in the workforce. Health System.
obtained a TSA position in Kahului. While
she was thankful to be employed, Rebecca The Office on Aging’s care manager be- For more information about Kūpuna Care
continued to struggle with the costs of care lieved the Armatos would greatly benefit services, the Kūpuna Caregiver Program, and
and the balance of caregiving and working from the Kūpuna Caregiver Program, which the Maui County Office on Aging, please
full-time. However, she continued to work has helped them since October 2018. Re- visit www.mauicountyadrc.org, or call (808)
and care for her mom because of her com- becca shared that being the only caregiv- 270-7774 or toll-free at (808) 643-ADRC.
14(Continued from page 13.)
The Importance of
Caregiver Education
By Kathy Wyatt, RN, MSN, MBA, LNHA
President, Hale Hau‘oli Hawai‘i
I
t is well known that Hawai‘i has the
fastest growing population of senior
citizens in the nation. According to
a report from AARP in 2019, there are
approximately 157,000 family caregiv-
ers who invest 131 million hours of care
for their loved ones. Providing care for a Caregivers at an educational workshop
loved one can be challenging, especially
for someone with Alzheimer’s disease or halehauolihawaii.org, provides lists of the Elderly Affairs Division, Department
other dementias. Many family caregivers upcoming workshops for caregivers and of Community Services, City and County
begin their caregiving journey with no caregiver support group locations. of Honolulu.
experience and can be understandably The Caregiver Foundation provides se- Becoming educated about Alzheimer’s
overwhelmed by their new responsibili- niors, disabled adults, and their care- disease and other dementias, learning
ties. Having no experience causes stress, givers training on caregiving, aging, practical caregiving approaches, and
uncertainty, fear, frustration, and a myr- and financial management, as well as is- using local caregiving resources are im-
iad of other emotions. One of the most land-wide caregiving support groups with portant strategies. Armed with the re-
effective ways to help ensure the highest educational components. Many resources sources needed to continue to provide
quality of care for those with dementia can be found on their website at www. safe, effective care for their loved ones,
is through caregiver education. Learning thecaregiverfoundation.org. and the knowledge that there is help in
about the disease and knowing what to the community to assist them, caregiv-
expect can help caregivers feel more in The Alzheimer’s Association–Aloha Chap-
ers can be successful in their endeav-
control and better able to plan ahead. ter offers a wide variety of programs and
ors, and the elderly can remain at home
services, including educational programs
Hale Hau‘oli Hawai‘i – along with other and in their communities. Our goal is
for caregivers, community groups, and
organizations such as the Alzheimer’s As- to reach as many people as possible to
professions, as well as online caregiving
sociation, The Caregiver Foundation, the give them this invaluable information
training. The Aloha Chapter also offers
Hawai‘i Parkinson Association, and AARP to make their lives and the lives of their
caregiver support groups that include ed-
– offers caregiving educational sessions loved ones better and easier. Caregiver
ucational components. The Aloha Chapter’s
throughout the year. The majority of these education also leads to improved health
website, www.alz.org/hawaii, offers a va-
offerings are at no cost to participants. outcomes, not only for kūpuna, but also
riety of resources and educational topics.
for their caregivers.
A non-profit organization, Hale Hau‘oli The Hawai‘i Parkinson Association has
Hawai‘i is offering four caregiver edu- Many caregivers work outside the home
an annual symposium where a leading
cational workshops in 2020 at various and care for elderly loved ones. Along
specialist on the disease answers patient
locations around the island of O‘ahu, with education, working caregivers
and caregiver questions. The organiza-
made possible by a generous grant from need help to care for their kūpuna. We
tion also offers caregiver support groups
the City and County of Honolulu. The strongly urge the Legislature to continue
with educational components. Their web-
workshop, “Dementia in the Family: funding the Kūpuna Caregiver Program,
site, www.parkinsonshawaii.org, pro-
Care Options and Resources,” features which helps working caregivers remain
vides education and caregiver support
speakers covering basic dementia facts, in their jobs and not be financially bur-
group locations.
caregiving tools, legal and financial top- dened by caregiving, nor become a finan-
ics for caregivers, and other important AARP offers caregiver education pro- cial burden on the state if they have to
information for caregivers. Exhibitors grams and online training and education leave their jobs to continue caregiving.
at these workshops will provide a multi- for both new and experienced caregivers.
tude of resource materials. Hale Hau‘oli Find educational topics on their website References
Hawai‘i offers caregiver support groups at www.aarp.org. 1
National Partnership for Women and Families, Paid
Sick Days Fact Sheet, July 2015.
in conjunction with The Caregiver Foun- Another excellent resource for family 2
https://lrb.hawaii.gov/wp-content/uploads/2019_Paid-
dation, as well as small group caregiver caregivers is the Senior Information and FamilyLeaveProgramImpactStudy.pdf. Accessed Feb-
training sessions. The website, www. Assistance Handbook, a publication of ruary 24, 2020.
15You can also read
