Hawaii’s Looming Elder-care Crisis

Dan Boylan
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Wednesday - June 24, 2009
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For more than a year now, my wife, the high-strung Filipina, has been talking about her arthritic finger. In the morning, she’ll put down her newspaper, lean toward me on the couch, extend her hand and say, “Dad, look at my finger. It’s getting more crooked by the day.”

I will lower my newspaper, assume a sympathetic mien, and say, “Does it hurt, dear?”

“Yes, it does!”

Now her arthritic finger is the middle finger of her right hand. And perhaps, after 38 long, hard years of marriage, she wants to show me her middle finger.

But the middle finger of her right hand does appear arthritic. It’s crooked and it swells abnormally at the knuckle. I think the old girl is beginning to show her age.

As are we all. When I watch the Sunday news programs, I’m struck by how all the advertisements are aimed directly at me: hawking medicines to treat arthritis, erectile dysfunction, enlarged prostates, hypertension. The list goes on and on.

It’s amusing, but it’s not. In Hawaii, we have a population that is aging more rapidly than that of any other state in the nation. Hearty Hawaii residents outlive folks in other states by four years. Attribute it to all that fish and veggies in Asian diets, the need to look halfway presentable in a bathing suit the year around, or a climate suitable for jogging, swimming, walking, whatever from January to December. I don’t know. But we do live longer.

Currently, 18 percent the Islands’ residents are 60 or older. By 2020, one in four of us will be 60 or older.

We are woefully unprepared for this aging of our population. Today, more than a decade before the tsunami of oldsters hits, Hawaii doesn’t have enough nursing home beds for the people who need them. And we’re way behind the rest of the nation. Hawaii has fewer than one-half the national average of long-term care beds per 1,000 aged 65 or older. We don’t have enough nurses aides either, or gerontologists, or geriatricians, or geriatric social workers.

Even if we had the beds and the nurses aides, gerontologists and social workers, we wouldn’t have the money to pay for them. Currently it costs $107,000 per year to keep an aging parent or relative in a licensed nursing home - $107,000 per year!

Every older person I’ve ever known has shuddered at the thought of being put in a nursing home. They want to stay at home; they want, in the jargon of geriatrics, to “age in place.”

Who wouldn’t? But as we age, everybody ultimately needs help of some sort - a couple hours a day of home care, perhaps. That’ll cost an 80-year-old on fixed income $16,000 per year.

So who does - and who will - take care of our aged? In all likelihood, a family caregiver, a close friend, a neighbor - someone who will neither be paid for their labor nor trained to do it. For loving children, taking care of their parents in their old age is a duty, an honor and act of love.

But caring for the elderly - even those we love - can be difficult and enervating. And in too many cases there is no respite from it, nothing save the caregiver’s whispered prayers for patience.

Insights on PBS-Hawaii broadcast the premiere of a documentary titled The Graying of Hawaii. The producers, and many of the experts they interviewed, criticized both Gov. Linda Lingle and Mayor Mufi Hannemann for the failure of their administrations to tackle Hawaii’s long-term care crisis. They gave better marks to the state Legislature and former Hawaii County Mayor Harry Kim.

I’m not sure blame is in order, nor the showing of arthritic middle fingers.

Action is.

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