In Hawaiian culture, respect for kupuna, or older individuals, has always been deeply ingrained. However, as time goes on, it can become challenging for kupuna to age gracefully in their own homes.
Hawaii has a significant kupuna population, and this number is expected to grow in the coming years. As of 2020, approximately 277,200 people aged 65 and older were residing in Hawaii, accounting for around 20 percent of the state’s total population according to the U.S. Census. Projections indicate that by 2030, one in every five Hawaii residents will be over the age of 65, comprising 23 percent of the population. Additionally, Hawaii boasts the highest life expectancy in the United States, with an average of 80 years old as of 2020.
As kupuna in Hawaii age, their housing and care needs may vary. Families often find themselves pondering how best to support their loved ones. Who will serve as the primary caregiver? Can the elderly person continue to reside at home, or will they need to move in with family, find a new home, or transition to a care facility? What are the associated costs? And what housing options are available in Hawaii for older individuals?
Many kupuna choose to “age in place,” remaining in their own homes as they grow older.
What does aging in place mean?
The U.S. Centers for Disease Control and Prevention defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.” Most seniors prefer to stay in their homes for as long as possible due to the economic advantages and enhanced comfort it provides.
What are some important considerations for aging in place?
1. Home modifications: Making homes safer and more accessible is crucial. Installing features such as stair lifts, accessible bathrooms, ample lighting, and lowered kitchen counters can significantly enhance the safety of the living environment for seniors. Certified Aging-in-Place Specialists (CAPS) can provide homeowners with recommendations for modifications that optimize safety, functionality, and design.
2. Support plans: It’s essential to have a comprehensive support plan in place in the event of injury or illness. As we age, our physical and cognitive abilities naturally decline, increasing the likelihood of injury or illness. Clear plans for communication and monitoring are vital. For example, how will anyone know if a kupuna has fallen? How can family members detect and support the onset of dementia? Personal emergency response systems (PERS) can assist with fall detection, while home sensors can monitor unusual behavior, including signs of dementia.
3. Managing chronic conditions: Primary care physicians and medical specialists play a critical role in creating medical care plans that address the management of chronic illnesses. A health journal or online healthcare management system can help kupuna and caregivers keep track of medications and appointments.
What other housing options and health services are available for older individuals in Hawaii?
Unfortunately, alternative housing options for kupuna in Hawaii often come with high costs or limited availability. Nursing homes in Hawaii can be nearly 50 percent more expensive than those on the U.S. mainland, and in-home health care, such as hiring a home health aide, can cost thousands more than the national average. The state has approximately 4,400 nursing home beds and 7,000 spaces in residential facilities for retirement-age individuals, which is insufficient to meet the housing and care needs of kupuna.
Here are some housing and care options commonly available in Hawaii for seniors:
- Skilled Nursing Facilities (SNFs): These are nursing homes that have registered nurses available for at least eight hours per day. SNFs offer additional support for individuals who have experienced falls
- Intermediate Care Facility (ICF): Provides custodial care for those who require significant assistance. Although Medicare typically does not cover this type of service, Hale Nani Rehabilitation and Nursing Center on Pensacola Street in Honolulu is an example of an ICF that offers this level of care. Oahu, Maui, Kauai, and Hawaii Island have several SNF and ICF facilities to cater to the needs of older individuals.
- Adult Residential Care Homes (ARCH): These homes, both in smaller family settings and larger institutional facilities, are licensed by the Hawaii Department of Health. Typically, elderly residents of ARCH do not require intensive medical care. While Medicare and Medicaid may not provide reimbursement for this type of care, supplemental security income (SSI) does. Across all the islands, including Oahu, numerous adult residential care homes can be found.
- Assisted Living Facilities: An appealing option as they offer comprehensive services to retired individuals. These facilities provide housing, medication management, meals, health services, private apartments, housekeeping, and various recreational activities. Assisted Living Facilities are usually privately funded, and One Kalakaua Senior Living is an example of such a community.
- Malama Adult Day Care: For kupuna who live at home but require socialization, supervision, or rehabilitation during the day, Adult Day Care centers offer the perfect solution. One such center is Malama Adult Day Care in Pearl City.
- Home Care services: Designed to support older individuals while they remain in the comfort of their own homes. These services encompass health care, meal preparation, cleaning, and assistance with personal hygiene. By utilizing Home Care services, kupuna can successfully age in place.
- Senior Housing: Often in the form of specific age-restricted buildings or communities, provides independent living with access to various amenities like pools and group exercise classes. Franciscan Vistas in Ewa Beach is a prime example, catering to residents aged 62 and older. These communities may offer optional services such as health care, housekeeping, shopping assistance, transportation, social activities, and legal support.
While Hawaii offers numerous housing options for kupuna, aging in place remains a popular choice. Aging in place requires the right home, thoughtful care plans, and a significant amount of love, often provided by family members. As a real estate agent, I am here to provide my expertise and help you find a comfortable home that meets the unique needs of kupuna as they age.