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Contents 4
Letter from the Editor
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Senior Medicare Patrol
10 Talk Story: Dialysis
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Queen Emma Festival 8 Kauai Club Scene 12
14 When to Call Hospice 19 Health & Wellness Directory
Matsuri Festival
20 Preventing Falls
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25 Lucious Lamb
Ballroom Dancing
26 Puzzles
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28 Community Resources 29 Ask the Nurse 30 Confessions of a Caregiver
Menehune Craft Fair
Elder Resource Magazine
Editor & Publisher Christine Bothmer, RN
Artistic Consultant Judith Lee
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31 Printed in Hawaii
Contact Elder Resource Mail: P.O. Box 1257, Koloa, HI 96756 Contributing Writers: Graphics & Design Email: cbothmer@elder-resource.org Pam Woolway, Dr. Robert Weimer Phone: (808) 212-2760 Julie Bothmer-Yost The material contained in this magazine is for educational purposes only and is not intended to replace the advice of your doctor, nurse practitioner, or physician’s assistant. Talk to your healthcare provider before making any changes to your healthcare regimen. All rights reserved. Permission is granted to reproduce portions of this magazine for educational, non-commercial purposes only; please give credit to Elder Resource including date of issue, website url or mailing address. All editorial photos by Christine Bothmer unless otherwise credited. Advertisement in Elder Resource does not necessarily imply an endorsement of products or services. We have no political or religious affiliation. We respectfully decline advertisements whose purpose is to influence public opinion on controversial issues or the outcome of elections or ballot measures. www.elder-resource.org 3
Letter from the Editor
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raditions are practiced throughout the year, and this holiday season is an opportunity to practice traditions that strengthen bonds between generations. While some traditions can be traced back through many generations, others are new, and some are yet to be discovered. Be they between large groups or small, close-knit family & friends or new acquaintances, I hope you have the opportunity to strengthen bonds with others. Happy new year!
-Chris Bothmer On the cover: Kumu hula Kauaiiki performs during the 26th annual Eo e Emalani i Alakai Festival at Kokee State Park. More photos, page 9.
What are your holiday plans? The Hanapepe Senior Club celebrated the holidays last year with a Christmas party at Keoki’s Paradise in Poipu. Along with singing Christmas carols, they performed funny skits and played games. The food was delicious and everybody had a great time visiting and socializing. Mele Kalikimaka me ka Hauʝoli Makahiki Hou! 4
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Senior Medicare Patrol
Empowering Seniors to Prevent Healthcare Fraud The Hawaii State Executive Office on Aging is empowering seniors to prevent healthcare fraud. Retirees are encouraged to volunteer their efforts and in return receive training on the basics of Medicare, Medicaid and typical scams that steal benefits from seniors. Protect • Protect your Medicare, Medicaid, and Social Security numbers like a credit card number. Never give your numbers to a stranger. • Beware when someone says they are from Medicare or other agency and asks for your Medicare number. • Do not be fooled into giving out your Medicare number if someone offers free medical services, supplies or equipment. Scammers often say they represent an insurance company, doctor’s office, clinic or pharmacy. Remember, Medicare does not sell services or supplies. • Check your Medicare statements for errors. These documents show personal information so shred them when you no 6
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longer need them. • Make a note of all your doctor visits, tests, and procedures in a journal or calendar. Detect Here are some signs someone may have stolen your medical identity: • Your Medicare statements show charges for services or supplies you did not receive. • Your health plan says you reached your benefit limit. • Your plan denies a claim because of a wrong diagnosis. • Your credit report shows unpaid medical bills you don’t recognize. • You get calls from a collection agency for debts you don’t owe. Report If you find errors on your Medicare statements or suspect someone might have misused your Medicare number, call the Senior Medicare Patrol for help with correcting the billing error and reporting medical identity theft or scams.
Contact Senior Medicare Patrol (SMP Hawaii) Toll free: 1-800-296-9422 email: report@smphawaii.org website: smphawaii.org
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Queen Emma Festival
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eaving the sweltering October heat behind, several hundred people drove up to Kokee State Park to witness and participate in the re-enactment of Queen Emma’s journey to the Alakai rainforest in 1871. The temperature drops noticeably as one drives up the winding road that offers dramatic views makai and mauka, as well as a refreshing mountain breeze. Festivities were held at the Kanaloahuluhulu Meadow, 3600 feet above sea level. While the lovely sounds of Nick Castillo’s ukulele and falsetto voice replaced the songbirds for the moment, people mingled and large blue dragonflies buzzed lazily above the grassy field. Awaiting Queen Emma and her entourage, some dancers performed spontaneously, while others, part of a halau from Japan, spent many hours rehearsing for their moment in the program.
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Following the chant by Kumu Kauaiiki (photo, front page), instrumentals and singing continued, followed by many performances by hula halau from around Hawaii.
The crowd coalesced with word of the Queen’s arrival. In this beautiful setting, with all the preparations, it felt like the real Queen Emma was truly arriving! From left: Harrom Hookano Kaili as Kaluahi, the Queen’s guide; Helen Leilani Lahapa Santiago as Queen Emma; Kauanui Santiago as Queen Emma’s lady-in-waiting; Richard Kaui as the kumu hololio or horse riding instructor. www.elder-resource.org
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Talk Story About Dialysis K
Christine Bothmer, RN
idney failure can happen suddenly, but for most people it occurs over years as the effects of high blood pressure or diabetes slowly take their toll.
Kidneys filter our blood, removing waste and excess water, creating urine. Blood tests determine how well the kidneys are doing their job, and doctors use this information when offering advice regarding diet (to extend the life of the kidneys) and to help people prepare for dialysis, should the time come. If the kidneys no longer function properly, dialysis takes over the job of filtering the blood. Hearing from your doctor that you might need to start dialysis is a life-changing moment. As with any serious diagnosis, denial is often the first reaction. Some people avoid preparations and even refuse dialysis. As waste products build up, they start feeling sicker and place themselves in grave danger. A person will die as a result of refusing dialysis. Building a community Leon “Angus” Gonsalves, is one of the founders of Ohana On Dialysis, a support group for people on dialysis, their families and caregivers. When he started dialysis Leon noticed everybody kept to themselves during dialysis sessions. He started talking to others and helped organize Ohana On Di-
Above: Flor, Sal, Rosita, Cesar 10
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Above: Susumu & Thelma Miyashiro, Leon Gonsalves, Robert & Felicia Bukoski
alysis. “It’s not only seeing you at dialysis, it’s seeing you away from the chair, the machines, the alarms,” says Leon. He enjoys bringing people together and also helps alleviate their fears of dialysis. His wife Judy chimes in, “A lot of people think dialysis will kill them. It’s actually the opposite--not getting dialysis is what will kill them.” A friend asked Leon to talk to a woman who did not want to go on dialysis because she thought she was going to die. “I’ve been down that road, I know what you’re going through,” he told her. When he was told he needed to have a fistula placed in his arm to prepare for dialysis, Leon refused. Luckily Judy was present and intervened, insisting the surgery be scheduled
for as soon as possible. After some heated discussion he relented and has never regretted the decision. “They take awhile to heal. Luckily mine had healed by the time I needed dialysis, otherwise they would have to put a temporary access [in the vein] in my neck.” He had no idea what to expect the first time he went in for dialysis. “I wish they told me,” he says. “Now I weigh in, they check my blood pressure, temperature and check for swelling. They hook you up to the machine and you can bring your own headphones for the television.” For people reluctant to start dialysis, Leon offers an analogy. “Dialysis is like riding on a plane. You sit in a chair, you have a
“I’ve been down that road, I know what you’re going through” tv screen, people come and check on you. After a few hours, you get up and go about your business.” Of course dialysis is not without it’s challenges but this group, consciously or not, takes a philosophical approach to managing the side effects and dietary restrictions. Robert Bukoski: “For me, I tell myself: I have renal failure; it doesn’t have me.” His wife Felicia enjoys Ohana on Dialysis get-togethers. She learns from others and shares her ideas for what works.
other dialysis patients, during each session.
“Now I have more energy, stay with my family, play with my son.” Auntie Ulu Breen also felt a need for Ohana On Dialysis. For her, there’s no time to sort through feelings after dialysis and she found it difficult to stay connected and get closure when somebody suddenly doesn’t show up for dialysis. She understands the importance of “HIPPA” privacy practices but says “it interferes with our ohana and feelings of aloha,” not knowing if somebody had to fly to Oahu to get their fistula checked or if they passed away. She relishes these potlucks for the opportunity to get together with her ohana, to continue making new memories and says, “It’s a difficult life but hey, just keep moving forward.” Despite the need for dialysis, Susumu Miyashiro maintains a busy travel schedule, flying between his childhood home in Wailua Homesteads, his current home in California, and other states. “I call the dialysis center and they take care of scheduling dialysis sessions at other facilities.” Continued on Page 14
Dialysis units run on a tight schedule, with people receiving dialysis for three to four hours per session, three times weekly. It’s not unusual for people to see the same faces, both staff and Right: Connie Vidinha, Colleen Faye, Judy Gonsalves, Ulu Breen
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Kauai’s Club Scene Senior Craft Fair
The annual Senior Craft Fair was a huge success, drawing a large crowd for holiday shopping and festivities. Left: A shopping bonanza with yummy food, raffles, great door prizes and crafts made by Kauai seniors throughout the year.
Lihue Seniors performing a folk dance from the Bulacan Province of the Philippines titled Bulaklakan, which translates as “Beautiful Flowers.”
Violet Bucao, a member of the line dancing group Vernie’s Dancers, dancing with the group to Roy and Glenda Tamashiro, members of the Kauai Ballroom Chichiquita, a high-energy song Dance Club, Hanapepe Chapter, dancing the cha-cha to Dean with a Latin beat. Martin’s classic Sway. 12
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Kauai’s Club Scene Halloween
The Koloa Senior Club hosted Waimea Seniors for a Halloween party. Bingo, a delicious buffet and pumpkin carving rounded out the day.
Pictured Above: Koloa & Waimea Senior Clubs. It was a fun day!
Marlese Roton (as Lucille Ball), Cassie Wilson, Cecelia Mahoe Helen Gerardo & Rose Semana
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When to Call Hospice (It’s not what you think)
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Robert S. Weiner M.D. Kauai Hospice, Medical Director
any people think of Hospice as “end of life care” and we certainly do that, but that’s not all we do. Our services are intended to benefit patients and families for at least 6 months, and in many cases our skilled palliative (symptom reducing) care can be delivered for a longer period of time.
There are no charges to the patient for our services as they are a government entitlement to those on Medicare, and private insurance or medicaid has equal coverage for those under 65. Because of generous community support we provide the same service to those without any insurance. We should be called whenever there is a diagnosis of a serious disease which cannot be cured. Hospice does not shorten life, in fact studies show it extends the length and quality of life. Our services include: Home visits by palliative trained nurses, and home health aids, medical social service, counseling by certified spiritual counsellors, palliative medicine physicians, volunteers,
and 24 hr. RN, and M.D. call by our staff. We also supply oxygen, hospitals beds, medications, and other equipment and supplies as needed for comfort. We do not wear uniforms or show up in marked cars, but we will come at prearranged times to comply with family convenience. We make information visits in the home or at our office with no obligation. We can do confidential interviews at our Kukui Grove office on Pahee St. regarding how our program might serve a given individual without even discussing that person’s identifying information. Just call 245-7277 and ask to speak to the intake nurse or a doctor.
Continued from Page 11
Sal is all smiles watching his young son playing at the beach this day. Shortly after starting dialysis he was introduced to the idea of peritoneal dialysis, which is performed at home. “At the beginning I was hesitant to try peritoneal dialysis,” he says, adding “now I have more energy, stay with my family, play with my son.” The dialysis takes place at night while he is sleeping. He has a backup system in case the machine breaks. As for the woman who didn’t want to start dialysis? She’s been on dialysis for four 14
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months now. She feels better and enjoys the moral support of getting together outside dialysis. “Sitting in that chair gives you a lot of time to think.” As for the challenges of living with kidney failure, she enjoys the opportunity of being able to “talk it out” during Ohana on Dialysis potlucks with others who are facing similar challenges. February 2015 will mark five years on dialysis for Leon. He’s glad to make a difference, get people talking, get them out. “Get the people out. You’re not dead yet!”
Giving Back to the Community
This year, Elder Resource Magazine has been delivered with over 1000 home delivered meals with Meals on Wheels to homebound seniors through Kauai Economic Opportunity Over 1000 have been provided to food pantries around Kauai through Hawaii Foodbank, Kauai Branch and 100s more to non-profit & government agencies dedicated to the wellbeing of older adults. It would not be possible without the support of our advertisers.
Mahalo Nui Loa www.elder-resource.org
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The 29th Annual
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Matsuri Festival
he Kauai Japanese Cultural Society, celebrating their 30th anniversary, welcomed residents and visitors to the 29th annual Matsuri Festival at the Lihue War Memorial Convention Hall. 2014 marks Kauai County’s 40th year sister city exchange with Moriyama City and 25 years with Iwaki City. Dozens of people from Japan arrived to celebrate the occasion in the spirit of cultural exchange.
Bottom right: Mr. Hirayama of Iwaki City demonstrated soba noodle making by rolling out a thin sheet of dough, folding it into eight layers, and slicing with a large knife to form the noodles. In the kitchen, soba noodles were cooked and prepared with a combination of ingredients including mirin, wasabi and green onions. Absolutely delicious!
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The 29th Annual
Matsuri Festival Right: Performances were ongoing throughout the festival. Here, the Hanapepe Senior Club dances with straw hats to the folk song Hanagasa Ondo, from the Yamagata Prefecture of Japan.
Above: Ms Mie Komiyama demonstrates a step in the process of using natural dyes to color cotton material. Festival attendees were able to experience this process first hand by dying garments available for a small fee.
Right: Shodo, the art of calligraphy, as demonstrated by Rev. Nicole Sakurai, below. Ms Aki Matsuyama was one of many participants who enjoyed the opportunity to try her hand in the art of shodo.
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Exercise of the Month:
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Ballroom Dancing
oin the Kauai Ballroom Dance Club and get ready for fun! Learning dance steps and sequences challenges your mind, while the physical activity helps maintain muscle strength, improves balance and increases endurance. Be prepared to work up a sweat! Come as you are--dressy or casual, with a partner or solo. Next session of classes starts in January; for more info on the Hanapepe Chapter call Glenda Tamashiro at 335-3554. For info on the Lihue Chapter, call the Lihue Neighborhood Center at 241-6858. Nominal fee. The club learned three dance steps this evening by volunteer instructors. Steps are introduced and reviewed separately for men and women. When the music starts, couples come together and incorporate the new steps into their routines.
Above: Mike & Helaine Perel practice an East Coast Swing step taught by Dan & Cornelia Works. Below Left: Doug Duvauchelle and Jeanette Bonilla teaching an intermediate Cha Cha step.
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Right: Tom Midstokke & Rosemary Cooper practice the Bachata, taught by Glenda & Roy Tamashiro.
Elder Resource Magazine’s
Health & Wellness Directory of Products & Services
Tips & Ideas for Quality of Life
In this section: Ohana Home Health The Specific Chiropractic Ctr. Happy Science Bayada Habilitation
Jason Blake, Medicare Consult Kauai Athletic Club Kauai Therapy & Wellness Vim N’ Vigor
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January is National Glaucoma Awareness Month
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View the magazine online!
www.elder-resource.org Grilled Opelu The
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secret to getting fish off the grill without leaving the skin behind, stuck to the grill? A clean hot grill, slightly oiled, and patience. After about 4 minutes for a small fish like opelu (or a boneless filet of a larger fish), very gently try to move the fish. If it’s stuck, wait about 30 seconds and try again, and again after another 30 seconds if necessary. It will release from the grill when it’s ready.
Luscious Lamb Chops
For a special holiday treat try lamb chops. They’re moderately priced and have a slightly wild flavor that is complimented by this marinade, fusing Portuguese Sangria flavors with Asian influences of soy sauce and sesame oil. This recipe uses a skillet, but lamb chops are great off the grill as well. Served here with a fresh salad and corn on the cob. Marinade for 8 lamb chops: ¼ cup Orange Juice ¼ cup Red Wine ¼ cup Soy Sauce 1 ½ tsp Sesame Oil 1 Large Garlic Clove, crushed ½ tsp Ground Black Pepper Olive Oil for cooking Chopped Scallions for garnish Marinate lamb chops in the refrigerator for 8 hours, remove from marinade and pat dry with a paper towel. Heat skillet to medium/medium-high and coat with olive oil. For 1” inch thick lamb chops, place in skillet and cook for about 5 minutes. Reduce heat to medium-low, turn lamb chops and cover loosely. Continue to cook for about 10 minutes for medium-rare, 12 minutes for medium. Garnish with scallions if desired.
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Medeiros Family Reunion September 18, 19, 20, 2015
Let’s get all the descendents together.
For more information contact Shirley Simbre-Medeiros at 645-0668 or Suzette Medeiros at 645-2749 ASAP!
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From all of us at Elder Resource, we wish you a happy holiday season and a safe & merry new year
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Community Resources
Food Security
Need Help With Food Stamps? Assistance By Child & Family Service To schedule an appointment call: Dory at Hale Hoomalu (821-2520) Momi at Nana’s House (338-0252) Hawaii Foodbank Kauai Branch Helping to feed Kauai’s hungry To find a food pantry near you call (808) 482-2224 or visit www.HawaiiFoodbank.org Kauai Independent Foodbank Kupaa Kokua Kupuna: a monthly service offering a variety of foods for seniors 60 years and older. For more information call 246-3809
Government Agencies Agency on Elderly Affairs Information on senior resources Linkages to appropriate agencies Community outreach (808) 241-4470 www.kauaiadrc.org DHS Adult Protective Services To anonymously report abuse or neglect of a vulnerable adult call 241-3337 Long Term Care Ombudsman Protects the human & civil rights of long term care residents Executive Office on Aging 274-3141 ext. 60100
Kauai Lihue 3731; 28
Legal
US Dept of Agriculture Home repair grants for income qualified homeowners ages 62+ contact the USDA to see if you qualify (808) 245-9014
Legal Aid Free legal assistance for seniors Elder law, wills, power of attorney for information call 808-245-4728
Veterans Affairs Rural Health Program Mon 10-2, Kilauea Christ Mem. Church Wed 930-130, Hanapepe U. Church of Christ Thur 930-130, Hanalei, Hale Halawai Fri 930-130 Kekaha, Westside Christian Ctr For more info call (808) 246-0497
Seniors Law Program Educational seminars for your club or group by James Michael Ratcliffe Attorney at Law 246-8868
Support Groups Alzheimer’s Association Caregiver Support, Training, Counseling For more info contact Humberto Blanco 245-3200 or Humberto.Blanco@alz.org Caregiver Support Group Feeling overwhelmed as a caregiver? Group meets 2nd & 4th Thursdays 5:30-7pm at Kauai Hospice Call 245-7277 for info Parkinson’s Support Group Talk story & share ideas Last Tuesday of each month Regency at Puakea 5-630 pm Susan Storm 212-1250
Volunteer Opportunities Habitat for Humanity Build homes, community & hope Volunteers of all abilities needed Call Jess at 335-0296 ext. 152 Foster Grandparent Program Help children learn in school Provide one-on-one tutoring 241-3355 Share the Care We help organize family, friends & resources into caring teams. Contact Deborah Duda 332-7668 deborahduda@yahoo.com
Elder Resource Magazine
Think B.I.G. For persons with acquired brain & spinal cord injuries, family, caregivers 2nd Wednesdays, 430-630pm Kapaa Neighborhood Center
County Senior Centers Kilauea 828-1421; Kapaa 822-1931; 241-6858; Koloa 742-1313; Kalaheo 332-9770; Hanapepe 335Kaumakani 335-5770; Waimea 338-1122; Kekaha 337-1671 www.elder-resource.org
Ask the Nurse Christine Bothmer, RN
A Question of Respect Question: What is agism? Answer: Agism is prejudiced opinions about people based on their age. This can have a negative impact in their involvement at work, home, and even in the healthcare they receive. One way seniors experience agism is when their opinions are seen by younger people as “quaint� but are quickly disregarded as irrelevant or outdated. Many people don’t recognize agism because it is so common in our modern culture. In media, the aging process is frequently associated with negative connotations that reinforce incorrect assumptions, like all old people being hard of hearing, unwilling to learn new things, or as having dementia. Even young adults are often victims of agism. For example, in the workforce when their ideas are not taken seriously because they are perceived as not having enough experience to formulate really good ideas. Young adults eventually outgrow the effects of agism, but it gets worse for seniors as they get older.
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Confessions of a Caregiver
By Pam Woolway
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ur family equation for caregiving developed slowly, over five rigorous years following our father’s death. Two sisters and I divide the year into three, with each caregiving our 85 year-old mother four months. Mom spends summer on Kauai.
My first summer with Mom was clumsy; not clumsy like, “oops, I tripped over a crack,” clumsy like a caffeinated circus performer juggling 14 greased kittens: ridiculous, slightly hazardous and horrifying to observers. Like the day mom was anxious to leave the house, and against my good judgement, I surrendered to her call for action. See, the wheelchair was a relatively new development with the deterioration of her spine, and the onset of Parkinson’s. Restlessness and inactivity kindled her agitation. We left the house, ignoring the dark skies and gusting winds. As my husband silently transferred Mom into the car, I dismissed his closelipped smile and empathetic eyes hinting at his disapproval. He wanted to discourage this decision, but secretly, I think he may also have relished the thought of a few hours alone. When we entered Ace Hardware in Lihu`e it was dry. When we exited 10 minutes later, a gale sent the rain sideways across the parking lot. Mom waited in the store while I moved the car beneath the covered entrance. As I rolled her chair into the wind, I knew how badly this would go. Red vested employees assembled to watch from the doors just outside the rain’s shadow. One gentleman raced to hold the passenger’s door open against the wind’s force, as I wrestled Mom to her feet to back her into the seat. “Hurry Pam, hurry,” Mom kept repeating into my neck. My hair striped my face in wet strings, but I could still see the distress on the faces of our audience silhouetted against the artificial light streaming from the store. This was clearly a time when all one could do was stare. I was so new at caregiving; transfer30
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Contributed photo
ring Mom between places was still new to me. On a good day she helps by using her arm strength to hold the edge of the door or to lift a foot gingerly into the car. This was not that kind of transfer. Her feet were nailed to the ground, her arms gripping my shoulders as I swung her toward the door. I won’t lie: I may or may not have pushed her back into the seat just to get it over with and escape. I couldn’t look into the eyes of the employees as we reversed. In the car, we sat quietly, our hair wetted to our heads and steam forming on the windows. That was two years ago. This past summer with mom was markedly different; the learning curve of the year before having leveled out. This column will hopefully be a chronicle of triumphs, hard lessons and coping mechanisms developed for achieving balance while caregiving. For more on this subject visit the Resource Playground at ohanahomehealth.com, where I share helpful resources. Pam Woolway is Community Development Coordinator for `Ohana Home Health in Kalaheo.
Menehune Craft Fair
Left: Fualupe TuihalaMemory Robinson’s craft fair, on the West fatai Silva end of Waimea, is one of the many placwith one es you can shop local for the holidays. of the many tapa products her family produces.
Above: Sosaia Pulu with his many carvings of Maori, Hawaiian & Tongan designs.
Above: The band Kuuipo, with Linda, Dee Dee & Rhoda added to the festive environment.
The perfect gift for those living off-island… Give The Gift Of Elder Resource Magazine This Holiday Season. Get one for yourself too. It’s a great way to support your senior resource. One Year (6 issues) for only $24! Includes 1st class postage & protective envelope. Pay using Paypal. Go to www.Elder-Resource.org and follow the Subscribe link. From: To: Name___________________________ Name______________________________ Address_________________________ Address_____________________________ City, State, Zip____________________ City, State, Zip________________________ Mail check and this coupon or reproduction to: Elder Resource PO Box 1257 Koloa, HI 96756 www.elder-resource.org
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