Contents 4
Letter from the Editor
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Salt Pond
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Healthy Aging
“Helping out & learning from our ancestors�
County Senior Centers Friendship House Journaling & Reminiscing
12 Portuguese Festival 14 Happiness Planting
Festival
16 Waimea Walking Tour 18 Uku: the Gray Snapper 20 Community Resources 21 Crossword Puzzle 23 Caregiver Tips: The Prevention & Care of Skin Tears
On the cover: Reiko Hashimoto, of Osaka, Japan, displays a delicious plate lunch of shoyu chicken, fresh salad with strawberries, Japanese pickles, brown rice with vegetables & seasonings and a brownie for dessert, at the Happiness Planting Festival in Lihue. More photos, page 14.
Elder Resource Magazine
Printed in Hawaii
Contact Elder Resource Editor & Publisher Artistic Consultant: Judith Lee Mail: P.O. Box 1257 Christine Bothmer, RN Contributing Writers: Koloa, HI 96756 Graphics & Design Paul Gammie; Rosalie Meuleman; Monica Con- Email: info@elder-resource.org Julie Bothmer-Yost trades, Winifred Tamura-Lis, Misao Tamura Phone: (808) 212-2760 The material in this magazine is for educational purposes only and not intended to replace the advice of your healthcare provider. All rights reserved. Permission granted to reproduce portions of this magazine for educational, non-commercial purposes only; please credit Elder Resource Magazine including date of issue, website url or mailing address. Advertisement in Elder Resource does not imply endorsement of products or services. We have no political or religious affiliation. Subscriptions $24 per year (6 issues). Subscribe at elder-resource.org or follow contact info above.
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Letter from the Editor
SB 2264, the “Care Act”
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uring my time as a home health nurse I had the opportunity to interact with some of the unsung heroes of healthcare--the informal family caregiver. “Informal” in this case means unpaid, and most have no formal training in the care of older adults, whose care needs tend to increase as they advance into very old age. Hawaii Senate Bill 2264, also known as the Care Act, was a step in the right direction of addressing the need for communication between hospitals and informal caregivers. According to AARP there are nearly a quarter million informal family caregivers of older adults in Hawaii.
The Hawaii State Senate Committee on Judiciary and Labor, referring to SB 2264 in a report to the senate president, made note of the increasingly complex nature of being an informal family caregiver: The role of unpaid caregivers is expanding to include medical and nursing tasks that historically were only provided in hospitals and nursing homes or by home care professionals. . . . This measure recognizes the importance of unpaid caregivers and their need for adequate training and support. The problem is not isolated to Hawaii. In the 2012 report, What Do Family Caregivers Do, the American Psychological Association found at the national level, “caregivers do not receive adequate training, preparation, or ongoing support from health care systems.” Despite these facts, SB 2264 did not pass. Testimony against the measure included statements that hospitals already have protocols ensuring discharge instructions are given. Having worked on both sides of the issue--as a staff nurse giving discharge instructions and as a home health nurse helping struggling caregivers get back on track--I can tell you the care has become too complicated for this current format. It is well documented that transitions of care--whether from a nurse or hospitalist to the oncoming shift; from one physician to another; or from an acute care facility to rehab--are not infallible and are in fact a time to which errors in care can be traced. To avoid errors in care, a lot of thought goes into developing protocols for smooth transitions within the healthcare system. Don’t informal family caregivers and older adults deserve as much for a smooth transition home? --To respond to this editorial, comment on our facebook page: facebook.com/ElderResource; submit an email via our website; or mail a letter.
-Chris Bothmer, RN
The Kekaha Senior Club toured the Wailua river recently, compliments of Smith’s Kauai. Contributed photo 4 elder-resource.org I August 2015
Home Safety Tips
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By: Paul Gammie of Gammie HomeCare iving out our lives in our own homes is the goal of most seniors today. The high cost of institutional care is a driving force challenging people to think about their options as they age. Finding ways to improve our homes and making them safer for any generation of life does not always need to be complicated or expensive. Here are a few things to consider during a home safety review:
Be aware of trip hazards! Exposed wires or curled carpet ends can be dangerous. Move wiring away from normal travel paths, cut or replace curled carpet ends, move any objects restricting clear walking paths to the side. 2) Be sure steps have a handrail. 3) Have a series of small night lights that automatically activate when it’s dark. Placed in the bedroom, hallway and bathroom, these can be helpful if a person gets up and walks in the dark. 4) Be sure your bed height allows you to firmly put your feet on the ground when getting in or out of bed. If you are remodeling your home, planning ahead can really help! Ideas to consider include: 1. Make any doorway at least 30” wide. 2. Avoid creating steps inside a home whenever possible. 3. Consider installing a roll-in capable shower in a bathroom remodel. 4. If living in a two story house, be sure at least one bedroom is available on the ground floor. Much money can be saved by incorporating these concepts known today as “universal design” when building or remodeling. It’s so much MORE expensive to rip out and replace a traditional 26” wide door with a 30” door than just putting in a 30” door in the first place! Check with a qualified contractor to be sure doors are wide enough for your specific needs. Good planning and common sense can go a long way in keeping our homes safe for everyone. Paul Gammie is owner of Gammie HomeCare, located at 3206 Akahi Street in Lihue.
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Scenes from Salt Pond, Hanapepe “Helping Out & Learning from our Elders” -Kana By Christine Bothmer
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ecently in Hanapepe, Chad and Kana were helping out with the tradition of cultivating salt, known by the Hawaiian word pa`akai. While today it’s just the two of them, other times there are many--some younger, some older. It’s not only about salt cultivation. By being together and working on a common goal, talking story, you never know what you’ll learn and what you’ll teach--about salt and about life. On a clay flat near the ocean, water from salt water springs is transferred to evaporating pits. As the water evaporates, the salt is left behind for harvesting. Clay and brine shrimp give unique properties to this highly-prized salt in this ancient Hawaiian practice.
Above: Kana skims plant debris blown into a kaheka. In the background other kaheka are further along in the evaporative process. The white salt is visible towards the front, while in the background clouds reflect off the water.
In the foreground, a punawai--the deep pool from which salt water is drawn. Sweat equity goes into preparing the the punawai and kaheka, but at this stage it’s less work and more talking story. “There’s nothing strict about the work--it’s fun,” exclaims Chad, a retired fireman who was invited to work the salt in 1992 and continues to help. Kana explains how a small amount of this year’s harvest will be saved for next year: “Pulapula, or rebirth--using salt from the previous year to seed the bed and wake it up.” 6 elder-resource.org I August 2015
Preserving cultural practices while incorporating modern conveniences Kana readies the hose to transfer salt water from the punawai (spring) to the kaheka (evaporating pit), while Chad stands by, ready to activate the pump.
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Healthy Aging
County Senior Centers By Christine Bothmer, RN
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Cindy Duterte & Melanie Okamoto elanie Okamoto and Cindy Duterte are dedicated to ensuring healthy aging through recreation. They are two of the the driving forces behind the County Senior Centers, and in this interview they discuss various aspects of the program and facilities.
Please give us an overview of the County Senior Clubs. The County of Kauai, Department of Parks and Recreation has nine senior centers throughout the island. They provide a place that is welcoming, comfortable and accessible for seniors to pursue mutual interests, receive health and educational information and engage in activities that enhance their independence and community involvement. How are the clubs similar to each other and how are they different? The clubs are similar in the way each site is open to providing meaningful and engaging activities. Each club is unique because there is a diverse mix of cultures at the senior centers, and they are operated by officers with different talents and resources as well. Every generation has unique interests. How do the clubs adapt to the changing needs as new generations join? The current seniors realize that the new generation of seniors is not going to be interested in following
the regimented schedules of the current senior center format. The new senior will prefer a wider variety of services and activities. Our goals focus on maintaining a quality service for our existing seniors while adapting to a changing environment to meet the needs of the “Baby Boomer� generation. We will create systems that embrace choices and flexibility, resulting in a win-win for all. The senior club calendars list a lot of different activities. Does one have to be an official member to participate? Is there a fee or residency requirement? To participate in a class does not require membership. Most classes and activities are free, some have fees which vary with each activity. Seniors encourage participants to join their clubs at an annual minimum fee which entitles them to participate in special functions. You do not have to be a resident to become a member. For more inforation call (808) 241-4462; email mokamoto@kauai.gov; or visit www.kauai.gov Parks and Recreation, senior programs; or follow the link from the Elder Resource homepage at elder-resource.org.
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Healthy Aging
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By Monica Contrades y name is Monica Contrades and I am a member of Friendship House. At Friendship House, we’re not patients or clients, but members of a community of people who happen to have a serious mental illness and who also have similar hopes and aspirations for friends, jobs, and good places to live‌pretty much just what anyone else would like to have. I knew many members who attended the Friendship Clubhouse so I decided to join and use it as a venue to help myself and advocate for mental health services.
Friendship House is a Clubhouse Model Psychiatric Rehabilitation program established in 1988 providing mental health services for adults with serious mental illness. We are a voluntary program helping members achieve partnership, trust, teamwork, wellness, empowerment and meaningful work. Staff and members work side by side in all aspects of running the clubhouse. We have two units that members can choose to work in daily. The food service unit where members are involved in menu planning, grocery shopping, budgeting, cooking, waiting tables and other responsibilities that come with serving a daily nutritious lunch. The communications unit is responsible for maintaining statistics on attendance, a newsletter and performing other clerical duties using computers, typewriters, copiers and online services for email and the internet. My advocacy has taken me to speak at many community agencies. Community relationships are very important to Friendship House as they help members, like myself, to educate the community on mental health services. We currently have 75 active members, 13 of which are seniors all of which are actively involved in clubhouse activities. I have been a member of Friendship House for 50 years now. I don’t feel like I am alone or isolated anymore. The clubhouse is my home away from home. The staff treats me as an individual and as a friend, and they do that with all the members. For example, if people need help with rides to medical appointments and grocery shopping, the clubhouse is there for them. Friendship House made my dream come true when they provided me many opportunities to advocate for mental health services. 10
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Healthy Aging Journaling & Reminiscing
Telling Your Story
By Winifred Tamura-Lis, MSN hen Dad retired from working full-time over 30 years ago, a friend suggested he write a journal to keep track of his activities, thoughts, and feelings. Dad laughed and said, “What would I write about and why would anyone care?” But he took some sheets of paper and started to write his family history. He added unique adventures from his youth and his journal took off. Over 25 years it grew into a 64-page story. Dad no longer writes, but his journal has become a legacy of a life well-lived, of hard times and of happy times. For him, every cloud had a silver lining.
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Anyone can Journal by keeping records through writing (including letters or emails), voice recordings, videos, art or photographs. You can write daily or whenever you have something to share. Journaling is a thoughtful reflection of life, an account of feelings which can help people learn about themselves. Journaling helps connect the past with the present and future. Journaling can empower a person with self-con-
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Above: Misao Tamura & Winifred Tamura-Lis fidence, self-worth and independence. It strengthens good feelings and promotes psychosocial connectedness for the mind, body and spirit. In Hawaii, we “talk story” – journaling through speech or reminiscing. Reminiscing is present in every culture and is a way to review life experiences and recognize accomplishments. Anyone can share through journaling or reminiscing. So share life’s disappointments, celebrate the joys and connect with others! It is therapeutic, promotes healthy aging and a good quality of life. Winifred Tamura-Lis, PhD, MSN, BA, CQT, RNBC, is certified in gerontological nursing, has worked as a charge nurse in long term care and is a full-time caregiver for her father.
Chasing Rice Birds - from Misao Tamura’s journal
was the summer of 1930 and I was 13 years old. Father and Uncle Watari had made an arrangement that I should chase-- “scare” rice birds that came to feed on growing rice grains. Uncle’s rice farm was located in Hanalei Valley and included close to four acres.
Knowing father too well I did not refuse to go, but I did not want to go. I had never been away from home for any extended period of time. In Hanalei and other north and east shore valleys and stream banks where water was available, the rice industry was very extensive. It had to feed the great oriental population in the islands working on the sugar plantations. But around the year 1948 the competition from California and other mainland growers put an end to rice growing in Hawaii. Rice birds were another reason for the downfall of rice growing in Hawaii. Early each morning as the
rice grains began to mature in early summer, the birds roosting in mature sugar cane leaves on the 5000 acre Kilauea plateau left for the rice fields in two’s and in flocks of countless numbers. The birds were tiny but their numbers wreaked havoc on the industry as their tough beaks pressed out the milky contents of each young grain. After feeding all day long, before nightfall, the birds returned to roost in their snug fields of sugar cane. Summer in Hanalei Valley chasing birds started at dawn. I carried an improvised two feet square white flag on a stake, yelling and waving the flag as I circled the four acre rice paddies, round and round all day long for 10 to 11 hours except for a break for lunch. I lost my voice at two occasions during this summer. I cannot believe to be that conscientious that summer as to have lost my voice yelling at birds.
Bon Dia!
By Christine Bothmer
A celebration of Portuguese culture and history at the Kauai Museum.
Dee Dee Wilhelm tells a story of how her ancestors came to Hawaii from Portugal by ship 130 years ago. 12
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From left, Kelsie Lima, Gwen Zaima, Rose Ferreira Harris and Shan Texeira Resinto at the malasada station.
Alice Arruda prepares to transfer homemade Portuguese bread into the forno, a domed oven preheated with a wood fire. After the forno was thoroughly heated the coals were raked out and the oven cleaned. The bread quickly baked to a golden brown, coming out moist and slightly sweet.
Dan Nelson, retired teacher and volunteer for the Portuguese Genealogical & Historical Society of Hawaii, flew over from Oahu to offer services including helping people research their family history. visit our archives I elder-resource.org
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Happiness Planting Festival By Christine Bothmer
Taiko Kauai
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ith the abundance of activity and goodwill at the Happiness Planting Center in Lihue, this annual event met its goal of planting happiness in the hearts and minds of everybody attending. A small taste of the performances, events and offerings are presented here, and many more took place throughout the grounds. From sushi rolling to kimono picture taking to a calligraphy booth, the Hiroshima Peace Museum exhibit and more, there was something for everybody at this event.
The Sacred Earth Choir 14
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Dorene Sautner, RN, volunteered at the Elder Resource booth. Here she is, checking the blood pressure of Evelyn Bradberg. Dorene is retired from Kauai Hospice. Thanks for your help, Dorene!
Hands on Flowers
Elder Resource Magazine Ray Nitta & Carl Matsumura pounding mochi. The heavy stone usu, or mortar, is passed from generation to generation. This one is made of lava. Hot water is poured into the usu so the vessel will be warm to avoid cooling the freshly steamed mochi rice. Thanks, Ray & Carl for all your hard work--everybody enjoyed the delicious result!
supporting older adults & caregivers through education & empowerment
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Waimea Walking Tour By Christine Bothmer
Waimea Church, originally built in the 1830’s by Reverend Rowell. Hawaiians helped collect and transport limestone and ohia timbers for construction.
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letha Kaohi, whose roots stretch back to the Hawaiian pre-contact era on the Mana Plain of West Kauai, leads walking tours of Waimea Town for the West Kauai Visitors Center. Intertwining familial history, the broader Hawaiian culture and events leading to today’s Waimea, she is a wealth of knowledge and as a former librarian ferrets out fact from folklore during her historical reflections. She dedicates hours each week to her lively and entertaining tours. Added bonus--walking is great exercise! Walks are every Monday and start promptly at 8:30 am, reservations required. For more information call 808338-1332. Open to residents and visitors by donation.
Gulick-Rowell missionary house, built in 1829 is in the early stages of restoration. According to the National Register of Historic Places Inventory Nomination Form, it is “one of the oldest and best preserved as well as finest examples of early missionary housing on the island of Kauai.” Hawaiians were paid in “goats, Bibles, textbooks and other articles” for helping build the home including cutting huge blocks of limestone from reefs for the foundation and some walls. 16
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Aletha Kaohi stands in front of the Waimea Hawaiian Church, one of a handful of churches where Hawaiian is the primary language. Originally built in 1865, this replica was erected after Hurricane Iniki demolished the original.
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The Gray Snapper: “Uku� By Christine Bothmer
Allen Stinson reeled in these gray snappers while sailing from Lihue to Hanalei. While not as glamorous as its cousin onaga, or red snapper, uku is also tender and succulent. Delicious served sashimi-style, thinly sliced with wasabi & shoyu.
But what to do with the other fish?
Wrap in foil and grill. Serve with grilled corn & zucchini.
Season & steam. 18
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Gray Snapper Patties: • Break leftover cooked uku into small pieces, about 2 cups. • Mix cracker crumbs, about ⅓ cup, 1 egg, salt & pepper and form into patties. • Sear in a little oil. Serve with fruit for a quick and healthy breakfast.
Make a gravy by melting 2 tablespoons butter. Add 2 tablespoons flour and stir for a few minutes over medium low heat. Whisk in 1 ½ cups broth and stir until thickened. Add cooked uku torn into small pieces, heat through and serve over egg noodles. Garnish with parsley, add salt & pepper.
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Community Resources Food Security
Support Groups
Volunteer Opportunities
Need Help With Food Stamps? Call Child & Family Service Dory: Hale Hoomalu 821-2520 Momi at Nana’s House 338-0252
Dual Diagnosis Anonymous meets Fridays 1:30 - 2:30 at Friendship House, Kapaa area For info call Carla: 808-346-3384
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
Alzheimer’s Assn caregiver support groups, training, counseling. Call Humberto Blanco at 245-3200 Humberto.Blanco@alz.org
Kaua`i Community Seed Bank Help us to discover, grow, store and distribute valuable seed crops for Kaua`i’s present and future generations! Call Paul 652-4118
Kauai Independent Foodbank Kupaa Kokua Kupuna: a monthly service offering a variety of foods For seniors 60 years and older. Call 246-3809
Caregiver Support Group Feeling overwhelmed as a caregiver? Group meets 2nd & 4th Thursdays 5:30-7pm at Kauai Hospice Call 245-7277 for info
Government Agencies
Parkinson’s Support Group Talk story & share ideas Last Tuesday of each month Regency at Puakea 5-630 pm Susan Storm 212-1250
Agency on Elderly Affairs Information on senior resources Linkages to appropriate agencies Community outreach (808) 241-4470 DHS Adult Protective Services Information-Report on Adult Abuse/Neglect call 241-3337 humanservices.hawaii.gov
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Think B.I.G. For persons with acquired brain & spinal cord injuries, family, caregivers 2nd Wednesdays, 430-630pm Kapaa Neighborhood Center
Legal
Long Term Care Ombudsman Protects the human & civil rights of long term care residents Executive Office on Aging 274-3141 ext. 60100
Legal Aid Free legal assistance for seniors Elder law, wills, power of attorney Call 808-245-4728
US Dept of Agriculture Home repair grants for income qualified homeowners ages 62+ contact the USDA to see if you qualify (808) 245-9014
Seniors Law Program Educational seminars for your club or group by James Michael Ratcliffe Attorney at Law 246-8868
VA 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; 246-0497
Community Resources is a benefit for the community. To list your agency’s free senior service contact info@elder-resource.org.
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Habitat for Humanity Build homes, community & hope Volunteers of all abilities needed Call Christina 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. Deborah Duda 332-7668
Elder Resource Magazine Activities County Senior Centers Kilauea 828-1421; Kapaa 822-1931; Lihue 241-6858; Koloa 7421313; Kalaheo 332-9770; Hanapepe 335-3731; Kaumakani 335-5770; Waimea 338-1122; Kekaha 337-1671 Kupuna Party 2nd Tuesday of each month 10:45-12 noon themed parties with bingo & healthy snacks call 826-6687 Princeville Community Center
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A man lost his balance. He didn’t fall, but his arm slid along a doorway opening, leaving a 7-inch tear to the skin on his forearm.
The Prevention & Care of Skin Tears By Christine Bothmer, RN
A skin tear is a type of injury common in people ages 80 and older. A skin tear looks like a shallow cut or slice. Sometimes the skin will slide to the side, exposing the bottom layer of skin or underlying tissue. The most common cause of skin tears is when a person with delicate skin bumps against something. Skin tears are often not painful at first, but repeated dressing changes are. The risk of infection or other complications adds to the pain and anxiety caused by a skin tear. Several factors predispose the skin of older adults to being easily torn. Age-related changes include a thinning of the skin, a decrease in the fat layer under the skin, loss of skin’s ability to stretch and spring back and a lower production of protective oils. Other factors include the side effects of some medications, smoking habits, some chronic diseases, and lifelong exposure to the sun and other elements.
Large skin tears or tears to the leg or foot of a person with diabetes or poor circulation should be evaluated by a healthcare professional. Their goals will probably include gently cleaning the wound and patting dry, sliding the attached skin flap back over the wound if possible, applying a dressing that won’t stick and won’t damage the surrounding skin, and looking for other injuries.
To avoid skin tears, pad furniture and equipment; apply lotion to help keep skin supple (apply gently so as to not cause a skin tear or bruise); wear protective clothing; use proper techniques when helping somebody move; avoid tape on the skin to secure dressings; have adequate lighting for moving about, and ensure adequate diet and liquids based on the individual’s needs.
As a caregiver, you will likely be required to perform the dressing changes at home. Observe how the dressing is applied and take notes. Be sure you have this information before leaving the clinic:
Crossword Solution
• How often to change the dressing. • Type of supplies needed. Usually the clinic will provide supplies for at least one dressing change. Bring them with you to the store to make selecting supplies easier. • Any signs or symptoms to be reported to the clinic. • If a follow-up visit is needed and with whom. Clarify who will make the appointment. • If new medications are ordered and how to obtain them. If you need training in any of these areas--ensuring a proper diet, proper transfer techniques, more instruction on wound care or a home safety evaluation, ask the clinician for a referral. People who are homebound, as defined by Medicare, may qualify for a limited number of in-home visits to help with caregiver training.
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