POSTED: 01:30 a.m. HST, Nov 16, 2010
LAST UPDATED: 03:00 p.m. HST, Nov 18, 2010
Margaret Chiu, a petite grandmother with a delicate frame, raised her hand tentatively in the classroom at Kapiolani Community College.
"What do you do if you can't lift him?" she asked in a soft voice. "My husband is heavier than me."
Caring for elderly relatives seems like it should come naturally, but it can be risky. And the job gets tougher over time, unlike looking after children, who keep learning new skills. With Hawaii's senior population expected to soar in the coming decades, support and education for elders and their families will be crucial, experts say.
"This is not innate," said Cullen Hayashida, director of KCC's Kupuna Education Center. "You can be good at it, and you can be pretty bad. You can hurt yourself if you don't lift people properly."
The center offers low-cost, short-term courses in elder care to train family caregivers and home workers as well as classes to help baby boomers stay fit and productive in their older years. Family members can learn and practice skills, such as how best to maneuver an invalid out of bed, and grapple with the touchier psychological issues involved in navigating the shift from independence to dependence.
The "Hands-On Skills for Family Caregivers" course that Chiu attended recently covered basics like how to handle bed baths and incontinent care, simple exercises and moving frail seniors from the bed or wheelchair. The students, mostly middle-age or senior citizens, watched attentively, then tried out the techniques, laughing when they got things wrong.
Yesterday» Graying of Hawaii
» Boomers to remain politically powerful
Today» Over extended families: Hawaii's high costs and healthful living mean that more senior citizens will be cared for at home.
» Helping hands: Counseling and advice are available for at-home caregivers.
Tomorrow» Booming costs: Hawaii is unprepared for the costly combination of more retirees and fewer workers to support them.
» Keep working: By choice or necessity, many boomers will postpone their retirement.
Thursday» Unhealthy debt: The state has put aside nothing for the expected $10.8 billion in health care costs for government retirees.
» Changing care: Hawaii's future health care will feature more technology, fewer doctors.
"It's just tricks of the trade," said instructor and physical therapist Ann Low in her brisk, upbeat tone. "If you know where to push and pull and just use gravity, it doesn't take much work. You've got to save your back and bend your knees."
After practicing in the nursing lab, the group went out to the parking lot to see how to handle getting their relatives in and out of a car. "It's a challenge," said Elsie Yamashita, who looks after her 92-year-old father. "That's why I took this class. I really needed to find out how to do it so I don't wear myself out. My dad is so heavy. I've been doing it wrong. You don't want them hanging onto you."
In a separate evening course, "Dealing with Your Parents' Stuff," gerontologist Barbara Cook guided caregivers in a discussion on dealing with physical and cognitive changes in older relatives, how to share responsibility and tackling the accumulations of a lifetime.
"People say it's like caregiving for a child, but it's not," Cook said. "The child is taking on more responsibility, they are gaining understanding, growing out of the dependency, whereas a parent is declining and often doesn't want to admit it."
Many nonprofit groups offer support services, education and respite for seniors and their caregivers. Among them are the Alzheimer's Association Aloha Chapter, Catholic Charities Hawaii, Child & Family Service and Project Dana. A state-sponsored program, Kupuna Care, also works to meet the needs of frail older adults who cannot live at home without help.
Caregivers can easily become isolated, and need help and education so they do not get overwhelmed, said Betty Lou Larson, who recently retired from Catholic Charities Elderly Services after nearly 30 years.
"Hawaii's people are very generous but you get burned out," Larson said. "Some seniors are not easy to take care of; they get belligerent. There's a real need to help caregivers, especially as this age boom comes on. They need help to cope with difficult behaviors so they can continue doing what they want to, which is provide loving care."
Project Dana, a volunteer program of "selfless giving," provides a lifeline for homebound seniors and disabled. Its volunteers offer friendly home visits, rides to medical appointments and grocery shopping, housekeeping and respite care, as well as support for caregivers.
Ann Shiroma, a widow who lives in senior housing in Moiliili, cannot ask her daughter for help because she lives in San Francisco. Instead, volunteers from Project Dana have stepped up to help Shiroma with a compassion that is hard to match even among blood relatives.
"Project Dana, oh my goodness!" said Shiroma, who has arthritis and walks with a cane. "I can't imagine how nice they are! They are amazing."
A retired banker drives her to doctor's appointments. Another volunteer stops by weekly to give her physical therapy. A student even comes to clean her house once a month for free.
Harold Y. Kuwahara, her volunteer chauffeur, says he is happy to help, and also regularly drives another gentleman to visit his wife in a care home.
"These people are less fortunate than I am," said Kuwahara, 82. "I can drive, luckily, and I'm relatively healthy, so I might as well do it as long as I can. Otherwise, they don't get out."
"It makes you feel good inside," he added. "At our age anything positive helps."
Mary Osorio, a case manager with Child & Family Service's gerontology program, said more of Hawaii's people should help seniors overcome loneliness and other hurdles of their twilight years.
"It's a whole community mindset," she said. "What is our responsibility, but more so, what is our honor and privilege to care of our elders? You've got to think about it as if it was your own dad or mom."
"What trouble is it to buy another bag of groceries for a neighbor when you're going to the store already?" she asked. "It's not rocket science."