For the past eight years, Debbie Kumai has rarely gotten a full night’s sleep, usually waking several times a night to care for her stepmother-in-law, Kay Kumai, now 88, who has Alzheimer’s disease.
Kumai and her husband, Steve, got a well-deserved break June 12 and 13 when Kay became the first night client at Hawaii’s first adult night-care facility.
The couple attended a wedding.
"It was really nice to be able to enjoy our time with each other and to do things on our time schedule," Kumai said.
Hale Kakoo, an adult care facility in Alewa Heights for people with Alzheimer’s disease and dementia, added night care to its services June 1, filling a need for such patients and providing respite for their caregivers.
"It’s the first one in Hawaii," said Rosanna Evers, director of social services for the Waianae Coast Comprehensive Health Center, which oversees Hale Kakoo and other adult day care centers. "The only comparable programs are on the East Coast."
Many people with Alzheimer’s disease and dementia suffer from "sundowner’s syndrome," a condition in which their sense of night and day is thrown off, said Dr. Rika Suzuki, a geriatric psychiatry fellow at the University of Hawaii.
Some are prone to wandering and want to leave the house, a common part of Alzheimer’s, she said.
The night-care facility addresses that problem.
"That’s such a novel idea," Suzuki said. "It’s a great idea to preserve the relationship between the caregiver and the patient."
But she added, "While it’s a respite for the caregiver, it’s yet another adjustment for the patient."
Debbie Kumai concedes the experience was disorienting to Kay, who was thrown off her routine, but added that her own chronic sleep deprivation had made the break a necessity.
Kumai said her stepmother-in-law sometimes awakens 10 to 12 times a night. With Kay’s sleeping hours adjusted and using sleep medication, Kay stays in bed longer but still wakes up in the wee hours.
That sets off a bed alarm that wakes up Kumai.
A full-time speech pathologist with the Department of Education, Kumai said she has been so tired lately that she that left work early one day because she could not function.
"Our whole life is consumed by Kay," Kumai said with no hint of resentment. "We can’t go out to eat anymore. We can’t go shopping."
Taking Kay along on outings is not an option because she becomes agitated and loud, said Kumai.
But Kumai says she understands things are difficult for Kay, who no longer recognizes her or her husband.
Hale Kakoo has a homey feel, with artwork, faux fireplaces, china and cloth napkins. The 5,000-square-foot house, at 1816 Alewa Drive, is on city property next to Na Pueo Park.
Under its lease with the city, Waianae Coast Comprehensive Health Center can accommodate up to 12 patients during the day and 12 at night in Hale Kakoo. State regulations do not allow a patient to stay 24 hours a day in day care.
Donna Schmidt, president and chief executive officer of Case Management Inc., which oversees foster homes and care homes, said her agency uses the day care to give its caregivers a day off and also to allow patients to socialize with one another.
Rates are $60 a day between 8 a.m. and 4 p.m. and $100 for night care from 7 p.m. to 7 a.m.
Waianae Coast Comprehensive Health Center has plans to apply for nighttime care at its Pearl City center. For more information on Hale Kakoo, call 542-9073.
