 Aloha. I'm Marsha Joyner and we are navigating the journey. Navigating the journey is dedicated to exploring the options and choices for the end of life care and to assist people to talk about their wishes. It's time to transform our culture so we shift from not talking about these things to talking about it. It's time to share the way we want to live our lives at the end of our lives and to communicate about the kind of care we want and don't want. We believe that the place to begin this is not in the intensive care, but it is now to talk about it. According to the Hawaii State Plan on Aging, by 2035, one-third of the population here in Hawaii will be over 60, I'm quite a bit over 60, and predominantly female. Over the next three years we must add another 2 million home care jobs to the 3 million we already have, just to keep up with the growing trend. Together, together we're going to explore these paths. Together we can make these difficult conversations easier. Together we can make sure that our own wishes and those of our loved ones are expressed. Behind every great movement stands a team of passionate organizers, communicationers, and visionaries, and meet our own Pedro. He is the Hawaii community organizer for caring across generations. I hope I got that right. It's a national movement of families, caregivers, people with disabilities, and aging. These are people working to transform those times at the end of life. The caregivers, he's also the campaign director for care for our kupuna, which I am, the local movement to create a legislative plan for long-term care, including the kupuna caregivers program. And so I want you to meet this beautiful young man who has no idea about the end of life or being a kupuna. But it's people like, like this young man with all this energy and drive to care for us that we have this today as a beautiful guest, Pedro. Thank you so much. I want a great introduction. The only thing I disagree with you is that it's not just a kupuna, it really is going to take all of us, including our very youngest, which I'm not, and they're very youngest. I wish I were, but definitely it's going to take all of us to be able to work on this. Yes. And so that's why I wanted to talk to you. To tell our audience exactly what is it we're doing as a community, what we're not doing as a community, and then how we can help those of us that can help. Well, one of the things that we're looking at and caring across generations is leading in the United States to be able to do is to revolutionize the way that we look at care. One of the things that we don't like to talk about, which is a sort of a buzzword, is the silver tsunami. I love that. The only thing is that tsunami has a negative connotation, right? I know. But it is a wave. It is a wave. So we like to think about it as a wave, because you can serve a wave. Yes. A wave can have a lot of positive, and it's needed for our shores, and it's needed. Well, I was at one of those stores that has a discount for seniors, and the woman asked me for my ID card, and I said, can't you look at me? And she said, no. Everybody's got white hair now. I said, oh, okay. That's true. I said, okay. So, but we like to think about, we have the opportunity right now to create action so that we're dealing with prevention rather than dealing with a crisis later on. And there's opportunity for business, there's opportunity for our families, there's opportunity for our young people to grow into jobs. As you're talking about, there are so many positions that need to be created in Hawaii alone. So that's a great opportunity for young people to start preparing for those jobs of the future. If we're talking about jobs of the future, care professions are one of those. One of the things that caring across generations is working on though, is making sure that those are livable wages, that those care professions are certainly livable wages. What is a care profession? What do you do? That's a great question. So when we talk about caring professions, it can be anything from a home health aid worker to a nurse practitioner, to somebody who's working in an adult daycare center, somebody who comes in to provide transportation services for the elderly. So it includes a really a variety of different services that provide care on the home. And one of the things that we are particularly looking at, the model that we're looking at here in Hawaii, is that the government or any given organization cannot supplant the care that is being provided by family members, by unpaid caregivers. There's just too much that are unpaid. We call it the silent army that are often suffering alone doing this care alone. You know, there's not enough money in anybody's budget to be able to do what they do because they estimate, I think ARP estimated something like 11 billion or 2 billion dollars in Hawaii alone that they provide in unpaid care. Well, I'll give you a classic example of that. My mother, who I thought was the strongest person in the whole world. Oh my. I'm just glad it wasn't me. Yeah, I am too. Go away. I thought my mother was the strongest person ever. I guess all children do. And then one day she was fine. Then she fell and she was alone. So it took us three days to discover that she had one day she's great and the next day I am a caregiver. Yeah. And I knew nothing about being a caregiver. So my question to you is how do we, I hate to say prepare for that, but so many people are in that category like one day everything's fine, the next day it's not. Yeah. How do we prepare for that? In that, what you're describing is what most people who go have to become caregivers go through. There's no preparation, there's no sort of how do you prepare for a grandpa having a stroke or how do you prepare for mom falling or how do you prepare for an accident to happen. I mean, you simply don't prepare psychologically for those kind of situations. As far as preparing financially, there is obviously long-term care insurance which we still encourage everybody to be able to seek out because we certainly don't know when that will happen. So similar to life insurance, what a lot of people don't realize is that life insurance doesn't cover things like becoming disabled due to a stroke or a fall or something that doesn't happen at work. A lot of times they'll cover work injuries but they won't cover personal injuries. So we always encourage everybody to look at long-term care insurance if they're able to afford it. Well, it wasn't so much the finances is that, well, I just didn't know what to do. Physically, emotionally, well, now what? When we brought home from the hospital, it was, well, you do this. Are there classes? Yes. That take ordinary people that to get ready for this because I guess we have to assume that at some point we will have to deal with this. So there's a couple of resources which is great because that tends to be, it's that psychological aspect that really wipes us out, that really makes it difficult for us to be able to go on with our everyday. So there are classes, one of the face-to-face classes that they have is at St. Francis. St. Francis holds caregiver classes, everything from bathing an individual to talking about finances, talking about things like power of attorney if needed. So it does prepare you both psychologically and physically to be able to care for somebody in your family. Each county also has an area disability research agency Aging and Disability Resource Center and those organizations that are provided, funded by the government, provide assistance to caregivers and to elderly if they need it, including trainings and including providing, connecting them with specific services that they might need. So now if you say well everybody in my family is doing okay but I'm at an age that I'm sure that somebody's going to have an issue, can I just go to these classes even though I don't have someone? I think that's a great idea. I mean Rosalind Carter said that there's three kinds of people in the world, those who are currently caregivers, those who will be caregivers and those who need caregivers. So then the idea is that all of us will somehow be touched by caregiving and as you said in your opening it's 100% right, we're not talking about it and we're certainly not preparing for it if we're not talking about it. So that's going to classes ahead of time, understanding the issue is incredibly important and talking to your family members about it. How would you take care of a loved one of your parents or your grandparents if and when they do need caregivers? Do you have the financial assistance? Would your job be affected? Who would be the primary caregiver in your home? All of those conversations certainly need to be having in families as well as end-of-life care decisions but what we find is that there's been a great deal of education about end-of-life care decisions but there's a lot of years before end-of-life. Yes and that's where we are with you is this middle ground. Yes we navigating the journey has been about the end-of-life and we have talked about the end-of-life and all of these issues but now okay let's get from here to there. Let's see what what happens there. Yeah and so the Kupuna caregivers program which is one of the things that we have helped champion here in the state along with a lot of help from other organizations such as FACE the Alzheimer's Coalition you know many organizations have come together. The idea is that caregivers need our help so what if we created a system where rather than only focusing on the elderly and what the elderly need as help with what our Kupuna need is the people that are providing their care they need our help too. Well Pedro I'll tell you what let's go to break and when we come back let's talk about Kupuna care and what you're doing to get us ready to do whatever it is that we have to do to take care of our Kupuna to be a Kupuna. Okay we'll be right back. This is Think Tech Hawaii raising public awareness. on energy efficiency which means you do more for less electricity and you're generally safer and more comfortable while you're keeping dollars in your pocket. Freedom is it a feeling? Is it a place? Is it an idea? At Dive Heart we believe freedom is all of these and more regardless of your ability. Dive Heart wants to help you escape the bonds of this world and to fight gravity. Since 2001 Dive Heart has helped children adults and veterans of all abilities go where they have never gone before. Dive Heart has helped them transition to their new normal. Search diveheart.org and share our mission with others and in the process help people of all abilities imagine the possibilities in their lives. Aloha and I'm back and we are navigating the journey and today we are talking with this lovely young man Pedro is all about Kupuna care and Kupuna caregivers and so we're going to talk about the legislation that the governor signed what that means and how that affects us all. Hopefully we get all that in. Okay Pedro tell me what is what is the legislation Kupuna caregivers? So the governor signed this past legislative season the Kupuna Caregivers Act which establishes the Kupuna Caregivers program within the executive office on aging. We're really happy about the way that it that it turned out because there was not a single no vote from any legislator at any of the committees or any of the any of the joint sessions and what we're seeing is that you know there's no bad guy in this issue everybody wants to be able to take care of our Kupuna. The idea is how do we do that and is it a priority for our state and we're glad to be able to see that this pass and showing that it is a priority for our legislators and for our governor. What the bill does and what the program does it establishes $70 a day in help in services for people who are working caregivers and taking care of a Kupuna at home. So this is a little bit of a different way to look at it rather than only looking at the needs that the Kupuna has it's also taking into account the fact that it's usually a family unit that is taking care of our Kupuna and being able to help them age in place. Well now we have an audience that is not all just Hawaii so would you tell us what a Kupuna is? Oh of course Kupuna is what you know sort of layman sir might be our grandparents but certainly it's somebody who has wisdom and respect and has earned the age of having the wisdom and respect of others that that we don't have in our younger years. So that people are listening to us talk about Kupuna, Kupuna, well maybe we are. That's a good idea. What a Kupuna is yes and it's male and female. Oh definitely yes definitely male and female and so what the program the eligibility for the program such as somebody has to be over the the elderly who's who's being given the care has to be over the age of 60 or above and they have to have need assistance with two daily living tasks. So they have to have a family member at home. A family member who's providing care. No I meant I said that wrong so the person that gets the $70 a day is working and has exactly someone at home that needs care. Exactly that's over the age of 60 and needs two assistance with two daily tasks of living and the person who is working has to be working 30 hours or more outside of the home. Now we get a lot of questions of saying well some people have had to leave their work to be able or had to reduce their hours unfortunately as much as we would love to be able to provide this we want this to be provided for everybody who needs assistance because of the funding that was allocated by the legislature there had to be some priorities and so the idea is that somebody who was working 30 hours or more would probably need a little bit more assistance and so we wanted to be able to start there. The initial program is short in nature we're going to have to go back to the legislature that's coming next next legislative season to be able to ask for the program to be funded but at least at the very initial juncture what we want to be able to determine is how large is the issue we think that the issue is fairly large. I think it's our large yes but but we want to be able to have data to be able to say you know we know exactly how large this issue is and we know exactly how much money it will take to be able to to make a real dent in this. Do you have I know it's early in the program but do you have any idea how many people are participating? We don't so the program what we hear from Executive Office on Aging is the program will be ready to launch in January. There might be some workup that happens ahead of that and there certainly is all of the since it just passed a few months ago the Executive Office on Aging is working very hard to create the guidelines and all of those different things eligibility that will be needed but what we know is just from the press coverage about the bill passing that our website and Executive Office on Aging Office has received hundreds of requests so that's without without any prompting of asking people to call or even providing them a number to call. They figure out where to call and have been calling and asking saying I need this right away so once we actually start recruiting for the program we can only imagine the kind of response that there will be. Well I guess the reason I'm asking the next legislative session starts in January so if you're going back to the legislature you don't even know what to ask for. Well we're hoping that by that time we'll have some sort of list to be able to say here is the type of request that are coming in so that's exactly right as we hope to be able to do some of that upfront work in November, December to be able to at least have be able to see that tip of the iceberg at that point so that we're able to come in with something sensible that we'll be able to make you know what is that tipping point when is it that that we will be able to make a difference and we're looking at it not just from a family angle but also from a business angle these are working caregivers when when mom needs care at home and you have to call out sick that affects business. Yes that's that's what we're trying to change as well saying well what you can do is use the service to be able to provide that respite care so you can stay at work and mom would be able to get the care that she needs for a few hours or I always use this example I have a very good friend who his mother developed lung cancer and she is a vet and had to be taken from her home in Waipahu to tripler he lives in town so in order to do that he had to take almost the entire day of course he does to be able to bring her into town take her back home and then would have a few hours to go back into work with the Kapuna caregivers program he would be able to ask for transportation services so he could still go to the appointment but then if the transportation is taken care of then maybe he only has to take a few hours off of work rather than taking an entire day off. So that's good for him in business. Yes because well as a business person this is the time out of the day but that person takes sick leave so it's really taken away from their own sick leave it's if if they need yeah and what we often talk about is you know absenteeism you know that the idea of being absent you know whether it's for your own health care taking your family but there's also something called presenteeism right which is the idea is you know you're talking about you gave the experience about your mother I'm sure that when that first happened you can't just go back to working just have your mind clear and I was totally stunned exactly and usually it's a crisis mode it was beginning and so we're looking at those particular situations so that a person is able to go to go to work as quickly as possible be able to earn the income and still make sure that they're having their their family members taken care of because it takes a lot of your not just your mind but your your your actual health takes a hit when you're a caregiver as I'm sure you know that your own personal health gets affected by being a caregiver it and well I don't need to go into all those details but you're right it it comes from a place that I had never been before emotionally physically it's never happened before and I wasn't prepared for it like I said I thought she was I thought that she rose the sun and set the moon I mean I now what do you mean I get who you know oh definitely and that's what we hear time and time again so what we hear is you know $70 isn't going to provide 24 around the clock care I mean it's certainly but what we hear time and time again is saying if I just had a few hours of help somebody who's trained who would be able to take my hand and show me what I'm supposed to do that would make a world of difference well it it would if I had just known hey I can pick up the phone and say I need help and there's somebody that knows what to do and so that's exactly what this is supposed to be and in the ideas that again this isn't we did a lot of research in Hawaii about what kind of program might work best and what we heard from all of our local families for a majority of local families saying this is my responsibility I want to take care of mom I want to take care of whoever but I just need help I just I don't know what to do or sometimes I need to go shopping sometimes I can't take off work during those times I need help so if you can just help me during those times then I think I can make it yeah I think that's the big thing is just those those moments that you really need and then of course there's all this new medication and now what how do I administer this how do I move turn the person over how do I do all of the things that you know since you had babies you haven't had to do this it was like oh well and we taught and there are families that are having to take care of babies and and the grandparents and the grandparents as well we call that the sandwich generation you know the their sandwich in and I said well it's probably all that they can have time to eat as well as a sandwich you know between all of their and what you're describing is exactly right so one another another person who talked about his caregiving experiences it was a male that was taking care of his mother and he would say you know I could do everything except Bader Bader was always a really difficult part and if I could have had somebody just come in and help me with that portion I could have handled everything else because that was just difficult for our relationship we just don't expect your yes to do that for your mother yeah and so he expressed it was all boys in his family so he said it was gonna be one of us so those those are the kind of things that that the Kapuna caregivers program will be able to accomplish so now you are the advocate what does that mean well it means that I work with people like you and in other organizations to be able to educate the community about about what the issue is try to gather the other advocates to be able to to gather stories of of what does it really look like if a program were to work and then trying to connect all of those stories with legislators so that they're able to create legislation that makes sense for the community so typically it's a lot of a lot of talking a lot of trying to connect people who are interested with the story to be able to make sure that the solutions that the legislators are coming up with make sense one last question where are the unions in this we have definitely received a lot of support from the unions they understand that the local five has been very supportive ilw u and I think other unions would be coming to the mix if I make a little bit more time to be able to meet with them and explain because they the unions that have come aboard understand this is good for business this is exactly what our our members need is support with their families so that they can concentrate on work and they don't if somebody doesn't call out sick or leave work early or leave the job force early it doesn't you know it impacts their social security it impacts their own benefits so we don't want to do that we want them to be able to receive as many benefits as possible so most unions are definitely involved in this and and are happy about it now as an advocate and you reach out to the public okay so here we are the public how can we assist what can we do well definitely go to our care for kupuna.org website that's care the number four and kupuna.org and what you can do there is if there if you're interested in the program we're taking names now so that when the program is launched we contact you directly and we say the program is launched you can now sign up for it so that and then once the legislative season starts if you are if you have a story if you have any interest on this we will need your testimonies to be able to tell legislators to be able to say this is important for me we think that there's money out there for for police issues it's just a matter of priority so we as the advocates need to be able to say this is a priority for us and this is a priority for our community so again tell our audience how they can get involved what what is the webpage so it's care for kupuna and that's care the number four in kupuna.org and there is a sign up right there on the front page so that you'd be able to get our information get information about the program and then you'll receive information when it's time to act and contact your legislators they'll be all through there. So not just well I don't need help but how can I testify how can I write what what are the other things other than. Definitely definitely on our website we will need testimony we will need people to come out to we will have rallies none of that is quite planned yet but if you can sign up to be able to receive the information or people can always email me directly in my email just pedro at caringacross.org. Great okay how wonderful so please please contact Pedro again thank you so much for spending the time with us and we'll see you next week.