 and welcome to this week's edition of Business in Hawaii. I'm Daelyn Yanagida and we're broadcasting live from the ThinkTech studios in downtown Honolulu. If you want to tune in live, we are at www.thinktechhawaii.com and you may also subscribe to our programs and get on our mailing list at that site as well. The theme of Business in Hawaii is to share with you stories of local businesses by local people and our guests share with us how they build success and contribute to our growing communities and in the ThinkTech studio today is Jeanette Kojain, executive director of Kokua Mau. Jeanette, welcome to the show. Thank you very much. I'm glad I didn't ruin the name. It could have a Japanese influence but I understand that it's Kojain but I'm really pleased that you joined us today and I wanted to thank you for taking the time. Well, thank you for inviting us. My pleasure. I want to start our segment by sharing with the audience a little bit about yourself. Who are you? So as you said, Jeanette Kojain and I am the executive director of Kokua Mau and I have lived in Hawaii for about 23 years. I came here to get my master's in public health. So I am a health person. I've been involved with this field for over 30 years. So I went back east and got my undergraduate at Cornell and then moved back to California where I'm from outside of San Francisco and then actually worked in San Francisco in the middle of the AIDS crisis. For about five years I did a lot of international work and that's where I first came in contact with health and health issues and caring for people with serious illness. And really this question of how are we building a community where people are well cared for? How are we supporting people with serious illness? How are we supporting their loved ones? And how are we as a community coming together to care well for people? So fortunately we don't have that crisis in the same way but I find here in Hawaii we really have just such an excellent opportunity to be building those systems and support systems, strengthening those natural systems that we already have. So for me the work with Kokua Mau has really been just so rewarding and continues to be something that I really, I just am so grateful that I'm involved with this work. I think that with your passion for healthcare and for assisting those with serious illnesses it really blends in well with our culture because we do know that very commonly we have extended families here in Hawaii that are living together and generations taking care of one another well into their prime years. So clearly you're in a community that really needs your message and really needs your help. I'd love to first of all ask you where do you find passion in your work? I know that dealing in serious illness a lot of times those are not happy topic but I can tell that you have passion for the message that you deliver and I'd love to hear about where your passion for that comes from. You know it's a really good question because I'm not gonna lie that it's easy but I've been involved with this for over 30 years this topic and I am continually reminded of the importance of having good information and feeling supported and knowing where to go for help. So I'm all about asking for help you know no shame in asking for help and I really see again in my personal life my professional life the importance of getting good information, understanding I really like the expression you don't know what you don't know we don't know what we don't know and we hopefully are learning all the time oh that's not my field oh my goodness I need to learn about that and it's also the other reality is that people may have gone through serious illness with one person and that's then their reality not to say that's not their reality but there's a lot of good information there's other ways of doing it and people may not appreciate that there are systems and there's also an appreciation that we are really working on this so a lot of things that are better than they were five years ago, 10 years ago so I really see that this information and how Kokua Mau approaches this is really is the Ohana family approach how do we as professionals in our community how do we as interested people help other people and really one of our approaches is to go in front of other people we like to go where we're invited and that for me makes such a huge difference and in our community in Hawaii that's what we're about right so we are invited in around the community and I just feel so fortunate that churches and temples workplaces, community groups all sorts of people step up and say this information is really important I wanna know more about this and that for me is what really makes the difference is people who are not only willing to ask questions but listen and admit that oh my goodness I need to learn more about this and I find that when people are in the middle of it or they're sort of they're looking at this they're oh my goodness Jeanette I need your information how do I get more about from Kokua Mau can you help me with this and certainly those personal stories I really started I think the biggest input was my mother my mother was at work one day and she had a seizure and that's when they diagnosed a brain tumor she was still a working person she was very fit it was totally out of the blue and fortunately she worked for Stanford University they were very very supportive of her, of our family but I was so involved with how are we caring for her how are we caring for her how is she getting the best care possible how is she having quality of life throughout her life how are we supporting my dad can't even boil water right how are we figuring out whether or not we have the best care for her and that's really what carries me through that my mother had two years beyond what was diagnosed and so you know we're very thankful for that and I can look back and say you know as the eldest daughter I was a good dutiful daughter I did the right thing my mother died but we cared well for her and I feel really strongly about the fact that we were able to do that and I know other people are able to do that so that's really one of the main impotences for Kukua Mau and is that experience with me so Kukua Mau is a network we are a network of organizations and individuals here in Hawaii we're going on 20 years this is our 20th year and there are very few other states that have something like this but for those of us in Hawaii it's not really surprising that we are a Hui because we all take care of each other we know each other we're concerned about this and we want to live in a community where people are well cared for so we actually you know this is a community effort so we're a membership organization so health plans, health systems, hospices long-term care government agencies as well as individuals support this work so that good information and resources are available in the community so we like to think of ourselves as a movement to improve care and I really like that terminology because in a movement everybody has a role to play everybody has something to contribute you know clearly clinicians can do certain things but you're supporting your next door neighbor is another really important part of this so I see that we all need to be together in this to really confront what is a very difficult situation so Kukua Mau we have three approaches so I will admit I am a public health person proud graduate of UH and I like to think in a systems approach how are we going to do this so we think first of all we put people at the center of our work how do we help people who may be facing serious illness understand decisions they may need to make and then what are the resources and information that's available here to help people get that quality of life how do we help the person how do we help their caregivers what do we do so I really encourage people to go to KukuaMau.org excellent resources used across the state even stuff in 10 languages really good information that's out there so and we also have a speakers bureau we call it our ambassador program or the let's talk story program so we like to go where people work live and pray so and you know pray the last one we did 52 talks last year most of those in faith community we're having a big we have a big collaboration with the Hong Pa Hong An Ji movement we've done a number of things in Christian churches we work with the Jewish community and now we're launching a large work with the Catholics it's just so interesting how many people have these issues and if you're brave enough to listen to ask good questions to listen and to be there really how much dialogue can happen and how much suffering we can help to address or prevent it's a topic that used to be the norm in our communities we used to all be there for each other and now it's not and for us if we can make these conversations the norm if that can it is so much a part of our culture to be concerned about each other you know for us it's really just it's very natural so first thing we do is put the people at the middle visit our website lots of good information the second thing is we like to train professionals so we have a lot of education and networking opportunities we have a new free newsletter join our newsletter trainings that are happening we have monthly events how do we not only educate people but network because it's not easy our work and then the third thing we do is policy and systems change systems transformation so for us we look at policy like on a statewide level but also with companies how are you approaching this how can you build caregiver support into the work into the support that you're giving for people because we know how difficult that is so we like to approach it from different perspectives again as a movement there's things that we can be doing and even just bringing up the topic acknowledging that this is important you know leaning in as a business term now right if we can lean into this topic we really can address a lot of the suffering that's going on and be helping people to to really be to be recognizing wait there are things we can do ahead of time and if we're in a crisis don't worry there's also people out there to help how do you coin this topic I mean a lot of times people would say oh she's talking about end of life right but that's not the scope of it exactly and so you know for us what's really important is to say there are things you can do ahead of time to be prepared and you know in Hawaii people love that right I want to make this easy for my family I don't want to be a burden unfortunately we hear that I don't want to be a burden to my family I don't want to talk about this would that just going to stress them out this is these conversations are a gift to your family because you can talk about things in advance so we try and move these conversations upstream how do we have these conversations earlier so the technical term is advanced care forbs magazine says everybody should have an advanced directive so advanced care planning planning in advance for your care does include for instance the document that's an advanced directive so an advanced directive is for you to determine ahead of time if you can't speak for yourself would speak for you and a lot of people think oh it doesn't really matter it matters a lot and unfortunately I have a lot of stories of people who say you know you came last week and I sort of paid attention seriously I had a guy on the cell phone I don't even got my cell phone I'm in the emergency room my uncle had a fall what was I supposed to do so I like to say you know better ten years too early than ten minutes too late do these things early document your wishes and you get to choose I still remember this older woman who said oh you know I have four kids two of them are useless you mean I get to choose the two good kids I said you get to choose the two good kids and then what would you like and it's a chance for you to share your values your wishes and those kind of conversations we don't have them a lot we're busy what's important what's a good day for you and I gotta say for me as a person doing this with our friends what's a good day you know those days when just wow I am just lucky to live Hawaii I am so fortunate for all the things that I have how do we have more of those kind of days right you know I'm advanced planning discussions doesn't discriminate based on age a lot of people would think that it's an it's an old person's topic yes we know that it's not um we are going to go to a short break but when we come back and want to talk about that because there are some very striking statistics about young people dealing with very real issues um but before we go to break I want to flash up your information just so that folks know how to get in touch with you we have a slide with Kukua Mao's website and how to get in touch with you that's Jeanette Kojain executive director of Kukua Mao we are going to take that short break this is business in Hawaii we'll see you back here shortly Aloha I'm Keisha King host of at the crossroads where we have conversations that are real and relevant we have spoken with community leaders from right here locally in Hawaii and all around the world won't you join us on thinktechhawaii.com or on YouTube on the Think Tech Hawaii channel our conversations are real relevant and lots of fun I'll see you at the crossroads Aloha Aloha I'm Winston Welch host of Out and About it's a show that we have every other Monday on Think Tech Live here we explore a variety of topics that are really interesting we have poor organizations, events and the people who fuel them in our city, state, country and world we've got some amazing guests on here like all the shows at Think Tech so if you want to catch up on stuff tune into my show every other Monday and other shows here on Think Tech Live it's a great place to learn about stuff, to be informed and if you have some ideas come on my show let's talk about it see you later and Aloha welcome back this is business in Hawaii Jeanette Kojain director of executive director of Kukua Mao is with us in the studio today and Jeanette when we left to break we were talking about advanced care planning and how it's not a conversation that's reserved for just aging people but really it's a conversation, a planning, an experience that should be had by people of all ages and I know that there are some striking statistics about young people employees who are caregivers while they're working full time and I'd love for you to talk to that yeah so for us we actually have seen that I mentioned before that we've been doing talks out in the community and we like the phrase where people work, live and pray and we've really seen, you know, caregivers that people may not even identify as being caregivers because it's what they do they care for their spouse, they're caring for their grandparents, they care for their in-laws they're taking Uncle Kimo to the doctor twice a month, they stop by every weekend make sure that he's fed these caregivers are just such a crucial part of our community and, you know, most people are still going to work and where would they get information and I have so many people who, you know, as you say, the sandwich generation, right drop the kids at school, drop mom at daycare, go to school, go to work then reverse, go pick them up, take everybody home make dinner, take care of mom, fall into bed and repeat like where would they get information so we, that's again why we like to go out and I think, you know, it's absolutely right that caregivers have a tremendous burden and these are integral parts of our community and for people who, you know, employees we employers know this although they may not know it, it's really good to ask so we see that the people are spending, they estimate at least 20 hours a week on caregiving about, they estimate nationally that 20% of people are caregivers and I actually think that's pretty low for Hawaii because we're also, we take, we, you know, we have a ohana system people are there, they're helping each other out it is a big, it's a big burden and then the cost is tremendous especially when you don't have things in place, right so, you know, people estimate $7,000 a year quite frankly for Hawaii that's low that is low how are you going to make all of this happen so we see for employers and that's why we really started this work site wellness program that you have several things the employees are totally stressed out they may be retiring early they may be quitting they may be at their desk but not able to function either they're trying to solve a problem or just the stress of this you know, it's really, it's big one statistic that I find shocking in Hawaii, people who are caring for someone with dementia 50% of those people end up in the emergency room for themselves it's a tremendous burden we have a one sheet of your statistics that I would love to share if we could put that up you know, and this is really important it is sometimes people say oh it's just a women's issue well, first of all women are people but men and women do this together there are a lot of men and women who are doing this this is everybody is impacted by this and I find it's so interesting that you know, they estimate how many millennials are doing this whether again it's for their grandparents or for somebody else so they may be going online but how do you get good information how do you make sure that they've gotten good information and coming from myself coming from the human resources industry we do know that there's a huge problem with presenteeism that we have employees that are working for us but are we really getting the best work out of them because they have these competing priorities you said 20 hours a week well that means that they're working a full-time job and a half and which means that I'm not really getting 100% of them we also know that because employees spend so much time at work that they rely on their employers for the best information for example we talk to employees about planning for retirement we talk to employees about training and development higher education and that's where they're getting their information so it just makes sense that you would come into a wellness market as well to start talking about these planning events that need to happen they're crucial to people's lives that's right and so that's why we really hope that people will contact us because we're ready to work with you to make a tailor-made program something that works for you you know and you're you're right for me it's often it is sort of a it's strange why is it not a part of what we're doing so we need to acknowledge that it's not easy people may not know how to have these conversations good news Kahua Maui is here and I really hope people will see us as a resource for us we have a lot of experience this is our expertise this is what we do we know how to get conversations going to start conversations and to foster these these discussions so for employers who are thinking oh my goodness where do I start call us and we can work with you so for instance so we have a whole toolkit and we also have a website wellness.kakua mao.org that walks people through the advanced care planning process so you know it's interesting for people who are dealing with this right now you can get it done and you could do a lot of things very quickly for other people okay you have a little bit of time let's be thinking about this so our wellness the wellness.kakua mao is an excellent website and so with our toolkit we have resources we have things that we can tailor-made to to help you so for instance lunch and learn we can come in and do a lunch and learn we can do a series of lunch and learn introduce the topic get people thinking come back again answer questions so oftentimes people say you know my doctor doesn't have time for this yes that's so let's we are here we'll come in we'll work with you to make that happen we can do you know put things to put into your newsletter you can put stuff on a website integrating into a wellness program we think makes so much sense yes we plan for retirement this is part of retirement and I can tell you unfortunately by not planning ahead this can be a very expensive proposition as well as being super stressful for families so not appointing an agent not appointing these people it's a decision not to do something that you know quite frankly it's not good planning it's not preparing ahead we have another one sheet that you shared with us talk a little bit about your worksite wellness program and so this these are just some examples for instance so you know we again there are things that you can do you can create policies you can be running support groups for caregivers you can do a number of different things to be supporting caregivers as well as you know other to be making a supportive environment so again we're really happy to work with people and to see what works so we don't want people to think oh you got to have the full-blown program right away let's start simple let's start with some lunch and learn right we have through our website a lot of good free information so you know we can make the materials that are available for you to be to be there and we it's what we do and we so we need people who are brave who are willing to speak up I'll be honest with you people that have gone through it themselves understand what this is and for those organizations who are really leaders in this like UHA UTF we've worked a lot with them last year leaders you know who have seen this either because of a good experience or a bad experience they're they're really stepping up and and so for us we really see that this is a topic that is super important so I I do think it needs to have some leadership to make this to make that conversation go and then we'll work with whichever groups but coming from leadership it is really important we actually just finished shooting a short video with Howard Lee from UHA as a president of a health plan talking about why this is really important so you know it is really important and it does make a big difference you really can be you really can be making an impact so yes we want people to take the stairs lose weight smoking mental wellness and support for people is really really important and and again you know why I do this I do this because I see over and over again I had somebody last week who said you know I went to your talk at church my mom came I invited her to come we had those conversations and for the first time since my dad died we were able to have those conversations we were able to document better what she wants we really feel now that we have a good grasp on it and now she's bringing it up or she never would before it's I mean talk about a stress reduction who with tears in his eyes he's telling me this so this is you know you have to be brave but we just see the result from an employee benefits perspective you know one of the things as an employer we always look at our managing our medical utilization because it you know translates to cost and I think that a lot of people don't understand that these critical illnesses these events cost a lot of money but if you already have in mind how you want that medical event to be handled you essentially on the back end are able to manage that risk in a way by saying hey this person doesn't want extraordinary measures taken but rather they just want to be comfortable which of course will cut down time in an emergency room in ICU which also translates to cost savings if that's a perspective for business leaders to to look at as well in managing risk you know and the cost is really an issue that definitely comes up I'm always so reassured by businesses who say you know what we need is for people that have good care that's what I want and we you know like the phrase the right care at the right time in the right place well that can happen with conversations but if you're avoiding unnecessary and unwanted treatment yes you will be saving money and you know for the caregivers too if the caregivers are being supported if they're if they're being supported along the way you're also saving costs so I again I'm reassured when businesses don't start with the money but I'm often thinking wow you know you do appreciate that good care and and preventing crisis preventing the stress supporting the people people where they are that is that is going to save the money you know Jeanette I knew we could go on and on and on about the topic unfortunately we we have run out of time I do want to make sure that our viewers are able to see your information one one last time your website wellness.kukua.org for those worksite wellness programs your contact information your your telephone number and really encouraging folks to to reach out I wanted to thank you for your time important message very important message for all of us we are out of time but thank you to our guest Jeanette for joining us huge thank you to the amazing production staff in the studio if you would like to be a guest on our show please email your information to shows at thinktecahua.com Business in Hawaii airs every Thursday at 2pm and we are looking forward to seeing you here next week