 And welcome to Don't Just Age, Engage. Think That Kawaii's program about aging with creativity and exciting program. And it gives me great pleasure to us. Have you come join me today as we explore what it is to have an extraordinary elderhood. You probably don't know what's available within Honolulu, especially I'm talking about today. The kind of resources that are available and the extensive resources available to really make your elderhood extraordinary. And I'd like to take you quickly to the elderlyaffairs.com website, Michael. This is the elderlyaffairs.com website. Now, you don't see much here except that I can tell you that this is an extensive website that will give you and put together the city and county of Honolulu that will bring us together all the available resources that you could possibly need and want to explore. I was looking at the housing one the other day and there was a great video describing two different kinds of housing available to those of us who are in our elderhood. Tremendous information orientation and then access to the specific resources that are there and available to us. Now, like I said, I bet you don't have a clue of all of that and what all is available. But over the years, there have been those who have invested themselves in making it available to us, making it available to you. And now it's your fingertips with the wonderful technology that we have. And so I'm welcoming to thinkDekawaiis don't just age and gauge. A man who I just recently came in contact with as I affiliated with the Epiphany Episcopal Church. I am a Presbyterian minister, but I am and I'm doing my coaching with elders into their elderhood, but I'm recently affiliated with this wonderful congregation, Kaimuki. And one of the members is Lot Lao. And I'd like to introduce you to Lot Lao and ask him to contextualize for us this elderly affairs division of the city and county Honolulu. Lot, welcome. And thank you. Thank you very much, Larry. Thank you so much for joining with us. So Lot, I'm just really curious. Tell me where you were born and raised and what aspects of your early life really kind of got you involved and influenced you in wanting to be connected with elder resources and elder needs? Okay, thanks. I was born and raised on Maui. So I'm a Maui boy from way back pre-World War II. And what I am the eldest of four children and I have, for those of you familiar, Lot was a Chinese surname and my mother is Japanese. On Maui, I didn't grow up with any influence on my Chinese side because my father's family was here in Honolulu and he'd moved to Maui to do teaching. That's where he spent most of his days as an educator. So I grew up in the Japanese culture. And I want to point out as far as influences that I learned from my parents both and my grandparents, my aunties and uncles because I was the eldest grandchild, they took turns taking care of me. I respect for authority, respect for authority, obedience toward authority. I listened and obeyed to authority and it carried over into what I read in scientific ways or medical ways and what I heard from my teachers and especially my principals because I found a way to visit my principal in those days quite often. And I learned about authority at his or her desk. I never considered that I would be defined or disobedient but I could have been more skeptical. So that's how I answer the question. And I emphasize authority because it has to do with other things that I will say later on. Well, so when did you first become so interested in the general elder population of the islands? Okay, I am trained and have a master's in hospital administration. My early days in hospital administration, I was a planner and I was a manager. I didn't have patient contact and that didn't happen until I changed jobs and I started to work with what you already know a little bit about the elderly affairs division for the city and county of Honolulu. It is the area agency on aging for the city and county of Honolulu. There are agencies like that throughout our land and I'm sure that's an aspect that the audience is not familiar with but we are everywhere or in that sense. The principal purpose of an area agency on aging is to administer the provisions of the Older Americans Act. It was passed in 1965 in tandem with Medicare but it's like a sister or cousin that is not well known because most of the money is in Medicare. Most of the attention is paid to Medicare and its provisions. But I understand though that money came from the federal coffers to both state and local entities. Yes, to support the provisions of the Older Americans Act. Let me take a little bit more time with the Older Americans Act. Okay, sure. Frail elders services are designed to support frail elders. Those who are 60 and over. You know, back in the old days in the mid sixties people were frailer sooner. We've been blessed by longevity since then that I'm gonna have to say a little bit more about but the act of law covered those who are 60 and over and they covered services for persons who were in need of support with activities of daily living. Activities of daily living. And I'm gonna say more about that. And how I try to remember activities of daily living is with A, B, C, D and E, which we all know. I think we all know. And this is how I use it. A stands for ambulation. And that not only means how you walk about but also how you transfer. I have a difficulty getting into bed and you need assistance out of bed and you need assistance in the toilet and in bathroom, need assistance that has to do with ambulation, being ambulatory and that's the A. B stands for bathing. Now that's a term that does refer to a specific service. If elders are in need of bathing per se, people are available to be engaged to help them with that, male and female. But it also refers to personal hygiene for me. It covers aspects of grooming, cleanliness, your aspects like that. Continence is what C stands for for me. So you actually think about that as a keyword but it does refer to incontinence, does it? Right. You need help with those activities. D stands for dressing. And dressing can mean being able to dress yourself. If you need assistance with getting into your clothes, if it's evident that you need assistance with choosing what you wear. If you're inappropriate, inappropriately clothed, then that is a sign that you might need assistance. Dressing. And the final E stands for eating. So obviously you can picture someone who has to be fed. But also it does cover those aspects that have to do with preparation of meals, have to do with the difficulty of cooking. For example, if someone is in firm and doesn't remember to turn off the stove, that's a sign. It's not the only thing that might qualify for help with food like meals on wheels, but that's one of the aspects. So, ambulation, bathing, continence, dressing and eating. Yes? Yeah, one more point. These services have costs but under the Older Americans Act, they're not cost to the client. They're not. Under the Older Americans Act. Wonderful. They could be if you seek help from outside the system, the aging network system, and there are lots of private for free for service agencies in this town organizations that provide that, but at your cost or at your cost plus what you might be able to have covered under long-term care insurance. Lot, that is so helpful. As a chaplain with Bristol Hospice, Hawaii, I worked with the interdisciplinary team that every patient had. And we talked often about the ADLs, the activities of daily living. And I never heard such a comprehensive and easily accessible description of those activities of daily living. So those first five, the five letters of the alphabet are great mnemonic tool to remember. And if I may say to those of you who are caregivers for mothers or fathers or uncles and aunts, if you notice anything in these five areas, it's good to take note of that and be considerate about that. And to recognize that your loved one may be moving towards needing assistance. And some of the assistance that as Lot has described is available on the elderlyaffairs.com website. So please take, be aware of that. And it also becomes a criteria for assisted living facilities, whether or not a loved one would benefit from an assisted living facility. So that is fantastic a lot. That just really capsilizes the whole process so well. How has your work history? You said you were trained in hospital administration. And if I may give an aside, I spent 25 years in, 26 years in Lakewood, Colorado. And in our discussion together, Lot and I have found that we were in the, within reach of each other and we're in reach of the same hospital there in Lakewood, Colorado, the Lutheran Medical Center. Let me say one more thing before I leave the Older Americans Act perspective. I want to call attention of the audience to the senior helpline. It's 768-7700. And if you remember nothing else about, what we've been talking about, you can think of that number as the portal, as the doorway to all of the services that the Older Americans Act covers, 768-7700. Easily remembered. Thank you very much for that. That's the portal, the entry to everything that you need. That's great. That's fantastic. Under the Older Americans Act, 1965. Now, is money still coming from that act? Well, yes. It has to be every so often, I'm long retired from them. But so I don't know the frequency of anymore, but it has to be reauthorized by Congress. Because Congress needs an opportunity to balance the budget needs of the Older Americans Act and its services against the other needs of the country. And yes, sometimes it's been favored and yes, sometimes it has not been. Yeah, sure. So Lon, how has your work history, which we've touched on here just briefly, influenced your thoughts about elders and their lives? Thank you, Larry, for that question. The first thing I talk about would be lack of awareness. You see, when we go along with our lives, we handle one challenge after another for your family people. We are dealing with young children and older children and so forth and so forth. So it's very easy to understand how projecting forward to our older years, we may not prepare ourselves with an awareness of what might be available to help us as we age. So I find that lack of awareness among the majority of folks who are reaching the age that the Older Americans Act is talking about. So they make mistakes. So they often when they are asked about needing help in something or other, one of the activities of daily living, we encounter denials. Oh, I don't need that help. They think it might cost money, you see, and they don't know that it is authorized by the federal government. So that's one lack of awareness. There is insurance. And sure, you know there is long-term care insurance to cover many of the services that we are talking about. And of course, there's not an awareness of that. I mentioned denial of mortality. So denial occurs in the elder as well as the children of the elder. Absolutely. And I know from my work and observations that arguments occur among family members about what to do about grandma. And this may occur in long-term care. It may occur in hospital corridors or over the bed of grandma. And it may happen between siblings who have been very involved with grandma. They know what needs to be done. But there's a sibling who lives on the mainland. It's not been involved. Prompted by some awareness of what's available. And they want everything to be done for grandma. Yes, Lot, that's so true. And you've described, you've described a situation that occurs so often in hospice care. And we always remind people, remember your mother or your father or your loved one has, still hears what you're saying. Hearing is the last sense to leave. So it can put your loved one in a terrible predicament as far as her emotional experience or his emotional experience in the dying process of siblings are arguing over how to best take care. I'm sorry, that just triggered my remembrance, Lot. What else did you want to say about this? Well, so it follows. It follows from what we've just been talking about in our experience, that families need to get over denials and need to talk about this aging process and what could happen long, preferably long before there's any sign of aging, of infirmity. Or of dementia. Long before, everybody's hailing, hearty and focused. And I know that's difficult in the pressures of daily living, but that's my observation and that's been my advice to people. That is excellent, Lot. And the fact is that you and I are in the same elderhood stage, although I think you're younger than I am, you sure look way younger than I. We won't go into that. We can settle that on a bet later. Let me have one more comment about long-term care insurance. This is one of those insurances that if you delay and you get older, for sure your premiums are going to be higher, regardless of whether or not you have pre-existing condition. And that might disqualify you, even pre-existing condition, depending upon what it is. But I know for sure, if you wait beyond, let's say, your mid-50s or your late-50s and you try to get into the market then, especially since there are more elders now who are surviving to those ages and needing assistance. And we were talking about limited budgets. There will be higher costs for those premiums. Well, if I may comment on that. Percy Ihara of generations encouraged me to consider long-term care insurance in my 70s and that it's not too late. So there are adjustments going on, I think all along as more people get into that age group. And so long-term care insurance is not outside of consideration. He said before 79 years old. So it can be worth it. And the reason that when you think about, the reason I'm thinking about that as a possibility is that we have sources in Medicaid which handle room and board. Medicare does not do room and board until the last week of life. But, and if you don't have access to your own personal treasury to support your aging, place you're going to age and in fact, the place where you eventually will die, then there is Medicaid resource. And then there is this long-term care insurance which can be purchased out of the low-rate premium really and can be a great asset. So it's worth looking into at least as part of the constellation of your support system as you go through this elderhood time. So how have your own personal activities influenced how you are aging? Let me start with a bias. Okay. Because Americans live maybe 20 years, maybe a quarter of a century longer than they used to in the beginning of the 20th century. And they're living long, not any longer but healthier because they benefited from all the information that has come forward. This is my bias. I believe much of those years, many of these years could be used in more community service, giving back. I believe people should try to accept and embrace aging. You know, you and I are smarter than the people who are much younger. You don't brag about it. Yes. So when you accept and embrace aging, they have a better opportunity to realize their value as elders with a value that we all need with our lives, right? So start with the bias and personalize it. I am trying to prepare for my passing while I have time and awareness. My motivation is not to compel any of my children to do what I should or could have done. So I try to anticipate it. I know better than they what needs to be done. So why shouldn't I do it? Well, I have the capability. Yes. So 20 years ago, I started talking with them about this. And 20 years ago, there was no sign of infirmity. Oh, yeah. So they were willing to listen to what I say. They weren't in denial for themselves or about me. Because when you start to talk to somebody who may be in their late 70s or early 80s about what your preferences might be, a person who's already has that in mind because they have seen changes in you will be in denial. Oh, grandma, don't talk about that. Oh, dad, we've got lots of time to talk about that. And if you're straight, it's the elder who wants to talk about it. So that's what I believe and that's what I'm acting upon. I know from my experience that elders are valuable people and I want folks to have the opportunity to realize that same thing. Yeah. So what do I do to try to encourage that? I keep that. You keep that. I exercise down at the Y. I walk up and down this rise. You're gonna be involved with music sometime soon when we start having ukulele and Hawaiian music at the church. I have been doing that in long-term care facilities until we were stopped by the pandemic. I play golf, I work in the yard. That's the kind of thing that I do. And I encourage folks to make religion and the growth of their spirituality a part of their lives too. I'm not gonna say much more about that, but churches do the same kinds of things because they're tuned into the needs of the elders also. Yeah, I would say the spiritual practice, whatever your spiritual practice may be, meditation, contemplation, active engagement in society for change and social justice, continuing to pursue that as best you can. And as you're inclined to, it's very important for inner life. Sometimes I have noticed people just get tired of trying to make it happen in the external world. And so they turn internally at this stage of life. Part of the spirituality of aging is a shift from the externals of our adulthood where we have contributed to society we've made families, we've made businesses, we've achieved and accomplished many great things. And then in elderhood, we start looking more profoundly than before internally as we move through that final stage of life. And it may be questions like, what does it mean to me? What is, how have I made this past life real? How do I integrate the various parts of my past life into a whole seamless theme and story of my life? I think that's a wonderful experience to be had in elderhood. And it happens, like you've said, in a congregation, in a community of people where we're all going through some of the same experience. Well, you have made a wonderful impression on me and I'm sure on our viewers as well a lot. Are there any thoughts or principles that guide you now? I'm gonna move quickly to summarize some main points. And the first main point about the Older Americans Act is to remember 7687700. And just learn about what they cover. If you believe in the value of long-term care insurance, consider it buying earlier rather than later. And it's good for me to hear, Larry, that the market is opening up along with the opening up of that cohort, age cohort. That's the thing I'll say. Just to give back from the gifts you have given, the long life you have given, give back to society. It's good for your health, by the way. Embrace your age. Very true. It's the only life you have. Keep active and engaged with society. As we define quality of life, going to Las Vegas doesn't count. Perfect lot. Perfect lot. Don't just age, engage. And Laos, my friend, you have embodied that yourself and have addressed that perfectly here today and turned us to ways in which we can certainly do that with the help of the division of the elderly affairs from City and County of Honolulu. Thank you so much, everybody, for joining with us and tune in in two weeks. We'll take a look at some work that's going on and some opportunities at the Waikiki Community Center with the presence of Merle O'Neill on my show here. And in the meantime, don't just age, engage. Aloha. Thank you so much for watching Think Tech Hawaii. If you like what we do, please like us and click the subscribe button on YouTube and the follow button on Vimeo. You can also follow us on Facebook, Instagram, Twitter and LinkedIn and donate to us at thinktechhawaii.com. Mahalo.