 This is Stink Tech, Hawaii. Community matters here. Okay. It's age with grace. Aging with grace. Without borders. Without, well, no, but that's the name of the show. This is Colin Hiroshita. He's helping me do this. He's a gerontology consultant. And he's been a gerontology consultant for as long as I know him, which is actually quite some time. Right. That's right. That's right. So it's age with grace, aging with grace, but the name of the show today we're going to talk about is age without borders because that's a virtual summit we're going to talk about with Colin. That's right. Welcome to the show, Colin. Thank you very much. I always appreciate it. You know, a chance to talk to you. It's an important subject and I always like talking to you. So first, let's identify this virtual summit, age without borders. What is that? And who does it serve? How does it work? Well, the age without borders initiative was developed about over a year ago and it has had one conference thus far, but it's a virtual summit. What this means is that the organization put together for this particular one conference that will be at the end of this month. About 60 international speakers from around the world, 17 countries, each of whom are given about a half an hour to talk about their specific skills and knowledge. And so it's like going to a conference, but it's free and it's much cheaper than going to a conference which will set you back about $2,000 and the travel and the time involved. So this is a great opportunity to learn both for professionals as well as for unpaid family members skills and insights so that they can do their job better. So how is it broken down? I want to learn something. I go on the website which is www.AWBCaregiving.com. Correct. How do I find stuff out on that website? Good question. Well, AWB stands for Age Without Borders so it's www.AWBCaregiving.com and when you go to that website, you will be able to identify a particular link which will say you can click here and have free access to this, all of these 60 speakers during the week from January 22 to the 26 at no cost. And they could be anywhere. You can be anywhere in the world, right, in the world, right. Now if you want to retain some of these great presentations, then there's a cost associated, but for that week, it's free. Very cool. So it's like you're live, almost, you're there, you're there for the week. Yeah. If you want to come back, that may cost you something, but being there for the week doesn't cost anything. Absolutely. And you know, when you go to a conference, it's impossible to go and listen to 60 speakers. And here, you know, it'll take you about 48 hours to listen to it all, you know. So you've got to set some time aside for yourself to do this. So some examples then of what the speakers are speaking about? My goodness, there's such a wide array. There's some people that are talking about broad issues. Some of them are dealing with technology and how technology can help because today, we have so many people that need help and we have fewer and fewer health care workers. And when... Especially gerontology health. Gerontology health. It scares. Absolutely. And so when family members have to go out to work, you know, mom and dad, who you care for, is home alone and that becomes a little dangerous. And so there's some technologies that are available. And then there's some personal stories about people who have gone through the process and some of the lessons that they have learned. There's others that have shared very specific skills, tools that are available. So there's a whole variety of things. One of the things about this particular virtual summit is that in addition to the 60 individuals who are speaking, and that includes myself, by the way. I hope so. Yeah. Yeah. There's also something called a care package of various kinds of tools and other kinds of resources. Even some music and poetry and other sorts of useful tools that one can use and retain. So that's also free during that particular week as well. So this is a whole primer on everything you need to know. Absolutely. When does it start? Is it online now? When is it happening? It starts from January 20th, which is at the end of the month. Oh, yeah. A few days away. Yeah. Just a few days away. And so it'll be a great opportunity for people to have access to this and it's available worldwide. Okay. And it's going to repeat. It's not just the one time only, yeah? During that week, each show will be available for about 48 hours because, of course, the world is a big place. And so your market is the world. And the market is the world. You're speaking to everyone in the world. Everyone in the world, yes. And so day one will be shown for 48 hours, day two will be shown. So there's going to be a certain amount of an overlap, but that'll start from January 20th. But will you do this again? Will you have another online conference along these lines say the year, six months, whatever? That's a possibility. That will be something that will be too determined. They had one last year that I also participated in and we focused specifically on this term called active aging, targeting the boomer population and the pre-retirees to remain well, to live long, you know, until their last breath, you know. Yeah. I love the idea. So give us a definition of active aging and give us the years on boomers. What generation? How do you define that generation? That's a tough question. But we're, you know, we're looking at people from, let's say, let's say about 50 to about 75 and maybe 80 that are pre-retirees or thinking about retiring, some of that are early retirees and are still very active. But oftentimes people that certainly want to live long and they want to live well, but oftentimes are not really clear with regards to how to do that. And so when we look at pre-retirement seminars, oftentimes it's about your, you know, Medicare and your social security benefit. And others will talk about how important, you know, remaining physically active is. But active aging is more than just your health or your finances. There are 11 facets that are involved, you know. We have to watch our physical fitness and our social fitness, our medical fitness, our nutritional fitness, you know, our financial fitness. And we have to also watch our purpose, you know, in terms of trying to clarify what it is that we want to do with the rest of our life. Who are you now that you are retired and without a job title? Yeah, this is a life and death decision. Absolutely. If you get older like that, you're facing, you know, the grim reaper. You have to decide what you want to do with your remaining time on the planet. Absolutely. And what good can you provide? You know, how can you remain useful? Ah, that's a very interesting question, because if you remain useful, by definition you remain connected. If you remain connected, you know, your life is better, your sense of awareness is better. You're using your brain. Using your brain. If you use your brain, your brain will last longer. Absolutely. Absolutely. Yeah. Yeah. So this is all part of what we call active aging, you know. It's a very, it's a very, what's the, give us a little bio of yourself. I know you were in KCC for a long time. Yes. Doing aging issues. Right. Right. And then you've been involved in the conversion, if you will, of St. Francis in Liliha into an aging facility. Talk about it. Well, yes. So I am still a consultant with St. Francis, which was once a hospital, that now has decided that they wanted to convert the entire facility into a Kupuna village, you know, an elder care village that dedicates itself to elder care services from institutional care to community-based care to active aging exercise and wellness type of programs as well. I want to say institutionally, you mean people live there? Nursing homes. Yeah. Okay. And then St. Francis is also in the process of setting up an assisted living facility that people that are frail but still independent. So it's going to create an entire array of different types of services there. And there's this dedication towards elder care. My job there is to focus around training, around family caregiver training as well as the active aging. Professional staff training. Not so much for unpaid caregivers. Unpaid caregivers. Yes. That's right. Oh, that's wonderful. That gives you a connection, doesn't it? That's right. They're growing numbers of older adults, which means that they're growing numbers of family members that are caring for moms and dads and aunties and uncles as well, you know. And this becomes a major challenge because these are also people that are working. And so to the extent that you need to do this type of work, it pulls people away from their jobs and it can have an effect on productivity as well. So these are concerns that we all have to be concerned with, yeah. Yeah. I mean, it's really interesting because what it suggests is that you don't just sit there like in the old days and the zone on the TV. You want to have a quality of life, you have to do some things. I remember my stepmother lived in New Jersey and they had an elder facility in the neighborhood and they would go into Manhattan, they would go on these trips, everybody would get on the bus, they would do very exciting, interesting things together and together was the magic word. Right, right, right. You know, if you do it together, you're not isolated, worried, somebody will take care of you. Yes, yes, yes. And you can, you know, bounce your ideas about people and how a collective experience, you know. Right, right, right. We want to keep people in, you know, isolation is very corrosive, you know. Someone once said to me that being isolated is almost like smoking a pack of cigarettes a day, you know, in terms of the, it's negative effect on your health, you know. So we've got to stay connected. If your loved ones pass away, you've got to reconnect. You've got to reconnect. Yeah, yeah. It's very important. You need an institution to do that, it's hard to do it yourself. Right, right, right. You need to meet new people and actually engage with them. So let's take a short break, Cullen, Cullen Hayashita. Cullen is a gerontology consultant having worked at KCC in a teaching role and also consulting with St. Francis, which is, what am I going to say, evolving into a full service elder care facility. That's right. We're talking today about Aged Without Borders, which is a virtual summit. And when we come back, I'd like to talk about, you know, how it is in Hawaii, you know, what's the situation right now and how are we going to, you know, make it better for all of us, including you and me, when we get into that special zone, we'll be right back. Okay. This is Think Tech Hawaii, raising public awareness. I'm Ethan Allen, host of a likable science on Think Tech Hawaii. Every Friday afternoon at 2 p.m., I hope you'll join me for a likable science, where we'll dig into the science, dig into the meat of science, dig into the joy and delight of science. We'll discover why science is indeed fun, why science is interesting, why people should care about science and care about the research that's being done out there. It's all great. It's all entertaining. It's all educational. So I hope you'll join me for a likable science. What work is it? Yeah. Okay. We're back. We're live with Colin Hayashita. He is a gerontology consultant. That means old age consultant. He's been, he's been a gerontology consultant since he was a young man. What brought you into it anyway? Why did you get so committed to this whole area? Well, that's a long story. Well, I... Some do it with family. It has to do with family. Well, you know, we were living in Cleveland and I was a professor there teaching 18th century, 19th century Japanese Chinese society. Can you believe that? And then a river caught on fire. My daughter got all sorts of health related problems. And so we decided, you know, this is not working out. So let's come back to Hawaii. McKinney decided to pick me up without any background in the field. And they said, we'll train you. We'll train you. This was back in 1978 and they provided me with a lot of support. You found it. You liked it a lot. Yes. Yes. So that was the beginning, back in 1978, when, you know, gerontology really was not of much interest to much people, many people around. But then over 10 years I was able to acquire some knowledge base and, you know, over time we... I was involved with many people on this, but got involved with creating about 50 different initiatives in Hawaii having to do with elder care. All directed towards finding, you know, more cost effective home and community based type services. Yeah. Yeah. So the discussion of those initiatives will help us understand what the problems are. Right. So first let's talk about the problems. I mean, I remember years ago, my wife and I was courting her. We went to Kauai where she was from and we found that down in a kind of ditch under between Kaloa and the road there was a whole string of these plantation looking houses with steel roofs and, you know, green walls and that's where the elder population lived. And everybody would come down and give them soup all the time. And they were part of larger family, the community in Kaloa, I was so impressed with that. Everybody cared. I don't think it works that way anymore. People don't do that for other people. You know, if you get old you have to find some system that will accept you. So is it easy? Is it hard now? Yes. You know, I think your point is well taken that there's a certain amount of loss of community, you know, people helping people, which was so much a part of that, you know, plantation life, that we need to somehow find ways of reconstructing to a certain extent. You know, we take condominiums, for example. We've got so many people living in a very small confine and yet people don't know each other and don't want to know each other and there's no community. But I think there are opportunities there in trying to create community. And this is important because you know why we've got, I don't know, thousands of these condos and many of them were built in, let's say, in the 1960s by 40-year-olds who are today, you know, in their 80s. And so we found certain condos that are like 40 percent, 50 percent over 65, right? So these are like aging in place communities in a sense. And we've got to find ways of recreating this people helping people type environment, you know. And there are possibilities. City and county of Honolulu through Mayor Caldwell and the ARP have worked on something called the age-friendly city initiative. And this is from the WHO. And HMSA has worked from the other angle and they've worked with the, what was it called, the National Geographic Magazine. They've created this program called the Blue Zone. And what had happened was the National Geographic Community went to various parts of the world and they found certain areas where people are living, where there's a lot of centenarians there. And they tried to identify some of the secrets for a long life. And they brought this together in nine principles called the Blue Zone. And so HMSA now is trying to work with certain communities in Hawaii to recreate some of those types of principles and build communities. So these are all good things. We've got a lot of work to do in this area. Yeah. So I mean, the idea is everybody, you know, from, I mean, HMSA directed by, you know, Profit. Yes. But HMSA wants people to be in communities so they're healthier. Right. And therefore, you know, they don't get sick and... Not institutionalized. They don't get, it's like the Deakin's Chariot. Do you remember the story of the Deakin's Chariot? The Deakin built a Chariot that would last a hundred years. Everything on it was going to last a hundred years and it lasted a hundred years. And on his hundredth birthday, everything fell off and it was completely collapsed. And maybe that's the way to go. That's right. You make that Chariot last as long as you can and at a certain point, you know it's going to be, the wheels are going to come off, but at least it's a short, it's a short moment at the end. That's right. That's right. Well, that's related to that book that I made reference to by Roger Landry, you know, Live Long, Die Short. We want to be able to live a long life in good health until our natural life span and a short death. We don't want a long death, you know, in an institutional facility. There's not that much quality related to that, right? So what work has to be done and what work are you doing in these initiatives you mentioned earlier? Well, on the caregiving side, I'm part of a local organization, a nonprofit called Hawaii Family Caregiver Initiative, a program consortium. And we have been trying to advocate for things having to do with caregivers. For example, at the legislature a couple years ago, ARP had started an initiative called the CARE Act where they wanted to try to promote hospitals, encourage the hospitals to provide instructions to family caregivers before they're discharged into the community. Great idea. Great idea. And that passed a couple years ago. So that's in place right now. How do you incentivize that? How do you make that happen? You know, there's no penalty associated with not doing it. What is happening is that hospitals are just putting together some instructional sheets that they're providing the families with. So it's more through encouragement rather than through, you know, a hammer, so to speak. Yeah. And it's the same thing as the HMSA thing. They're motivated to do that because they'll, you know, then everybody's healthier. Right. Right. Right. And the other thing, one of the other things that we've been assisting with was the need to look at family caregivers who are working, and there's so many of them around, right? And so a couple years ago, a bill passed the legislature to provide some financial assistance to these family, working family caregivers. And right now it's being implemented, but the amount of money is small. So during this coming legislative session, there's a bill that's going to be introduced to expand that by maybe by six-fold. Yeah. Well, I mean, when you go down and testify on that, I assume you will. Yeah. You know, I think the big question is to demonstrate to them that the bill curve is going out. Yep. And there are more people. And there, you know, there's a greater need because on the one hand, you need to help the Kupuna, and on the other hand, you have to help the young family whose lives are being thrown out of the kilter because they need to help their own. Right. Right. And then at the same time, you know, it seems to me that this is a community here, and from a political point of view, the Kupuna community, who, Kupuna community, K, K, okay? Leave off and let her care her. I don't want a third K, but that community could be, maybe to some extent already is, a powerful political force, and the legislature cannot ignore them yet. Oh, absolutely. Older adults, they vote in great numbers and in high percentages. And the legislators, they know that. They know it. But you know, it's not just the Kupunas that we're caring for. It's the families. They're the ones that are immediately affected. And more and more, we're finding that the legislators are making reference to their family members. So they are beginning to get it, you know. Yeah. Well, anything else? Anything else cooking, or should we cook anything you're planning in the future? Well, we're beginning to, you know, the focus, much of my work has been around dealing with frailty. You know, older adults, you know, from a frailty as well as a disabled perspective that is aging and sick care. And what I've done recently is I begin to pivot towards looking at older adults as an asset to the community, that we should not simply, you know, give people a gold watch and say, you know, you're out to the pastors, but recognize that older people have skills, they've got assets, they've got knowledge, they've got experience, and they've got a lot of time on their hands. So we've got to find a way of somehow making certain that they remain useful and contributing to the community, because that's going to make them well and perhaps even have a moderating effect in terms of the need for long-term care. So that's something that we want to work on. Now part of this is that the boomers now and the older adults that are around right now probably have pensions, and we're going to see pensions go away. So a lot of the boomers that are coming up, the older adults in the near future and the ones that were working in the private sector, do not have pensions. They've got 401Ks that will not last that long. And so we have to find ways of making it possible for older adults to continue working. Some, they need to work because they're shorting cash. You know, longevity is a great thing. It's a blessing. But if you run out of cash, it's a curse. So we've got to find ways in which we can somehow make certain that we can provide people with a clearinghouse to help them find opportunities to continue to work. Employment agency. Employment agency. And some of them do not have to work, but they want to do something, be useful. And so that is also an important part of what we need to incorporate in this clearinghouse. Yeah, but I mean, what you were talking about, it does raise the dark side. And the dark side is that Donald Trump and his friends will cut all kinds of social benefits to Medicare and Medicaid and Social Security, for that matter. I think Paul Ryan is looking at cutting it all. Yeah. I mean, I hope we can throw them all out of office. But in the meantime, if we don't, for any reason, and they stay around, seems clear to me that they're going to cut these benefits. It was a two-step transaction, where the first thing you give a tax break to the corporations, the second step almost immediately is, oh, we don't have enough money now. We have to cut benefits. It's like one followed the other, and it had to be an intentional plan. So if that happens in Hawaii anyway, then you have more people in a situation where there's Social Security, whatever is left of it, and Medicare and Medicaid doesn't really cover their expenses and there are more of them because the boomers go out on the age curve, what happens to us? The state government, what happens to us? Who's going to take care of them? That's right. This is a huge, big problem. It's a huge problem. Yeah. What do we do? Well, we have to realize that we are the ones that we've been waiting for. There's nobody else, and there's some of us who have been in the field, and we just need to recognize that we've got an obligation to pass on that knowledge and bring together a network to create the change, the positive change, because we have an obligation to the next generation. We're the ones that we've been waiting for. Yeah. And the next generation would like to see us independent. Absolutely. The next generation does not want to see us become dependent. No. And for that matter, they don't want to be dependent either. No. So we really have to make this a working body of the population. And if we can remain independent for as long as possible, until our last breath, it's a gift to the next generation. It is. Right? But I'd like to pose a problem to you that right now the unemployment rate in the state of Hawaii is 2 percent. Correct. We're less, you know, it's very fortunate, I suppose. But if, you know, the kupuna are looking for jobs, what happens? Well, this is, you know, many of these companies are not paying too much attention to the fact that our kupuna are there, you know. And we don't necessarily make it that easy for them to navigate this whole process of job finding. And some of them may need certain skills, some coaching, need to do some resume writing, or they, you know, and there's a whole variety of different sorts of things that we can do to assist them to make that transition. So we've got to look at this population, particularly at this time when we're so short on labor, as a huge resource, a huge resource. And they come to work on time, you know, they don't have girlfriend and boyfriend. Old fashioned work ethic. Right, they don't have boyfriend and girlfriend problems like that. Not usually. Not usually. Anyway. Well, you know, part of this is that that generation has to see itself as in this model, as the working model, work until you really, really can't. And you know, it's not just that we tell them that, that's a good idea from all kinds of points of view, but also that they, you know, integrate that into their thinking and that they're ready to come to work. Ready to, you know, do the job, whatever it is, please their employer and achieve things. Yeah. Right. It's a great thing for them, but we have to tell them and make them understand that. You know, a lot of times, employers think, well, you know, we're talking about an older person who may have some health problems and this is going to create a lot of problems on my, on my, you know, my overhead, but you know, it is possible to look at the older adults as people with Medicare and, and it is possible to make arrangements for a population like this to, to, to perhaps waive, you know, some benefits in, in exchange for work. And so there, there, there are things that we've got to look at collectively and, you know, and negotiate to see whether or not it's still. It's a beautiful idea. So how do you implement it? How do you, you know, here we are, it's January 15, 2018. How do you implement this and make it happen? I need to create a kitchen cabinet. I'm looking for people who understand the importance of this, this, this cohort as a huge asset to our community. And then perhaps, you know, start with small projects that are very implementable and can lead to success. We may need to create some, some excitement in the community by bringing some national and international leaders to talk about this and, you know, create more of a buzz. One of the things that is also possible, I guess, in creating this awareness is looking at, look at our senior fairs today. It's all focused around, you know, this is a great nursing home or a great assisted living facility or great home healthcare agency. That's all sick care, as I said. We don't have a companion active aging type summit or a festival that celebrates age as an asset and look at older adults looking for opportunities, paid or unpaid. Now Japan has been doing this for about four or five years now. I'm bringing a group of about ten of us in March to Japan to look at what they're doing and we want to, we want to bring that back to Hawaii. So it's a variety of things, but we've got to keep moving forward. So how does this relate to the notion of aging in place? Those people in the condominiums you were talking about from the 60s who was still there and who liked their condominiums and were happy in the condominiums. Are you talking to them? Do you want, you suggest that they stay there and do active aging from their condo or should they consider going to, you know, a senior facility, an institutional senior facility? Well, everyone, you know, will have to make some decisions on their own, of course. Oftentimes aging in place seems like something that is what we want because we want to remain where we are. At some point in your life, you might find that it may be, you know, let's say if it's not a condo, it's a single family house and you've got a big house which may be 2,000 square feet and you don't need all that space and then it collects a lot of clutter and it becomes more trouble than it's worth. You know, we need to look at ourselves and make some decisions about downsizing, you know? So those are questions that we need to learn about. We've got to educate ourselves about what's available in the community and what probably is best. We may need to do some things as far as housing is concerned for ourselves, but we can still go on and continue to be useful. Yeah, but one thing is clear and it's not only Trump and his Republican friends who want to cut benefits. It's medicine, it's our social fabric, it's state economics. All these things are in play, all these things are changing, and so are attitudes around the kupuna. So you're in the middle of that, you're doing very important work. You know, you're helping me by getting the word out, you know? We're both getting old together so we can understand this better every day. Okay, you watch my back, I'll watch yours. How's that? Thank you, Colin. I appreciate it. Thanks so much for coming down. You're welcome. Thank you.