I have gray hair and I look my age. Unfortunately, as it happens with all too many older people, I have sometimes been judged by the color of my hair and the wrinkles on my face and quickly dismissed, deemed to be an out-of-it old geezer who knows nothing about technology, or about the world or what’s going on. It’s not always true, of course, but it has happened to me enough to have been noticeable.
Although we work hard to stay healthy and active, and living in Hawai’i helps keep us this way, we know a time will come when we will need more care and assistance, especially for possible medical conditions. I’ve covered some of the issues involved with growing old in the islands, especially as it pertains to housing, and present below some more advantages and disadvantages, and how things operate here:
- PRO: The strong influence of both native and Asian cultures translates into greater respect for the elderly in Hawai’i overall. The islands have a long history of caring for its elderly, or kupuna. Kupuna literally means ancestor but also infers someone who is both wise and beloved. Seniors outside of family are traditionally referred to as “aunty” and “uncle,” and the terms are used by children and younger people of all ages. Both Brett and I have yet to be treated with anything less than full respect here from everyone we have encountered, no matter their age, a somewhat different experience than we encountered on the mainland at times. The trend in Hawai’i is to keep seniors living on their own for as long as possible, and many services exist to help the elderly remain independent, including van service to doctor appointments, senior centers, Meals on Wheels or community meals, and low-cost or free housekeeping assistance. Traditionally families care for their kupuna but with demographics and the state’s economy changing, family care is changing as well and more and more elderly are turning to services provided by the state.
- CON: While the number of assisted living and retirement centers has been growing in Hawai’i, the costs for them are growing as well. Even with more homes and senior residences available in every price range, with the growth in the elderly population there is a waiting list for vacancies. If round-the-clock health care is needed, nursing home costs in Hawai’i are approximately 44% higher than the national average. However, even having enough money to cover your costs does not mean there will be an open spot when needed. On some of the islands, private homes offer boarding where elderly can live and receive care. However, these are sometimes operated according to the ethnic background of the owner with different cultural norms, customs and even diet a part of the experience. Boarding in a private home can mean a loving, pleasant experience or it could be a nightmare of abuse and neglect. However, Hawai’i conducts unannounced inspections of licensed private boarding homes, and inspections have shown there to be thankfully few problems with these homes.
Brett and I moved to Hawai’i with the intention of remaining there until the end of our lives, but life has had other plans for us. With our son in Japan, and our daughters living back on the east coast, it makes more sense to eventually relocate somewhere other than Hawaii in spite of our love for the climate and lifestyle here.
All of the points made in the past few weeks about Hawaii retirement can of course be extrapolated to any other place. Some of the pros and cons are unique to Hawaii, but all still give ideas for consideration when deciding whether to stay in a location or move elsewhere in retirement.
The Occasional Nomads 
I had looked into the independent/assisted/nursing facility in Lihue, Regency Puakea and it would have been over $8,000 a month for the two of us for independent living. I talked with my landlady about renting both sides of the cottage and putting a caretaker rent free and a stipend. She readily agreed and said, ”Say when and it’s done”. The relief of knowing I have a plan B is wonderful. I hope we never need that option or that it is very far down the road. But, it’s there.
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You have the ideal set up where you are Joy, but after I read this I realized we are in a similar situation here – we could afford to rent the upper or opposite-side apartment for a caregiver at a considerably lower cost than what it would cost at Regency Puakea or another place. If we weren’t so far away from family here or wanting to travel again while we can we’d definitely consider staying otherwise and I know our landlord would go for it as well.
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The difference is that the studio here is a full time vacation rental. Val is a saint and relieved me of any worries. But, I sure realized that I can buy a lot of health care for what it would cost at Puakea. That’s the only place on the island for assisted living at this point I think.
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I think there is another assisted living place in Waimea, but you may be right. I had just never considered until today that our apartment building would allow for the same sort of set-up that you mentioned. We’d have to wait until someone moved out, but it would be doable from either of the other two apartments.
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Although Hawaii is priced much higher, I have to say the cost of independent/assisted living in the US in general is eye popping. I do some volunteer work that takes me into many of our local facilities. While they vary a bit (and the staff does too…from surly to friendly/helpful), they are all way beyond the means of many, many people. My mom is living in an independent living situation up north where they get hard winters. I can definitely see the advantage of a warmer climate at her age. But a lot of the elderly want to be wherever home is. And she is one of them. It’s not going to get easier or cheaper at this point. I think we will eventually end up talking her into moving closer to a few of us where I live, but time will tell. It’s stressful.
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My mom worried constantly about the cost of her long-term care costs, and she did pretty much deplete her savings, even with assistance from Medicaid and the VA. But like your mom, she liked where she was and it was home. She did come and tour several places in Portland when we were there, but she couldn’t deal with the rainy weather and costs were somewhat more than what she paid in Colorado, and the thought of leaving there was too much for her. Brett and I still haven’t figured out what or where we’ll settle – we’ll travel while we can, but eventually are going to have to make a decision. It’s already stressful.
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I know I am beating a dead drum…here is another important reason for YOU to claim your VA status. There are VA homes all over AND VA has compensation for caregivers of vets. I know it is dependent on status, but it might be a back door long care insurance. I know we are staying on top of those rights for My husband.No such help for spouses.
Laurel is right GOOD care is expensive- way more then I ever expected. It os always going up. Not only that, people without family nearby tend to struggle. We found that during my mom’s place lock down for COVID. Without eyes on, things get missed.
Does Japan make any grants for elderly? If not, what are the chances of half time in Japan and half in the Northeast? Maybe the amount you have been setting aside for university you could hold on to for longer term housing in your kids’ homes?
OTOH- we sponsored a 99 yr old on Oahu. He got together with four apartments in his building and hired a full time nurse. She was retired as well (64) and worked 7 days a week/ 4 hours per…and was on call. All four were retired Navy people 🙂 I think people just think sideways sometimes. If you had a history of dementia, things could be dicey for this type of solution.
I really despise having to think about these things.
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I really enjoy your blog. Just a small note: the Hawaiian word for elder is kupuna (Kapuna refers to a land section on Oahu, along with other place meanings). Thank you for writing, especially about your Japan adventures! Such a joy to read!
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Thank you for the pointing out the mistake – I know this and will get it fixed!
We are looking forward to future adventures in Japan – just a little more than a year to go, God willing.
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My mother died in 2015 and at that time was paying $9,000+ per month in skilled nursing in a religious-affiliated non-profit continuing care community. This was located outside the county seat town where our family had lived. Most of the nurse’s aides were from the local farming community and were not drawn to nursing specifically but were just looking for jobs. It was a mixed bag of good care and sometimes appalling care. Try to look at it from all angles when making the decision. I am at a loss about my own next steps!
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Nina – sorry for the late reply; lots going on here!
I think what my mom would have been paying toward the end of her life might have been comparable (I don’t know; I was always kept out of the loop on these things). I just know it was expensive.
Brett and I are talking about options for the future. Right now our top choice is to eventually settle in an urban area where there are hospitals and healthcare near by, rent a studio for us and one for a caregiver as well and provide said caregiver free housing and a stipend. The unknowns of course is whether there will be affordable housing in the future and whether we can hire someone to provide good care. It’s definitely a dilemma for the future.
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