There was a buzz about the venue as soon as I walked in. A line…
When I decided to travel by foot between Hawi and Waimea on a weekend trip, I didn’t expect to set up a work meeting with the stranger I met traveling alongside me. Her name was Dana (name changed for privacy), and she was returning to Hilo after an afternoon church event up in North Kohala. As we traveled, she told me about her life, I told her about mine, and we realized we shared something in common: that our work centers on realizing healthy aging and kūpuna well-being here in Hawai‘i.
Dana is an activities leader at a non-profit organization called Hawai‘i Island Adult Care (HIAC) that offers adult day care services. Adult day care is a service that provides entertainment, opportunities for socialization, and physical exercise for older adults with physical or cognitive disabilities. At the same time, they provide caregivers the respite they need to pursue work or other activities, all with the peace of mind that their loved ones are receiving high-quality care from experienced professionals. Located in Hilo, HIAC is Hawai‘i Island’s only adult day care facility, so when Dana invited me to see it for myself, I gladly took her up on it.
A Visit to HIAC
When I arrived, Frank Manley II, Program Director and LPN of HIAC’s dedicated care team of Certified Nursing Assistants and activities leaders, gave me a comprehensive tour of how HIAC supports Hawai‘i Island families. What I found left me feeling amazed.
To start, HIAC’s facility retains its own kitchen to provide participants with fresh, healthy meals during their visit. The facility also offers dementia-friendly features such as secure, enclosed outdoor spaces that give program participants the autonomy to move freely without compromising their safety. When I was there, participants were creating beautiful art, including clay Christmas trees, as part of their regular ceramics classes. In partnership with Hawaiʻi County Office of Aging, HIAC also offers a monthly Free Family Caregiver Respite Day, where caregivers can bring their loved ones to the center and HIAC staff will care for them free of charge. Caregivers can be treated to a massage, participate in wellness activities, feast on a healthy brunch, and learn more about their loved one’s condition and how to be a better caregiver. According to HIAC, “the greatest benefit for the caregiver, is that opportunity to have time to themselves and to simply sit and ‘talk story’ with other caregivers.” (HIAC About Page).
Centers like HIAC keep kūpuna healthier for longer, allowing for a better quality of life for themselves and their caregivers (see this AARP article for more). Despite this, there are simply not enough centers like HIAC to meet the potential demand for this service across the islands. In 2020, there were 36 adult day care centers, with only three serving Hawai‘i Island (Hawai‘i Department of Health). Since then, many have closed or been converted to other types of facilities and today, only one center is left to serve Hawai‘i Island. Adult day care programs across the islands have simply been struggling to return to pre-pandemic participant levels and HIAC is no exception.
Barriers to Serving the Community
For HIAC, there are many reasons for this struggle and in our conversations, Frank illustrated how their ability to effectively serve East Hawai‘i is directly impacted by the ability of kūpuna and their caregivers to reach the facility. The lack of robust public transportation, notoriously congested traffic during key parts of the day, and the sheer lack of other facilities on the island can result in commutes of an hour or more for families seeking to take advantage of the services HIAC has to offer. Without adequate investment in accessible transportation systems, HIAC has had to look into alternatives, like hiring their own drivers and vans, to bridge the demand.
Then there’s the issue of being known and accepted as a service that families can rely on. For one, the term, “day care,” can invoke feelings of disempowerment or infantilization for kūpuna, potentially negatively impacting their sense of self and overall well-being. Despite the near universality of caregiving, caregivers may also experience deep cultural pressure and feelings of shame or false inadequacy for not being able to care for their loved ones on their own. These are the reasons why HIAC’s Family Caregiver Respite Day is so critical: it offers caregivers direct respite while also spreading awareness rather than misconceptions about what adult day care is and how much more support caregivers can have to care for their loved ones.
Lastly, affordability is a serious issue for many families as the sandwich generation here in Hawai‘i faces mounting pressures to care for not only themselves but for their children and parents too. As our systems of housing, food, education, and other basic needs continue to fail even the hardest working families in Hawai‘i, people of all ages suffer (Hawaii’s Generational Economy: Economic Impacts Of Aging). Recognizing this inequity, Dana tells me that HIAC does what it can within this failing system, fundraising to make their service more affordable for those who need it but cannot access it without financial assistance.
For the small but mighty teams in Hawai‘i working to provide adult day care services, it’s clear there are many challenges to reaching those who may benefit from it. Still, HIAC and other adult day care centers offer greater choice for caregivers and support for Hawai‘i’s kūpuna. The real and holistic benefits that adult day care, day health, and related services offer to families are immeasurable. For that reason and more, we can find folks like Dana, Frank, and the whole HIAC team pushing forward and doing what they do, despite all the challenges that lay ahead.
Curious to hear from a caregiver about their HIAC experience? Check out this video produced by Nā Leo TV and go to 5:30 to hear from Mimi Trusdale about her and her parents’ experience. Learn more about HIAC by visiting their website or calling them at (808) 961-3747.
About the Author:
Kiara Bacasen is the Kūpuna Collective Special Projects Coordinator VISTA, who through this chance encounter was able to bring aboard HIAC as one of the newest members of our Kūpuna Collective. The Kūpuna Collective is a growing group of kūpuna facing organizations that come together to share knowledge, resources, and support for aging efforts across Hawai‘i. Part of this work involves highlighting different members to elevate issues impacting not just their work but our collective efforts to build an age-empowering Hawai‘i. To learn more about the Collective, check out hiphi.org/kupuna/.