Friday, February 25, 2011

Issue of aging needs to be at the top of Legislature's agenda

The opinion piece below appeared in the Honolulu Star-Advertiser on Friday, February 25, 2011. Link here.


The new administration has indicated support for issues related to aging — more attention to bringing down federal funds and sensitivity to those in the community dealing with long-term care. Our First Kupuna, the governor, has every reason to do so.

Will it be enough? Physicians are crying for relief from reimbursement shortfalls and hospitals barely meet their budgets while caring for patients wait-listed for community care.

Families groan under the weighty responsibilities of the "sandwich generation," trying to care for children on the way up while welcoming parents into their homes, sometimes reluctantly.

Plenty of lip service is given to the support of aging issues but more concrete action is needed if we are to deal with the coming tsunami. Aging issues remain at the bottom of the list of priorities for some legislators.

One bright spot lies within the work of the legislative Kupuna Caucus, which meets monthly to listen to concerns of seniors, advocates and experts in the field of gerontology. Supported enthusiastically by groups such as AARP, the state Policy Advisory Board for Elder Affairs, Grandparents Caring for Grandchildren, the Executive Office of Aging and consumers, the caucus has put forward a comprehensive package of bills.

While many of the bills have financial implications, others are more dependent upon changes in attitude, community participation and the recognition that, sooner or later, aging happens to all of us.

Two of the bills in the package have broad implications for seniors and their families. Preventing falls is the focus of House Bill 507 and Senate Bill 939.

A fall can lead to major complications, not limited to the obvious result of broken bones. Confine an older person with a fracture to bed for just a few days, and you have potential for decubitus (pressure sores) and pneumonia.

Premature death is often associated with falls. Costs of care and rehabilitation are burgeoning. When falls occur, they are often avoidable. Prevention needs be universal and the community needs to be educated.

Palliative care is addressed in Senate Bill 941 and House Bill 512. Palliative care relieves symptoms and improves quality of life without necessarily focusing on cure as an outcome. Many times palliative care is part of hospice care, but can be used to improve quality of life in serious illnesses where there is pain or other symptoms. This is an ideal form of therapy for those in their last years of life and should be a reimbursable service.

Resources are at the very core of our ability to address many of the issues that accompany aging. Of course, seniors who live on a fixed income are rightly concerned about a proposal to tax pensions, yet there are many in the community who are willing and able to make the sacrifice.

How this debate comes to a conclusion may well mean the realization by some that to deal with the needs of the aging community, we will all have to contribute.

We often see public outcry over the location of care homes, long-term care facilities and senior housing, but these facilities are in short supply in our community. Change must come.

We debate closure of low-census public schools, but couldn't some of the extra space be used for senior day care? An added advantage of this would be to provide the students in the school with ready-made grandmas and grandpas.

Times are tough. There is no debating that. However, many of our kupuna have gone through tougher times and are a model of resilience. We need to learn from them and to put the issues of aging right at the top of our agenda for the future.

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