Aged face shelter shortage
By Christie Wilson
Advertiser Staff Writer
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| Hazel Yasutomi, 74, has her blood pressure checked by Nora Fuerte, a home care aide, at the Harry and Jeanette Weinberg Senior Residence at Maluhia. Home Care Aide Helen Ines, right, has lunch prepared for Yasutomi.
Gregory Yamamoto • The Honolulu Advertiser |
Twice a week, 74-year-old Hazel Yasutomi leaves her one-bedroom apartment in 'Alewa Heights to go across the street to mingle with friends and join in exercise classes at the Maluhia Long-term Care Health Center.
There, she can also see a doctor who specializes in geriatrics, get physical therapy for her stroke-related impairments, and enjoy a hot meal.
With no family to care for her, Yasutomi, the former owner of Hazel's Cafe in Wailuku, wouldn't have been able to live on her own for as long as she has without the attention she receives at the center and at the Harry and Jeanette Weinberg Senior Residence at Maluhia, where she lives with the help of a federal rent subsidy.
Many other frail seniors aren't as fortunate. For them, the options are an isolated and often unsafe existence alone at home or premature admission to a nursing home.
Demand for programs that encourage "aging in place" is accelerating as Hawai'i's elderly population grows rapidly.
But aside from a handful of projects such as the Weinberg Senior Residence, which has only 39 rental units, the state has little to offer in the way of "affordable supportive housing," according to a report released by Stephen M. Golant, a professor at the University of Florida's Institute on Aging.
The report, commissioned by a task force of agencies that deal with housing for the elderly, cites U.S. census figures that show Hawai'i's population of residents ages 65 and older grew by 29 percent between 1990 and 2000 — the fifth-fastest rate in the nation. The population of residents ages 85 and older grew 69 percent — the fourth-fastest growth rate in the country.
In 25 years, it is projected that more than 1 in 5 residents in the state will be 65 or older.
Until recently, Golant said, housing for the elderly was approached from the standpoint of affordability and the physical condition of housing units. Little consideration was given to low-income residents with physical and cognitive disabilities and health problems who require assistance with housekeeping, meals, personal care or transportation.
Michael Flores of the U.S. Department of Housing and Urban Development agrees that most of the federally sponsored senior housing built in Hawai'i was designed for those who can live independently.
HUD provides rental assistance programs as well as money to build and operate affordable housing projects.
"Now there is a realization that those who already are living in HUD-assisted housing not only need affordable shelter but supportive services if they are to age in place," Flores said.
The need has become even more urgent, he said, as baby boomers move into their senior years.
While assisted-living projects have been developed in Hawai'i recently, they have targeted the well-heeled who can afford the costly fees.
Cullen Hayashida, president of the nonprofit Assisted Living Options Hawai'i, said a cheaper version is needed for those who aren't as financially secure.
One such project that can serve as a showcase for the rest of the state, he said, is the private, nonprofit Hale Mahaolu, which has been operating in Maui County for more than 30 years.
Hale Mahaolu owns or manages nearly 1,000 housing units for low- and moderate-income families, the elderly and disabled.
"There are four or five basic things — such as shelter, transportation and cleaning — that you need to remain at home in an independent way," said Roy Katsuda, Hale Mahaolu executive director. "If we only provided shelter, we would not be providing a meaningful way to live."
The agency provides meals and personal care services to the elderly in the community as well as to residents at its own sites, and coordinates with agencies such as Maui Economic Opportunity Inc. for transportation and housekeeping services.
As successful as it has been, Hale Mahaolu can't keep up with demand. It takes 18 months to two years to get a unit, and its Makawao site has an eight-year waiting list.
On O'ahu, the wait is two to three years for the few affordable supportive-living facilities available, said Hayashida, who works for Hawai'i Health Systems Corp., which operates the 158-bed Maluhia Long-term Care Health Center and 11 other state hospitals.
In addition, HHSC runs PACE (Program of All-Inclusive Care for the Elderly), which offers adult daycare, medical and dental care, rehabilitative therapy, social activities and other services at the Maluhia center.
The program also provides in-home care, close monitoring of medication, help with bathing, dressing and other needs to those at the Weinberg Senior Residence and elderly residents living in the community alone or with family.
PACE clients include those who qualify for government-sponsored insurance and others who can pay on their own, said director Audrey Suga-Nakagawa.
HHSC will be joining with the private, nonprofit Pacific Housing Assistance Corp., its partner in developing the Weinberg Senior Residence, to build a similar project in Iwilei that is expected to open in 2005.
Seeking more state and federal money to build such projects is one solution recommended by Golant in his report.
Another is to bring more services to the 7,000-plus seniors already living in federally subsidized rental units.
Golant and Hayashida agree that an important starting point would be to provide on-site social workers to supervise and monitor frail elderly residents and hook them up with appropriate agencies.
Hayashida said finding money to expand and improve housing for the elderly is always going to be a challenge, but some fixes could be achieved by simply consolidating and redirecting resources, such as moving health and human service programs to housing sites.
For example, an activities room in an apartment complex could house a daycare center for elderly residents in the building and those from the surrounding area.
Hayashida said the task force would review Golant's recommendations and identify the top two that can be accomplished within the next year.
Agencies commissioning the report include Assisted Living Options Hawai'i, Maluhia Long-term Care Health Center, the City and County of Honolulu's Elderly Affairs Division, HUD, Catholic
Charities and the Housing and Community Development Corp. of Hawai'i.
Grants from the McInerny and Hawai'i Community foundations paid for the study.
Reach Christie Wilson at cwilson@honoluluadvertiser.com or (808) 244-4880.
