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The Honolulu Advertiser
Posted on: Sunday, February 16, 2003

Elderly care takes place mostly in caregivers' own homes

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By Mike Gordon
Advertiser Staff Writer

Most of the care for Hawai'i's seniors is handled in 545 private homes that are licensed by the Department of Health.

These adult residential care homes provide long-term, 24-hour care — housing, meals, personal needs — in a residential setting. Residents live there full time, either in their own room or in a dormitory setting within the home.

Residents are dependent on their caregivers for assistance, some more than others. The cost can range from $1,500 to $5,000 a month.

In Hawai'i, a large number of care homes are owned and operated by immigrants, many from the Philippines, who are drawn to such work because caring for elders is common in their culture. More than half the homes in the state are on O'ahu, primarily in Waipahu and Kalihi.

The most common type of care home has two categories: one allows owners to house up to five people while the other allows six or more.

Residents are those who need a minimum amount of supervision when it comes to daily activities. They may need help with a walker or a wheelchair. They are able to feed themselves but do not prepare their own meals, shop by themselves or do their laundry. Some need friendly reminders to take medication.

The less common type of home is an expanded adult residential care home, which is available for older, more frail individuals.

If a resident requires skilled nursing care, a registered nurse is required to handle such needs as tube feedings, injections such as insulin, IV antibiotics or wound dressing changes.

A resident needing intermediate care requires a certified nurse aide, who helps with bathing and toilet needs and feeding.

The state also has 46 nursing homes, which are much larger and resemble a more traditional, institutional setting. Although federally regulated, they are licensed by the state.

Nursing homes are acute care facilities with staffs of doctors and nurses. Consequently, they are more costly and in Hawai'i generally cost more than $5,000 a month.