THE GRAYING OF HAWAI'I
Age-old cultural values

By Tanya Bricking Leach
Advertiser Staff Writer

Ruth Tamashiro cares for her 89-year-old mother, Hatsuye Shimabukuro, at their home in Kalihi. Rebecca Breyer • The Honolulu Advertiser

In the 1940s, Hatsuye Shimabukuro was a young mother. Now that she's 89, her middle child of five, Ruth Tamashiro (far left), cares for her. Family photo

Free forum on sunday How valid is the perception that Japanese-American and other Asian families take care of their elders without relying on any public assistance? What challenges will the next generation of Japanese-Americans face in caring for their elders? Eldercare panelists will address these and other questions at a forum Sunday. "Okage Sama De: Challenges, Sacrifice and Satisfaction in the Japanese American Community in Hawai'i" 9:30 a.m.-noon Sunday Japanese Cultural Center of Hawai'i, 2454 S. Beretania St. Free 945-7633

It was a hard life. Shimabukuro quit school after the third grade because she was considered strong enough to work. She married and had five children. And when her mother grew old, Shimabukuro cared for her because it was a matter of pride. The idea of sending an elder to a care home carried too much stigma.

Now that Shimabukuro is 89 and frail, and counts strokes, dementia and diabetes among her afflictions, her daughter, 69-year-old Ruth Tamashiro, is continuing the tradition.

There's truth in the common perception that Japanese-American and other Asian families feel a greater responsibility to take care of their elders without relying on assistance, said Karen Miyake, the county executive on aging for Ho-nolulu's Elderly Affairs Division.

The tradition is most evident among new immigrants who feel they must gain respect by honoring their families, Miyake said.

"As people get acculturated here," she said, "that feeling of having to take care becomes less and less."

The demands and complications of the Japanese tradition of caring for elders is the topic of a forum Sunday at the Japanese Cultural Center of Hawai'i: "Okage Sama De: Challenges, Sacrifice and Satisfaction in the Japanese American Community in Hawai'i." At the forum, panelists also will explore challenges of eldercare and available resources.

Although Asian families have traditionally cared for their elders, the crisis over who bears the responsibility for them is broad, Miyake and other panelists said.

"It's getting tougher out there for everyone," said panelist Cullen Hayashida, a social gerontologist and co-host of "Kupuna Connections," an 'Olelo television program for seniors and caregivers.

Several of the panelists were sources for The Advertiser's December 2004 series, "The Graying of Hawai'i." The topic comes up frequently, they say, because it's something every family faces.

Honor thy parents

Ruth Tamashiro and her husband, Ken, used to rent out part of their duplex in Kalihi for extra money. Now, Shimabukuro, known fondly by everyone as "Grandma," is the tenant in the small bedroom stocked with her twin bed, medical supplies and a chair for relatives who visit.

The Tamashiros' three children are grown, and when Grandma Shimabukuro moved in 10 years ago, it was just after they talked her into giving up driving because she'd sometimes doze off behind the wheel.

These days, a Catholic Charities van picks up Grandma for adult daycare most weekdays, giving the retired Tamashiros a few hours to themselves.

When Grandma gets home, she requires a schedule of baths, feedings and care. On weekends and holidays, she usually spends the day in bed.

"This is new to us, too," her daughter said. "Babies, at least they grow up and grow stronger."

Tamashiro can only watch as her mother grows weaker.

Tamashiro goes to Project Dana, a local support network, a few times a month for advice and counseling. It keeps her in touch with about 30 other people in the same boat, and it makes her feel connected.

She said she feels peace of mind that she's doing the right thing.

But she and her husband have bought long-term-care insurance in hopes that their children will be spared some of the burden.

Sense of community

Shimabukuro's wedding photo. Family photo

The early Japanese arrivals, for example, had organizations that reflected the regions of Japan they came from. They developed ethnic neighborhoods that supported one another in times of deaths, births or other celebrations. It was neighbors helping neighbors, the same way early Americans built barns and churches, Hayashida said. Now, though, he sees groups such as condo associations focusing solely on structural issues rather than on building relationships.

Changing that will be part of the solution for caring for our elders in the next generation, he said.

But cultural style in caring for elders is definitely not a thing of the past, a 2001 AARP study found.

Its survey indicated parents of Asian and Hispanic heritage expected their family members to participate in their care, whereas Caucasian parents were more likely to view living with their children as a sign of failure. Caucasians expected a mix of personal attention and community services as they age.

As the ethnic landscape of Hawai'i blends, we will need to spend time building relationships and making decisions about how to best care for the elderly in our communities by concentrating on building community relationships and knowing our neighbors again, Hayashida said.

"It's not going to be possible to rest on our laurels and say cultural values will carry us," he said. "Things will change over time very quickly."

Tanya Bricking Leach writes about relationships. Reach her at tleach@honoluluadvertiser.com or 525-8026.

Breaking the ice

Many families avoid difficult conversations about their parents' future until a crisis strikes. But experts say it's important for adult children to get dialogue going with their parents about their needs and wishes early, and revisit the issues as needs evolve. Whether you hold family meetings or address topics a little at a time, here's a checklist of subjects to bring up:

• Housing: Is your parent's home still appropriate for his or her needs? Does it need safety modifications such as grab bars for the bathroom?
• Daily activities: Does your parent need help with household chores such as cleaning or preparing meals?
• Transportation: Can your parent drive safely and get to the store, doctor, religious services and social activities?
• Health: Is your parent getting appropriate medical care?
• Money: What are your parents' financial needs now and in the future, and are they in a position to meet those needs?
• Insurance: Do they have adequate health insurance?

Source: AARP's brochure "Family Conversations That Help Parents Stay Independent"