Since 1883, Lunalilo Home has provided care for kūpuna with aloha; hōʻihi (respect, dignity); laulima (collaboration, teamwork); mālama (caring); hoʻomanawanui (patience); kūlia i ka pono (striving for the right); and lokomaikaʻi (benevolence, grace). The residential care home was established in accordance with the will of King William Charles Lunalilo, the first aliʻi to create a charitable trust for the benefit of his people (see www.lunalilo.org/about/history-of-lunalilo-home). Although he reigned for just 13 months, from January 8, 1873 to his death on February 3, 1874, Lunalilo was dearly loved by his people, who nicknamed him “Lokomaikaʻi” because of his kind, generous nature.
Originally located in Makiki, ma kai of where Roosevelt High School now stands, Lunalilo Home moved to its present site on the slopes of Koko Crater in Maunalua (now known as Hawaiʻi Kai) in 1927. It offers round-the-clock care and supportive services such as respite care, day care and meal pick-up and delivery. Any senior who is ambulatory or independently mobile with devices, and who needs minimal supervision and/or assistance with personal care, is eligible to apply for admission to the home. In keeping with Lunalilo’s will, priority is given to kūpuna of Hawaiian ancestry.
“Elder care in general is a difficult process; plus, we in Hawaiʻi are raised with the notion that we must take care of our aging loved ones,” said Diane Paloma, Ph.D., chief executive officer of the King Lunalilo Trust and Home. “There’s tremendous guilt when we realize we can no longer do that on our own and have to put them in a care home, away from everyone and everything that’s familiar to them. At Lunalilo Home, we’re dedicated to fulfilling the wishes of King Lunalilo to provide a safe, comfortable, nurturing haven for kūpuna. We are another ʻohana for them.”
Throughout the day, clients may participate in diversions ranging from movies and trivia games to Bingo contests and cooking demonstrations. On Friday afternoons, they enjoy live music performed by the staff.
Also contributing to holistic health are private Zoom sessions with a clinical psychologist from I Ola Lāhui, which was founded in 2007 to address the need for behavioral health services for Native Hawaiians and those living in rural communities. Lunalilo Home launched this service in January, thanks to a two-year grant from OHA.
“In the beginning, a psychologist from I Ola Lāhui came every Thursday to meet with residents coping with depression, loneliness, anxiety and feelings of abandonment,” Paloma said. “Because of the pandemic, we had to institute a no-visitors policy, but, thankfully, the Zoom meetings are working well. Mental and emotional health are as essential to wellbeing as physical health.”
Meals at Lunalilo Home provide sustenance for both body and soul. As much as possible, menus offer comfort food that kūpuna remember from their childhood. Crops flourishing in the on-site garden include kalo, ʻulu, ʻuala, eggplant, squash, herbs and green onion. They appear in ʻono dishes such as pinakbet, chicken sabao and beef stew thickened with poi and made with easier-to-chew meatballs. ʻUlu and kalo have been substituted for potatoes.
“It’s great to know we have a source of fresh, healthy food for our kūpuna right in our backyard,” Paloma said. “As a bonus, growing some of our food has helped our bottom line.”
Finances are also an ongoing concern for many families in Hawaiʻi. Elder care requires a lot of time, energy and money—adding another layer of stress as people struggle to make ends meet.
Because of the “silver tsunami,” demand for care-home beds statewide is already far exceeding supply. That is driving up costs, widening the chasm between those who can afford to obtain services and those who can’t.
“If your parents can pay out of pocket, every resource will be available to them,” Paloma said. “If they can’t, there won’t be many affordable options. What do you do? You sell their house, take a second mortgage on yours, work two or three jobs and/or tap into your 401(k) to help cover the cost of their care.”
To stave off the additional expenses, people will usually wait as long as possible to seek assistance. Kūpuna might be left at home alone during the day, perhaps incapable of cooking or remembering when to take their medication.
“Elder neglect and abuse are becoming more common, especially with the turmoil the pandemic has caused,” Paloma said. “Abuse can be physical, mental and/or financial. We’ve seen cases where kūpuna really need supervised care, but they’re kept at home because their Social Security check helps pay the rent or mortgage.”
In traditional Hawaiian society, kūpuna were honored for their skills, insights and knowledge; however, when Western ideals were adopted, their role was diminished.
“Today, many people depend on their parents to pick up their kids from school, take them to soccer practice, help them with homework and maybe even bathe and feed them,” Paloma said. “When Mom and Dad can no longer do that, their perceived value changes. Instead of helping to provide care, they now need care, and they become one more task to be handled in already hectic lives.”
She believes addressing these issues requires a collective effort that starts with how people view elder care.
“The word kuleana is an excellent example of that,” Paloma said. “Kuleana means responsibility or burden, but it also means privilege. Kūpuna can share stories about old Hawaiʻi that many of us know nothing about. They have wisdom and amazing life experiences and deserve to be cherished and respected. It is our kuleana to care for them, but how we do that depends on how we define kuleana. Burden or privilege? For us at Lunalilo Home, it is a privilege.”