Na Pu‘uwai sets new course for Lanai senior care

New partner Johns Hopkins School of Nursing takes over after Arcadia ends its collaboration

With its 12-year collaboration with Arcadia elder and home health services companies closing at the end of August, the Lanai nonprofit Na Pu’uwai launched a pilot program with the Johns Hopkins School of Nursing to help kupuna stay healthy at home, according to an announcement.

While Arcadia shared its clinical expertise and provided training for Na Pu’uwai nurses, the nonprofit brought in federal funding through its Health Resources Services Administration allocation to provide in-home care for Native Hawaiian residents of Lanai.

“We were disappointed when Arcadia announced it decided to discontinue our collaboration,” Na Pu’uwai Executive Director Kamahanahokulani Farrar said. “However, we do not want our patients to feel abandoned. We want to assure our patients that we are not going anywhere; we will always be here for them.

“With Arcadia’s plans to exit Lanai by the end of December, we will be inviting all current and new patients to allow us to conduct a baseline needs assessment and develop individualized transition plans for each of them.”

The last day of home health services on Lanai through Na Pu’uwai was Aug. 25. It came as a result of Arcadia’s 30-day notification to end its relationship with Na Pu’uwai.

The nonprofit notified its Lanai employees that it will no longer be able to continue to employ them for the home health services. This included five registered nurses, five certified nurses aides, and an aide for light housekeeping. Their last day was Aug. 30.

“Although we are saddened by this decision, we recognize that this is part of our rebuilding process as we start this new program,” Farrar said. “We know there will also be growing pains along the way as we continue to explore more possibilities and opportunities.”

Na Pu’uwai had been serving 40 people on Lanai under a memorandum of understanding between the nonprofit and Arcadia Retirement Residence, Arcadia Elder Services and Arcadia Home Health Services. Arcadia Home Health Services has provided home care and health services as well as a limited amount of assistance, education and consultation, according to Na Pu’uwai.

It is one of five nonprofit organizations that make up the Native Hawaiian Health Care Systems.

Arcadia notified Na Pu’uwai in July that it was terminating its collaboration and would no longer provide services on Lanai by the end of that month, the nonprofit said.

Then, “Na Pu’uwai accelerated the implementation of its strategic plan to ensure those patients in the community would not be adversely impacted,” it said late last month. “On Aug. 1, Na Pu’uwai began another three-year grant cycle that will include new, innovative programs that tap into the medical expertise of other organizations.”

Farrar said: “Our foremost concern is the health and well-being of those individuals and their families, and to make sure they continue to receive the care they need. . . . As Arcadia winds down on Lanai, we are preparing to begin implementation of a new program in Hawaii to remain true to our mission of improving the physical, mental and spiritual health of Native Hawaiians and their ohana.”

The new program is called KAPA, an acronym for “Kupuna Aging in Place with Assistance.” It is modeled after the Community Aging in Place-Advancing Better Living for Elders (CAPABLE) program. That was developed at the Johns Hopkins School of Nursing for low-income seniors to safely age in place. It will ensure seniors remain active and engaged in the community.

The program was designed to improve health and decrease costs. It teams a nurse, an occupational therapist and a home repair person to make “common sense” modifications to homes to be more senior-friendly to prevent falls and improve access within their homes, the nonprofit said.

The program also takes advantage of older adults’ strengths to improve safety and independence.

According to Na Pu’uwai, CAPABLE is an evidence-based program approved by the National Council on Aging that has been tested in multiple small and large trials. Each of those shows that participants enjoy better function with lower hospital admission rates and decreased nursing home admission rates. As of May 2018, CAPABLE is being offered through programs in 21 organizations across 12 states and Australia.

Na Pu’uwai reports that in-home care is a lower-cost alternative to hospital or institutional skilled nursing care. Those care models sometimes result in kupuna being temporarily uprooted, separated from their family or support system, and relocated to Oahu.

Kapuaola Gellert, a Native Hawaiian Health Scholarship recipient who earned a doctorate in epidemiology from the University of North Carolina at Chapel Hill after serving at Na Pu’uwai for three years, will be involved with the program’s implementation, Farrar said.

Also, Jamie Kamailani Boyd, also a Native Hawaiian Health Scholarship recipient, will serve as a holistic nurse practitioner in the new program.

Boyd has served as an associate professor and health programs coordinator for Windward Community College on Oahu and has extensive nursing experience, including serving as a family nurse practitioner.

Farrar said there has been strong interest from registered nurses to participate in the new program, and training is scheduled to begin in October.

The program is designed to serve adults 50 years old and older and people of any age who may have difficulty performing daily living activities, such as bathing, dressing and grooming. Or, it helps people who do not have dementia or only have mild cognitive impairment.

During the pilot program, Na Pu’uwai will look for ways to make the KAPA program financially sustainable. There’s no cost to seniors participating in the grant-funded program.

The U.S. Census Bureau reports there are about 1,000 seniors age 50 and older on Lanai (516 men and 573 women). Also, people making up about 11 percent of the island’s population identify themselves as Native Hawaiian or Native Hawaiian/Pacific Islander.

* Brian Perry can be reached at bperry@mauinews.com.

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