Exploring long-term care options in Maui County

In Hawaii, we are blessed with the longest life expectancy in the country. This is due in part to medical advances, preventive care, decreased smoking rates and increased focus on adopting healthy lifestyles.

The flip side of this trend is that as we reach into our 80s, 90s and even 100s, the need for long-term care also rises. In fact, around 70 percent of those over age 65 will need some type of long-term care.

What is long-term care?

Long-term care includes services that meet individual health and personal care needs and help people live as independently and safely as possible.

The services may be short term, such as rehabilitation after hip replacement surgery, or long term, such as personal care assistance in the later stages of Alzheimer’s disease.

Nearly 80 percent of long-term care is provided at home by unpaid family members and friends.

The remaining 20 percent is provided by professionals in either a residential, home or community-based setting.

Residential long-term care

Residential facilities include nursing homes, care homes, skilled nursing facilities and assisted-living facilities in which the individual lives where he or she receives the services.

In Maui County, much but not all of the residential long-term care is provided by Hale Makua, Kula Hospital, Molokai General Hospital, Lanai Community Hospital, Roselani Place and care homes.

The cost for residential care can range from several thousand to over $10,000 a month. It depends on the level of services needed and the location. In contradiction to popular belief, Medicare covers little to no residential long-term care. The bulk of the cost is covered by individuals and their family, long-term care insurance, or Medicaid (but only under certain situations).

Home-based services

Home-based services are provided directly to a person in his or her current residence. The most familiar services are home-delivered meals, personal care, or chore services and respite care.

In Maui County, the list of organizations that provide home-based services is too long to name them all. A few of them include nonprofit and government agencies such as Na Hoaloha’s friendly visitor and telephone reassurance programs, Kaunoa’s meals on wheels and assisted transportation, and Hale Mahaolu’s chore services. For-profit and home-health companies also offer services provided by nurse aides, registered nurses, physical therapists and other medically based services.

The cost for home-based services varies tremendously. Programs offered through nonprofit and government agencies often are either free or provided on a sliding scale. For-profit organizations provide the services at the market rate and may be as low as $15 an hour or as high as $50 or more an hour, depending on the service’s complexity.

Community-based services

Community-based services are provided to a person living in the community and are offered in a central location such as a medical or community center. Some of the most common include outpatient physical or occupational therapy, adult day care and respite services.

In Maui County, the list of providers is too long to name them all, but following are a few important players: Maui Adult Day Care Centers (MADCC) provides caregiver education and support, respite services, and day care at three levels of care. It has sites in Kahului, Wailuku, Lahaina, Hana and Kihei and facilitates six monthly caregiver support groups and six quarterly caregiver workshops. Kaunoa offers the congregate meal program, in which older adults gather regularly for socialization and a lunch meal.

The cost for community-based services varies from free to less than $60 for all-day care at MADCC (with scholarships available), to market rate for medically based services.

Maui County Office on Aging

The Maui County Office on Aging (MCOA) has long understood the value of home- and community-based services as the preferred method of long-term care. It’s not only more cost effective but also keeps people in their own or a family member’s home longer – which is what people want! MCOA works with families to assess and identify eligibility for programs and services in the community. They are the hub of aging services in the county. For more information, call them at 270-7774.

* Heather Greenwood Junkermeier is with the University of Hawaii Manoa Cooperative Extension, Maui Intergenerational and Aging Programs. “Aging Matters” will cover topics of interest to the aging Maui community and will appear on the third Sunday of each month.