HA‘ENA — A growing elderly population combined with a shrinking younger workforce has left some wondering if the island will be able to care for its kupuna in the coming decade.
“Many, many young people, our children and grandchildren, have left. They can’t afford to live here,” said Cyndy Johnson, a Ha‘ena resident. “And the people in my generation, we’re starting to say, ‘wait a minute, I thought there would be somebody here to help me.’”
Data from state Department of Business, Economic Development and Tourism projects that the population age 65 or older will increase by 3.3% annually on average, and that the elderly population’s share of the total population on Hawai‘i will increase from 17.1% in 2016 to 22.6% by 2030, in what some have termed a “silver tsunami.”
Meanwhile, the shares of all other population groups are projected to decrease.
Kaua‘i’s elderly population has already increased from about 15% in 2010 to nearly 21% in 2019, according to U.S. census data, and the effects of this shift can already be seen.
‘Ohana Pacific Health Home Health Care Administrator Jill Shinno reported that due to an aging population and an increased demand for home health care due to the COVID-19 pandemic, its average number of active patients doubled in the past year.
“We have come to a tipping point where our workforce-aged residents are not able to fulfill the workforce (needed) to care for the rapidly aging population,” said Shinno.
“There’s a vast nursing shortage,” said Wainiha resident and registered nurse Dana Gutzman. “The caregivers are busier because of COVID. Everyone’s being stretched to the max. I know three nurses who moved away just this month.”
A major driver of this demographic shift is housing, which poses a problem not only for young workers but also for elderly residents themselves.
“I absolutely see people struggling with housing here. I’ve been appalled that there isn’t more senior housing to accommodate these people,” said 79-year old Po‘ipu resident Jamie Mantegna. “People are being forced to move to Las Vegas or the mainland because they can’t afford to live here anymore.”
While the elderly are more likely to own their home than younger people, more than one-third of elderly homeowners still have a mortgage to pay, according to the DBEDT data. From 2015 to 2019, some 43.1% of those who owe mortgage payments spent more than 30% of their household income on housing, while about half of them spent more than 50%.
During that same period, more than half of the elderly renters in Hawai‘i spent at least 30% of their household income on rent, and nearly one-third paid more than 50%.
The problems elderly citizens face can be particularly pronounced on the difficult-to-access North Shore.
A mudslide closed Kuhio Highway in 2018 and floods cut the North Shore off from the rest of the island for months in 2019, during which time residents reported that hospice and home health care couldn’t reach the region.
“It was terrifying for me,” said Gutzman. “Seeing this is what it would be if there were very limited resources and people.”
Even in normal times, elderly North Shore residents can struggle to receive care, with Gutzman reporting that there were fewer than 10 caregivers on the North Shore.
Shinno reported that ‘Ohana Pacific sometimes had difficulty reaching North Shore patients due to long travel times and impacts to roadways due to weather.
This lack of care can force elderly residents to make a drive down Kuhio Highway if they need medical attention.
“It is really daunting to need a ride to Lihu‘e,” said elderly Wainiha resident Linda Derohan. “Sometimes I’ll cancel an appointment because I can’t find anyone to help me. That’s a real big problem with us on the North Shore.”
In preparation for the demographic shift, some organizations and individuals are taking steps to meet the needs of the growing elderly population.
The Hanalei Initiative, a North Shore community group, submitted a grant proposal to the county Office of Economic Development that would study elder care and develop a strategic plan to deal with it.
A huge part of the solution, Hanalei Initiative Executive Director Joel Guy says, is convincing young workers to begin careers in elder care.
“We need to let young adults know that they can live here, that there are opportunities and a need,” said Guy.
Rose Hayes, who provides hospice care on the North Shore, suggested the idea of a shared-housing model, where caregivers could live with multiple elderly patients. This, Hayes said, could provide housing opportunities for caregivers who might otherwise struggle to afford rent, while improving elderly residents’ access to care.
Meanwhile, ‘Ohana Pacific increased staffing and capacity this past year, has increased services within the North Shore, and is currently recruiting new home health aides.
•••
Guthrie Scrimgeour, reporter, can be reached at 647-0329 or gscrimgeour@thegardenisland.com.
