Kevin Y. Kawamoto
Special to The Hawai‘i Herald
There was a time when the study of human aging tended to focus on “sick care” and aging-related diseases. The years after a person retired were thought to be a gradual disengagement from the community as older people quietly lived out their limited twilight years and experienced physical and mental decline.
Today, thanks to a variety of factors, people are living many years beyond retirement — a phenomenon known as “longevity.” In Hawai‘i, longevity is especially strong, with average life expectancy estimated to be around 82 years, several years higher than the national average.
Some ethnic groups in Hawai‘i fare better than others when it comes to longevity. A population analysis published in 2017 (based on an analysis of 2010 U.S. Census data) by University of Hawai‘i and state Department of Health researchers found that people of Chinese, Japanese and Filipino ethnicities tend to have longer life expectancies than those of other major ethnic groups in the state. Females tend to have a higher life expectancy than males once they reach old age, although no one knows for certain why.
Although Hawai‘i tops the charts in longevity, the gains in life expectancy over the decades are a national phenomenon, and the study of aging is gradually evolving to reflect this reality. It is not only about sick care, but also about “well-care” — the mindset and activities that result in healthier aging biologically, psychologically and socially.
From a well-care perspective, questions arise about how to maintain a good quality of life during one’s conventional “retirement” years. In fact, some advocates for a well-care-focused approach to aging dislike the term “retirement” altogether. Instead, well-care advocates envision a person’s conventional retirement years as a season of opportunities to lead a meaningful, productive life, one that is filled with a sense of purpose and fulfillment. Terms like “encore career” — meaning work (paid or unpaid) that is done with passion for a cause or interest — have come to represent the period in one’s “Third Age,” the stage following retirement and middle age. For example, a 67-year-old woman who has always loved animals, but was too busy taking care of her family and working in an office all her adult life may decide to devote her retirement years to volunteering at an animal shelter. This so-called encore career is one that she loves, has a gift for and fulfills a need in the community. When she wakes up in the morning each day, she looks forward to going to her volunteer job and cleaning the cathouse before the shelter opens to the general public.
This past January, longtime Hawai‘i-based gerontologist Cullen Hayashida, Ph.D., discussed the importance of well-care during a global caregiving summit sponsored by an organization in Colorado called Age Without Borders. He joined more than 50 experts from around the country and world for this innovative, seven-day forum that took place entirely via the Internet. Speakers with varied backgrounds and areas of expertise were interviewed individually via online video conference technology for about 30 minutes. People registered for the virtual summit could watch and listen to these interviews from any Web browser in the world. Registered participants could also get free 48-hour access to the archived interviews on topics such as coordination of care, self-care, using technology to enhance caregiving, volunteerism and more. Speakers ranged in age from young adults to older adults and came from all walks of life and geographical locations.
For example, book author and former National Public Radio reporter Connie Goldman provided her insights on aging and the importance of cultivating meaningful relationships between the caregiver and the care recipient that go far beyond task-oriented matters. She said caregivers sometimes get so caught up with practical caregiving tasks that they don’t always remember to slow down and enjoy the relationship with the person for whom they are caring.
“I remember doing so many interviews with people who were caregivers,” Goldman said in her virtual summit interview, “and they’d talk about how they had so much to do.”
Goldman remembered one caregiver — an adult son helping his father — telling her, “My dad keeps saying, ‘Why don’t you sit down and talk to me? Come on, let’s talk for a while.’ And I’d say to him, ‘Dad, I’ve got to get this done. I gotta get home to my family. We have dinner at 7:30.’”
One day, as the son was driving home after visiting his father, he heard his father’s words in his head. The next day the son rearranged his schedule. “He made the time to sit down and talk,” Goldman explained. In doing so, the son “got to know a person he had never known.” The adult son came to understand how his father became the kind of person he turned out to be.
Goldman is herself an older adult, and a productive one at that. She is a prolific writer and a public speaker. Her website says that for the past three decades, “her public radio programs, books, and speaking have been exclusively concerned with the changes and challenges of aging.” Her recent book, “Wisdom From Those in Care,” was born of her own practice of listening to people who receive care to glean insights and inspiration from them.
“Her message on public radio, in print and in person is clear — make any time of life an opportunity for new learning, exploring creative pursuits, self-discovery, spiritual deepening, and continued growth,” says her website.
This type of message resonates with Cullen Hayashida, founder and former director of the Kupuna (Elder) Education Center at Kapi‘olani Community College. He now serves as a program advisor to St. Francis Healthcare System as it develops a multipurpose eldercare center known as the Kupuna Village on the grounds of the former St. Francis Hospital in Liliha.
Although no longer with the Kupuna Education Center, Hayashida remains active in the gerontological community in Hawai‘i and abroad, including in Japan, which has a rapidly aging population. He has restarted his Kupuna Connections show on ‘Ölelo Community Television, a series he started while heading the Kupuna Education Center. It is now produced under the auspices of the St. Francis Healthcare System of Hawai‘i. The programs cover a wide range of topics designed to help older adults live healthy, active lives. In addition to being aired on ‘Ölelo’s Channel 53 (at 9 a.m. on Wednesdays), a video archive of past programs can be found at http://www.stfrancishawaii.org/services/active-aging/senior-education-videos.
In a recent episode, Hayashida interviewed Douglas Park, a retired man who actively supports the work of the American Diabetes Association. Park, a Type II diabetic, is part of a bicycling group comprised largely of riders with diabetes. They have participated in the organization’s major fundraiser, the Tour de Cure, in which participants complete a bicycling route together. The goal is to lead an active lifestyle, and what better way than bicycling with supportive peers, all the while making sure that they take responsibility for their health and safety while biking.
Park was wearing his red bicycling jersey on the show. He said he wears the jersey a lot when talking to groups to demonstrate how kupuna like himself can promote good health through bicycling or exercising however they can. “Just getting up and moving,” Park said. “Making sure their bodies are in motion.”
Hayashida was interviewed by producer and host Kari Henley for the virtual global caregiving summit. He talked about his earlier professional background in sick care and “aging pathology,” as well as his transition to well-care, especially to the phenomenon of active aging. One of the ways of being a resource to community and loved ones, he said, is to make sure that elders take care of themselves, which is an essential component of well-care. He said it is important for elders to pay attention to their own health so they can provide good care for others.
“Oftentimes, we find older adults who are caregivers being superheroes and feel that they can do everything,” Hayashida said. “They don’t take the time to ask for help or to back away for a little while to refresh and regenerate themselves.”
He said today’s reality is that many older adults are caring for other older adults, which is even more reason to practice self-care. For example, stress and burnout are a real concern for those caring for others. Finding internal and external resources in the caregiving journey can help alleviate shouldering the burden alone.
Hayashida reflected on a concept he has come to value, namely ikigai, a Japanese word that translates to “a reason for being or a purpose in living.” Hayashida said there are many facets to healthy, active aging — for example, physical, medical, nutritional, financial, mental, social, recreational and emotional. What holds all these together is a sense of purpose, a reason for getting up in the morning. Ikigai is all about the “primacy of purpose.”
But how does one find his or her ikigai? It is found through a journey of self-discovery during which a person reflects upon the following questions: What do I love? What is my passion? What are my gifts? What are my responsibilities based on what the world needs? What is my life’s work?
Ikigai may be a paid or unpaid activity. It may be time-limited, such as raising children or caring for a loved one. A caregiver may say, for example, “For now, this (caring for my loved one) is my purpose in life.” That won’t last forever, but for the time being, that may well be one’s purpose in life. However, what about after one’s caregiving responsibilities are over? Or, maybe a person does not have caregiving responsibilities, but is retired from a career and now has 20 or so years left to continue living. How should such a person meaningfully spend those remaining years? What is his or her ikigai? Without a purpose or a reason for being, life can be like riding a boat without a rudder.
Along these lines, Hayashida last year offered a series of workshops for individuals wondering about their lives after retirement. “Who will you be without a formal job title?” asked the series’ promotional flyer. “The second half of life presents unique opportunities and challenges. Whether you’re an empty nester, thinking of an encore career, navigating changes at midlife, or shaping your new life in retirement, this interactive workshop will help you identify your goals, clarify your values, and forge a way forward.”
As baby boomers (those born between 1946 and 1964) continue to expand the ranks of older adults in American society, an ever-growing number of people will be reaching the conventional retirement age of 65 for each year up to the year 2030. What will all these people do with their remaining years of life and good health? They represent a resource that can benefit families, communities and society at large. But they need to discover their own particular ikigai, perhaps with assistance from well-care advocates like Hayashida, so that their gifts and passions can find linkages in the world around them. Older adulthood is not a stage of disengagement and decline. In fact, it may well be an opportunity for new beginnings, a time to fulfill dreams. What is your ikigai?
Kevin Y. Kawamoto is a longtime contributor to The Hawai‘i Herald.