Frances H. Kakugawa
Hawai‘i Herald Columnist
Omoiyari . . . Think of others first and good karma will return to you. — Frances H. Kakugawa
Readers . . . April is National Poetry Month, so how about picking up your pen or a book of poems?
The poets, in droves
Lick their pens, salivating
Over metaphors, turning
Death into life. It must be
National Poetry Month.
— Frances Kakugawa
26 letters of the alphabet —
Infinite combinations of words, sentences, paragraphs.
Yet feelings, emotions defy such combinations.
After one exposure
My 3-year-old grandson
Learns and remembers animals, objects, concepts.
My 74-year-old husband can’t remember his phone number.
My frozen anger, ready resentment,
Residue of guilt and remorse
Which letters speak my truth?
My freedom is waning,
My responsibilities waxing.
I need more letters.
— Sally Peters
Thank you, Sally, for sharing your poem.
A MATTER OF PERCEPTION
The weeds have been crying for a weeding for weeks.
Still frozen in my winter lazy bones, I thought, surely, I can find a way out of this. A little boy came to mind.
I was a student in the College of Education, observing the professor demonstrate “how to read a story to 4-year-olds.” Before she could begin, a little boy asked, “Teacher, why is your hair all grey?”
Before she could respond, another boy turned to the little boy and said, “Her hair not grey, her hair silver.”
So I took off my garden gloves and walked away. “Dem weeds not weeds, dem weeds flowers.”
So much wisdom from our children. Maybe the daily care of our elders is not a burden or a chore, but rather a gift. Maybe losing our loved ones is not about loss and grief, but rather about a life left for us to visit with memories and joy. Maybe the remorse we feel for not having been perfect is really about wisdom gained from our imperfections as a normal human being. And, maybe we are not grey; we are silver.
A caregiver asked me for advice on how to find a good care home for his wife, who has dementia. The following website lists Hawai‘i’s best-rated care homes and their phone numbers: https://health.usnews.com/best-nursing-homes/area/hi. A call to your local Alzheimer’s Association will also give you leads to these ratings.
I’m not sure how these homes are rated. Every state has protection rights for nursing care through its Ombudsman. Many registered nursing homes will have their rating number listed on their doors.
I helped to select nursing homes for two friends — one in Sacramento and the other in Hilo. The experience taught me to be cautious for several reasons.
• Alienation. Both homes did not allow the residents to have visitors when they appeared to be in the last year or so of their lives. They said that the residents’ behavior changed after their visitors had left, claiming that they grew agitated and refused to return to their beds.
This policy told me that the facility was not focused on the resident and that the management did not understand the nature of dementia. They also did not have the skills to work with residents with dementia. Their focus was on their own convenience. I called the Ombudsman and asked that they investigate one of the nursing homes. The results were immediate.
No resident should be barred from having visitors. Life in a care home can be very lonely and depressing without the sound of friendly voices or the warm touch of loved ones. Visiting a loved one in a care home is also good for the residents’ family members and friends. When a friend in my Sacramento neighborhood died in a care home a few years ago, I felt badly that I wasn’t able to explain why I hadn’t visited her.
A clean and odor-free facility is just one factor to consider when selecting a care home. The human aspects are not seen on rating sheets. I visited the home at mealtime and at other times of the day, as well. At some homes, residents are allowed to come out of their rooms only for their meals. Other than that, they are pretty much left alone all day. When accompanied by nursing home personnel, bedridden residents are able to visit the mall or park. Some families even hire private caregivers to take their loved one outdoors if the service is not available at the care facility.
• Bedsores and bathing. You should be concerned about bedsores, or pressure ulcers. Ideally, bedridden residents should be turned every two hours to prevent them from developing the pressure sores. They should also be checked for bedsores when they bathe. Unfortunately, not all care home residents are given a bath every day. Consider scheduling your visit at bath time so you can keep an eye on bedsores and other bath-related matters.
On one occasion, I heard my mother yelling, “Atsui! (hot) Atsui!” The aide had not checked the shower water, which was too hot. Additionally, she did not understand the Japanese word “atsui.” After she was fired, I learned that she returned to her own home, which she had turned into her own care home.
• Meals. Another matter you should pay close attention to are the residents’ meals. Are they nutritionally balanced meals? Do they contain fresh fruits and vegetables? Do they try to prepare and serve culturally sensitive dishes? One home I visited served saimin every day; another served canned green beans and corn every day. Ask yourself whether you would want to eat a “meal” like that every day. When my mother was in a care home, I sometimes supplemented her meals with a few of her favorite dishes, foods such as cooked pumpkin, tofu, miso soup, rice, green tea, etc.
You should also make unannounced visits to the care home every so often. The shortage of care homes and the high cost of caregiving service can strain our budgets. But that doesn’t mean families should allow these homes to call all the shots.
In the face of rules, efficiencies, standards of practices and profits for the industry, we are made to feel powerless. But we can affect change through every small action and insistence. If you have a family member in a care home, I strongly urge you to take a more active role in your loved one’s care. By so doing, we can help to improve these homes for the sake of our loved ones as well as those who care for them.
Readers . . . I will be back home in Hawai‘i next month. Here is my schedule. Please drop by and say hello.
• Hilo: Tuesday, May 14, 5-7 p.m., at the Hawai‘i Island Adult Care (561 Kupuna Pl.). I will speak on caregiving and adult care. The session is free, although registration is required. Call (808) 961-3747, x. 106, or (808) 987-7706.
My target audience will be family members who are caregivers and professionals in the field of nursing and elder care. I encourage family members who may soon become caregivers to join us.
A few years ago, a man sitting in the front row at one of my talks said, “I’m not a caregiver, but after being here, I can hardly wait to be the kind of caregiver my wife will someday need.”
He did indeed become that caregiver a few years later. Compassionate caregiving demands a whole new mindset and we may want to begin now, before caregiving is suddenly needed.
• Honolulu: Sunday, May 19, 11 a.m.-noon, at Native Books at Ward Centre for tea and a “Talk Story” about my four children’s books, whose main character is Wordsworth the Poet.
Now back to April and National Poetry Month:
On this Isle of Caregivers
A bottle, sealed with wax
Washes up on shore. Inside,
A pen and sheets of blank paper.
— Frances Kakugawa
On a lighter note, did anyone take a “mindfulness” walk since my last column? Here’s my crow when I looked up one morning.
The crow penetrates
The loud silence of my wake.
Hush, hush, Mr. Crow.
Frances Kakugawa was her mother’s primary caregiver during her five-year journey with Alzheimer’s disease. A native of Kapoho on Hawai‘i island, she now lives in Sacramento. Frances has melded her professional training as a writer and educator and her personal caregiving experiences to write several books on caring for people with memory-related illnesses. She is a sought-after speaker, both in Hawai‘i and on the Mainland, sharing strategies for caregiving, as well as coping with the stresses of caregiving.