New business helps North Shore elderly maintain independence

HANALEI — The old adage, “if you don’t use it, you’ll lose it” is especially true when it comes to keeping the mind active.

Increasing a sense of well-being and adding quality of life can be helped with the new privately run Elderday North Shore Daytime Activity Program for North Shore communities.

The intent is to help elderly people or brain injury victims continue a meaningful, independent quality of life without surrendering autonomy and avoiding nursing homes for as long as possible, according to program director Martha Jay. It is also meant to help reduce conflict in the family by providing a crucial role for loved ones in need.

“We are one family of humanity,” Jay said. “I am here as a caring member and that is really is why I am doing this.”

The idea came from several years of running a private counseling practice specializing in children and elders. She also worked as director of Social Services at Samuel Mahelona Memorial Hospital.

“I know what a well-run program should look like and I know the needs of the community and those of their caregivers,” she said. “Its enormous work.”

All too often, elderly people with failing cognitive abilities, Alzheimer’s disease or dementia, or people with traumatic brain injuries, are turned over to full-time care at rest homes. When possible, keeping them in a domestic setting with appropriate physical and mental exercise will add quality of life and perhaps years to their lives, Jay said.

The program is set up for five hours each Tuesday and Thursday at the Hanalei Community Center.

Pamela Gardener, who holds a master’s degree in social work, said the Hanalei region is her assigned area for the County Agency on Elderly Affairs. It is under-served for this type of service, she said, and although there is no official relationship with Elderday North Shore Daytime Activity Program, the service is needed because the nearest alternative is at Wilcox Adult Day Health Center in Lihu‘e.

“The niche that this program would fill would be through serving persons within the Hanalei area community who have mental disabilities, such as Alzheimer’s disease, dementia or traumatic brain injury, to name a few types of the population that this program would serve,” Gardener said.

“The program would be much more than just a ‘adult-sitting’ service,” she said. “In this sense, I would consider the program as an intermediate program between full-time care and no care, and on a day treatment basis.”

Kealoha Takahashi, the executive on aging for the Agency on Elderly Affairs, said they are interested in any program that aims to benefit seniors.

“In fact, several members of our staff have arranged to meet with Martha Jay to discuss the details of her program,” Takahashi said.

About 75 percent of dementia cases are the onset of Alzheimer’s disease, said Jay. Heredity is one factor and exposure to toxins is a possible cause, and obesity or substance abuse can increase the risk, she said.

“One percent of cases are reversible and its important to work with your doctor,” Jay said. “People that abuse themselves with drugs and alcohol tend to lose brain faster but its mostly genetic.”

With early-onset dementia, medicines can slow down the loss of cognitive ability, Jay said. Her program helps extend cognitive abilities and social interaction with stimulating brain exercises with continued learning from reading, crossword puzzles and alert socialization.

The dying brain cells don’t come back, but she said even with disease, there are collateral sprouts that compensate for lost cells when spurred by new learning and interaction.

“This is with people that stay stimulated, and stay away from television and computer games,” Jay said. “These are sedentary practices.”

Jay bases her program on research that shows the onset of dementia is highly correlated with depression and anxiety that contributes to a downward cycle. She said the process improves with recreation and mental stimulation.

The cost of nursing homes can drain the patient of their estates and leave nothing to their families, Jay said. Keeping seniors out of them until it can’t be avoided is a quality-of-life option that requires a stimulated environment with nutritious meals and snacks.

The family caregivers who sacrifice dearly to keep loved ones in the home are in need of a break. Jay said the program can give these overworked caregivers a couple of days to themselves.

The program lasts five hours to allow for outings and complete activities. It is not a day care and is run with a clubhouse model and is open to all but the those who lack ability for any participation.

“We make it so there is a sense of belonging, and not a burden,” Jay said. “I couldn’t do it without them.”

Jay said that with approximately 1,500 Alzheimer’s sufferers on the island, many of them are deteriorating their brains further in isolation, watching TV and not eating properly. Just to have an appointment that makes people have to get up, get dressed and go to the program helps.

She said that as social animals, people need one another. The activities give meaning to who they are and what they think.

Treating dementia is about orientation to time, place and purpose, Jay said. Its about asking questions in a way to stimulate and not startle or create stress.

For example: “It’s sunny today and it has been for the past three days. What do you think about that?”

When a person exhausts the thought, it strengthens neural pathways and helps them remember that it was sunny and everything that they associate with it.

“We ask in way that tells the answer but gets them thinking and talking and sharing,” Jay said. “We talk like people who care about them, and TV doesn’t accomplish that.”

Someone may take an article from the newspaper and ask people what they think and what they want to contribute to help the brain work without stress. It is followed with light exercise using music, chairs, yoga, stretching, gardening, arts and crafts and health talks. There are also activities involving singing, hula, making music and dancing, knitting, crocheting, sewing and painting.

The volunteers can shape activities, but most of all, Jay said they need a giving and loving heart. They need to be positive and bring something beautiful

Jay wants an atmosphere where people feel cared-for in a place where no one is more important than anyone else. She would only require an assessment and a doctor’s approval for light exercise.

To keep costs low, Jay is looking for grant support; the fee is $65 to $125 per person. It’s a small cost to keep mom or dad in a state of mind to remain in their homes, Jay said.

Helen Mattingly, a home health care giver with Loving Care Kaua‘i, said she refers clients to the program when she believes they would benefit from activities to keep the mind stimulated.

“It is highly recommended as far as I am concerned,” Mattingly said. “There are so many people out there that need help.”

Mattingly would like to see youth groups get involved as well. She said it would be mutually beneficial for young people to meet with the elderly at the Community Center to hear their stories.

Elderly people who suffer from dementia and other brain ailments often turn over power of attorney to their children. Mattingly said this is fine, but today there are more vulnerable seniors being taken advantage of by their own families.

Caregivers and programs such as Jay’s will help identify victims of physical or other types of abuse and make the appropriate referrals, Mattingly said.

“What isn’t love is a call for love and what isn’t love is fear,” Jay said.

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• Tom LaVenture, staff writer, can be reached at 245-3681 (ext. 224) or


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