FAF GAIT LIFE WHILE DEALING WITH ALZHEIMER'S.

BE A PART OF CONVERSATION.

AS WE EXPLORE DISEASE'S EMPABLGHTD ON THE COMMUNITY AND HOW WE CAN SUPPORT EACH OTHER.

COMING UP ON KAKOU: HAWAII'S TOWN HALL.

CHALLENGES OF ALZHEIMER'S.

ALOHA AND WELCOME TO KAKOU: HAWAII'S TOWN HALL.

I'M YUNJI DE NIES.

HAWAII RESIDENTS HAVE THE HIGHEST LIFE EXPECTANCY IN THE COUNTRY.

ON AVERAGE, WE LIVE PAST 80.

WITH AGE CAN COME WISDOM AND GREAT JOY, BUT INCREASED AGE IS ALSO THE MOST SIGNIFICANT IS ALSO THE MOST SIGNIFICANT RISK FACTOR FOR ALZHEIMER'S.

THE OLDER WE GET, THE MORE LIKELY WE ARE TO DEVELOP THE DISEASE, AND IN OUR COMMUNITY, MANY ALREADY HAVE.

THERE ARE MORE THAN 31,000 PEOPLE LIVING WITH ALZHEIMER'S ACROSS THE STATE.

FOR EVERY PERSON DIAGNOSED, COUNTLESS OTHERS ARE IMPACTED.

MORE THAN 60,000 UNPAID FAMILY CAREGIVERS ARE CARING FOR LOVED ONES WITH ALZHEIMER'S - THE VALUE OF THAT CARE TOPS $1.9 BILLION DOLLARS.

THESE UNPAID CAREGIVERS OFTEN FACE TREMENDOUS CHALLENGES - EMOTIONAL, PHYSICAL, AND FINANCIAL - NAVIGATING A SYSTEM THAT CAN FEEL OVERWHELMING AND UNDER-RESOURCED.

THERE IS NO CURE FOR THIS DISEASE, BUT WHAT STEPS CAN WE TAKE TO PREVENT IT?

WHAT ARE THE SIGNS OF ALZHEIMER'S THAT WE NEED TO LOOK FOR?

AND ONCE DIAGNOSED, HOW CAN WE BEST PREPARE FOR WHAT WE OR OUR LOVED ONES MIGHT NEED?

THAT'S WHAT WE'RE EXPLORING TONIGHT.

YUNJI: KAKOU MEANS ALL OF US, AS IN WE ARE ALL IN THIS TOGETHER.

ALZHEIMER'S TOUCHES FAMILIES ACROSS HAWAII, REGARDLESS OF BACKGROUND, AND IT WILL TAKE OUR COLLECTIVE EFFORTS TO MEET THIS CHALLENGE.

WE WANT TO HEAR FROM YOU IN OUR DISCUSSION.

YOU CAN EMAIL OR CALL IN YOU TSEU TODAY'S WEATHER.

PHONE LINES HAVE WORKED ON AND OFF.

CALL DOESN'T GO THROUGH, TRY TO EMAIL US OR USE SOCIAL MEDIA.

ALSO EXSTREAMS LIVE AT PBS.ORG D YOUTUBE PATIENT.

DOBLGHTS GOVERNMENT LEADERS DEDICATED TO ISSUE OF ALZHEIMER'S.

LET'S BEGIN.

WE WANT TO START WITH DR. GINA FUJIKAMI.

SPECIALIZES IN GERIATRIC MEDICINE ADD WORKS WITH ALZHEIMER'S PATIENTS.

LET'S START WITH THE BAKES.

WHAT-BASICS WHAT IS ALZHEIMER'S AND HOW DOES IT TYPICALLY PRESENT.

>> ONE OF THE MOST COMMON TYPE OF DIMENTIA.

WE THINK OF DIMENTIA AS SORT OF UMBRELLA TERM THAT INCLUDES ALZHEIMER'S, STROKE RELATED DIMENTIA OTHER MORE RARE CAUSE.

ALZHEIMER'S MOST COMMON.

TYPICALLY HAPPENS MORE AS WE GET OLDER.

SOLVE IT CAN BE GENETIC BUT SOMETIMES JUST HAPPENS FOR NO GOOD REASON AT ALL.

STILL A LOT WE'RE LEARNING ABOUT.

>>Yunji: WHAT IS THE TYPICAL TRAJECTORY OF THE DISEASE.

>> TYPICALLY, IT HAPPENS MORE WITH IF OUR OLDER POPULATION.

MORE OF SOLELY PROGRESSIVE DISEASE.

IT SOMETIMES CAN LAST FROM TIME-OFF TO 25 YEARS.

WITHIN THAT TIME, START TO LOSE SHORT-TERM MEMORY.

LONG-TERM MEMORY.

AND MORE PHYSICAL FUNCTIONING AS WELL.

>>Yunji: THANK YOU FOR THAT EXPLANATION.

LET'S MOVE NOW TO DR. NAKAGAWA CHIEF OF NEUROSCIENCE ILLNESS SUIT AND BRAIN HEALTH APPLIED RESEARCH INSTITUTE.

BHARI.

WE KNOW THERE IS NO CURE.

BUT WHAT KIND OF MEDICATIONS OR TREATMENTS ARE AVAILABLE FOR THIS ILLNESS TO SLOW THE PROGRESSION OF THE DISEASE?

>> SURE.

SOME MEDICATION WE CAN TAKE TO SLOW THE PROGRESSION.

MUCH MORE NOVEL MEDICATION THAT CAME OUT RECENTLY IN THE MARKET.

ANTIBODY FUSION TREATMENT THAT YOU GET WOULD ACTUALLY GO AND ATTACK THE EMLLOYD'S.

TOXIC WASTE, PLACK IT MAKES.

REMOVE THAT.

THOSE TWO ARE AVAILABILITY.

ORAL MEDICATION THAT YOU TAKE STEADY SORT OF LEVEL AND ALSO, SORT OF MONTHLY INFUSION.

ONLY CERTAIN PEOPLE PATIENTS CAN ACTUALLY QUALIFY FOR THAT INFUSION TREATMENT.

>>Yunji: HOW COMMON IS TO BE ABLE TO ACCESS THOSE MEDICATIONS AND HOW EFFECTIVE ARE THEY?

>> IV MEDICATION REALLY IS REALLY NEW.

SO EVEN OUR CONSTI INSTITUTION A HANDFUL OF PARENTS QUALIFIED SO PAR HANDFUL OF PATIENTS QUALIFIED.

ROW HE R ROBUST THINGS WE REQUET DO.

LIFESTYLE CHANGES MIDDLE AGE TO PREVENT DIMENTIA.

40 TO 50% IS PREVENTABLE.

>>Yunji: GET TO THAT LATER TONIGHT.

THANK YOU FOR THAT MOVE TO DIRECTOR OF ALZHEIMER'S ASSOCIATION ALOHA CHAPTER.

WE GOT THAT 31,000 FIGURE FROM YOUR ORGANIZATION.

31,000 PATIENTS HERE IN HAWAII.

CAN YOU BREAK DOWN THIS NUMBER FOR US A LITTLE BIT MORE, TELL US MORE ABOUT AGE AND GENDER WHAT THAT TYPICAL PATIENT PROFILE LOOKS LIKE?

>> WE DO KNOW THAT MUCH OF THAT INFORMATION COMES FROM REPORT WHICH IS BEHAVIORAL RISK SURVEILLANCE THAT IS DONE BY PHONE.

BAY WHAT I CAN SAYR SHARE PROBA3 OF THAT POPULATION IS WOMEN.

HIGHER RISK OF DIMENTIA OR ALZHEIMER'S.

MAYBE BECAUSE WOMEN LIVE LONGER.

IN TERMS OF BREAK UP, AND IN AGE, I WOULD SAY PERHAPS 85, 80% OF THOSE IN THAT POPULATION ARE OVER THE AGE OF 75.

>>Yunji: ALZHEIMER'S OF COURSE DOES AFFECT PEOPLE ACROSS OUR STATE.

WE'RE TALKING ABOUT RURAL COMMUNITIES NEIGHBOR ISLANDS AS WELL.

DR. VICTORIA HANES PSYCHOLOGIST AND COO HAWAII ISLAND COMMUNITY HEALTH CENTER PROVIDES CARE FOR NEARLY A QUARTER OF THE BIG ISLAND.

BIG ISLAND HAS MORE KUPUNA RELATIVE TO THEIR POPULATION THAN ANY OTHER ISLAND.

25% OF THE POPULATION THERE OVER THE A AGE OF 65.

DR. HANES, WE ARE SOME OF THE CHALLENGES, WHEN IT COMES TO ALZHEIMER'S PATIENTS ACCESSING CARE AND RURAL COMMUNITIES LIKE THE O THE ONES YOU SERVE.

>> THANK YOU.

ACCESS REALLY IS MAJOR ISSUE.

WE TALK A LOT ABOUT ACCESS IN HEALTH CARE.

IN REGARDS TO BEING ACCESS MEDICAL PROVIDERS PHYSICIAN AND SPECIALIST.

ONE THING TO KEEP IN MIND NOT RECOGNIZED ACCESS TO BASIC NEEDS.

THINGS LIKE TRAFFIC MANATRANSPORTATION.

REPUBLIC TRANSPORTATION.

ACCESS TO FRESH FOOD SIDEWALKS.

SOCIAL HE HEALTH FACTORS TO PREVENT PROGRESSION OF OUR DISEASE AND HELP OUR AGING POPULATION LIVE MORE FULFILLING LIFE.

RURAL COMMUNITIES ACCESS TO BASIC NEEDS AND HEALTH CARE, REALLY IS MAR MAJOR ISSUE WE RECOGNIZE IN TRYING TO ADDRESS HEALTH CENTER.

>>Yunji: HOW DO YOU THINK THAT IMPACTS PATIENT OUTCOMES?

>> WELL, ONE OF THE GREAT THINGS ABOUT BEING ON HAWAII ISLAND AND OTHER RURAL COMMUNITIES IS THE PARTNERSHIPS THAT WE CREATE.

THIS IDEA THAT WE HAVE TO COME TOGETHER TO BE INNOVATIVE AND BE CREATIVE WHEN IT COMES TO MEETING NEED OF OUR PATIENT POPULATION.

ADDED STRESS TO PATIENTS AND CAREGIVERS TO FIGURE OUT THINGS THOU GET INTO TOWN, THAT TWO HOUR DRIVE GET THE RESOURCE TO PAY FOR THE GAS, TO GET INTO SEE A PHYSICIAN.

THAT AD STRESS REALLY CONTRIBUTES TO LESS THAN DESIRABLE IM OUTCOMES.

CREATES SPACE FOR INNOVATION AN CREATIVITY IN THE COMMUNITY TO TRY TO MEET THOSE NEED SNOOS YOU MENTIONED CAREGIVERS.

SUCH AN IMPORTANT PART OF THIS CONVERSATION.

ARE TWO IN OUR TOWN HALL TONIGHT.

START OVER ZOOM WITH DR. BALAZ NURSE PRACTICIONER DIMENTIA ADVOCATE AND CAREGIVER FOR HER DAD.

TELLS ABOUT YOUR DAD AND KIND HELP NEEDS FROM YOU?

>> THANK YOU.

NICE TO SEE SO MANY COLLEAGUES.

WISH I COULD BE THERE WITH ALL OF YOU FATHER, TELL YOU ABOUT HIM.

CURRENTLY IS IN END STAGES OF ALZHEIMER'S.

IT'S BEEN A LONG JOURNEY.

WELL OVER ALMOST 2 DECADES NOW I THINK DISEASE DOESN'T DEFINE HIM.

HE WAS MORE AND STILL IS MORE THAN THE DISEASE.

MY FATHER GREW UP BOTANICAL GARDEN AND RAISED SHALL BORN AND RAISED DID A LOT, IN HIS PAST WITH HAWAIIAN CULTURE, WORK THAT HE DID RAISING ALL OF US AND TEACHES US ALL OF US MY SIBLINGS AND I INSTILLING VALUE AN MORALS THAT WE ALL STILL LIVE BY TODAY.

I WANT TO REMEMBER HIM AND JUST REMIND EVERYBODY THAT WE TALK ABOUT PEOPLE LIVING IN WITH THE DISEASE SO MUCH MORE.

THAN THE DISEASE.

THEY ARE WHO THEY HAVE ALWAYS BEEN.

OUR LOVED ONES AND WE'LL ALWAYS CONTINUE TO BE HELP THAT MY FATHER NEEDS FROM ME NOW.

COOR COORDINATION OF SER.

JOURNEY YOU CAREGIVER STARTED AT HOME.

CAREGIVER OUT OF HAWAII.

CAREGIVER BACK IN HAWAII.

AND AGAIN, I'M AWAY FROM HAWAII IN DC.

ON A CONGRESSIONAL FELLOWSHIP A ASCOORDINATING OF SERVICE.

I KEEP UP EVERYTHING HE NEEDS.

IN TOUCH ALL HIS PROVIDERS AND VA EVERYBODY THROUGH EMAIL AND PHONE CALLS WHEN I'M THERE IN PERSON.

LIFE LOOKS A LOT LIKE 24-7 NEEDS THAT EVERYTHING THAT HE NEEDS FROM FEEDING HIM TO TURNING HIM TO RANGE OF MOTION TO CHANGING HIM, TO SPENDING TIME WITH HIM.

SMILING WITH HIM.

WATCHING TV WITH HIM.

TAKE MOMENTS WHERE HE CAN'T REALLY MOVE AND CAN'T MOVE AT ALL.

WHEN HE GRABS MY HAND, WHEN HE MOVES A FINGER, WHEN HIS EYES CRINKLE, BECAUSE HE CAN'T SMILE THAT MUCH, BECAUSE OF THE STROKES, THAT IS WHAT LIFE IS LIKE.

THAT EVERYTHING REVOLVES AROUND HIS NEEDS.

IT'S BEEN AN HONOR AND PRIVILEGE.

I WHO DID IT AGAIN.

OF COURSE, CAREGIVERS WE NEED TO ALSO REMEMBER TO TAKE CARE OF OURSELVES AND I THINK THAT IS ALWAYS THE HEART P.A.

REMEMBERING -- HARD PART, TAKE CARE OF OURSELVES TO CONTINUE TO CARE.

>>Yunji: THANK YOU FOR SHARING ALL OF THAT.

HEAR FROM ANOTHER CAREGIVER.

JENNIFER OYER CAREGIVER TO HER MOM.

EL TELL US ABOUT YOUR EXPERIENCE MIRRORS OF THAT OR DIFFERENT.

>> MOM AT THE VERY BEGINNING STAGE OF ALZHEIMER'S.

DIAGNOSED IN NOVEMBER OF 2023.

IT'S BEEN INTERESTING JOURNEY MEETING WITH J VARIOUS DOCTORS CREATING THAT TEAM THAT SHE NEEDS FOR SUPPORT.

A LOT OF THAT SUPPORT CAME FROM THE ALZHEIMER'S ASSOCIATION.

IS I'M SO GRATEFUL FOR ALL.

INFORMATION AND RESOURCES THAT THEY PROVIDED FOR ME AND MY FAMILY.

RIGHT NOW, MY MOM STARTED THE INFUSION THAT DOCTOR TALKED ABOUT.

STARTED THAT IN JULY.

AND ACTUALLY JUST RECENTLY FAMILY DECIDED THAT SHE WE WERE GOING TAKE HER OFF THE STOP INFUSION.

AND SO SHE'S JUST TAKING ORAL MEDICATION RIGHT NOW.

AND REALLY TRYING TO JUST THINK OF HOW SHE CAN LIVE WITH THE DISEASE AND NATURALLY.

THROUGH DIET, EXERCISE, SIMULATION OF ACTIVITIES, SO IT'S BEEN AN INTERESTING JOURNEY.

>>Yunji: HOW ARE YOU ABLE TO BALANCE THE CARE FOR YOURSELF, JUST CAREGIVERS ALSO NEED TO CARE FOR ONE'S SELF.

HOW ARE YOU ABLE TO DO THAT AND CARE FOR HER.

>> I'M REALLY FORTUNATE IN THE SENSE THAT I WAS ABLE TO STOP WORKING FULL-TIME AND FOCUS UNDER SPEND MORE TIME WITH MY MOM WHICH HAS BEEN A BLESSING FOR ME.

BUT REALLY, I THINK IT'S A TEAM EFFORT.

SO MY DAD OF COURSE PITCHES IN AND HE DOES A LOT OF THE CAREGIVING AS WELL.

AND MY BROTHER.

AND SO HAVE I REALLY LEANED ON OTHER PEOPLE AUNTIES, UNCLES FOR SUPPORT.

AND ANY TIME WE NEED SOME RESPITE TIME, WE KNOW WHO TO CALL AND THEY COME OVER AND THEY HELP WITH MEALS AND IT'S DEFINITELY A TEAM EFFORT.

>>Yunji: COMMUNITY IS SUCH AN IMPORTANT PART OF THAT.

LET'S HEAR MORE ABOUT THE CAREGIVING SPACE FROM THE PRESIDENT OF HAWAII FAMILY CAREGIVER COALITION.

REGISTERED NURSE AND OPERATES ADULT D DAY CARE CENTER IN AIEA.

IN WORK WITH CAREGIVERS WE ARE SO.

BIGGEST CHAL CHALLENGES THY FACE?

>> BIGGEST CHALLENGE IS NOT KNOWING WHERE TO TURN.

AND NOT KNOWING RESOURCES OUT FOR THEM.

SO I TRY MY BEST TO LET THEM KNOW WHAT IS AVAILABLE.

ANOTHER CHALLENGE IS THAT THEY DON'T KNOW WHAT'S K COMING NEXT.

NEVER WILL KNOW, EVERYBODY IS INDIVIDUAL.

PROGRESSES.

THERE'S NO OKAY, TOMORROW, THIS IS GOING TO HAPPEN TO MOM.

DAY AFTER THAT, THIS IS GOING TO HAPPEN.

DOESN'T WORK THAT WAY.

>>Yunji: I KNOW YOU KNOW THAT.

JUST THEY JUST ARE OVERWHELMED BECAUSE THEY DON'T KNOW WHAT'S GOING TO HAPPEN.

EDUCATION IS REALLY IMPORTANT FOR THAT.

>>Yunji: ESPECIALLY WITH THE DOCTOR SHARED WITH US ABOUT THE TRAJECTORY BEING FIVE TO 20 YEARS IN THAT TIME FRAME, WHO KNOWS WHO YOU NEED TURN TO TODD PANG NOW.

SOME FAMILIES DO LIVE IN FACILITIES TO CARE FOR LOVED ONE WHEN THEY CAN'T CARE FOR THEM AT HOME.

OPERATES CARING MANOA.

ADULT RESIDENTIAL CARE HOME.

CREATED KUPUNA CARE PAIR WHICH IS ONLINE PLATFORM THAT HELPS FAMILIES CONNECT WITH LOCAL CARE PROVIDERS IN HAWAII.

TODD, KATHY JUST SHARED NOT KNOWING WHAT RESOURCES OUT THERE FOR CAREGIVERS.

IMAGINE IF YOU WERE SOMEBODY TRYING NAVIGATE SYSTEM FIGURING OUT WHERE TO SEND A LOVED ONE, WHAT IS THAT LANDSCAPE LIKE, DOES IT LOOKS LIKE FOR SOMEONE SELFING FOR LIVE IN CARE.

>> REALLY CONFUSING PROCESS AND DIFFICULT PROCESS TO FIND INFORMATION.

THERE'S MANY DIFFERENT TIMES OF SERVICES AVAILABLE.

DIFFERENT TYPES, CATHY'S DAY CARE PROGRAMS SOMEBODY WILL GO DURING THE DAY COME HOME AT NIGHT.

ALL CARE HOMES ARE 24-HOUR A DAY SERVICE.

NURSING FACILITIES THAT ARE A LITTLE BIT INHERENTLY MORE KIND OF CLINICAL.

AND THEN THERE'S ASSISTED LIVING IN INDEPENDENT LIVING FACILITIES WHERE RETIREES AND PEOPLE WOULD NEED SOME LIGHT HELP CAN LIVE AND STILL SOCIALIZE.

EACH TYPE OF PLACE HAS A DISTINCT PRO AND CON TO IT.

AND SO I THINK WHEN I RUN INTO FAMILIES, OFTENTIMES THEY'RE LOOKING FOR CARE IN A HURRY.

UNFORTUNATE.

BECAUSE IT'S DIFFICULT TO FIND THAT INFORMATION TO PREPARE.

AND ALSO, THEY MAY JUST BE BURNED OUT.

TRYING TO BE THE CAREGIVER FOR THEIR LOVED ONE.

AND MANAGE ALL OF THOSE NEEDS AT HOME.

WITHOUT BEING ABLE TO RELY ON SOMEBODY TO HELP ANY OF GAIT OR WHATNOT.

SO NAVIGATE I FOUND THERE'S A LOT OF STRESS INVOLVED WHICH IS SO COMMON AND CAREGIVER BURNOUT IS SUCH A REAL THING.

I COMMEND THE OTHER PARTICIPANTS FOR BEING SO DEDICATED TO THEIR LOVED ONES.

AND WHAT I'M HEARING FROM JENNIFER, QUITTING A JILL BIDEN, TO BE A FULL-TIME -- QUITTING A JOB FULL-TIME CAREGIVER POIPUED OUT.

CHALLENGING DIFFICULT LANDSCAPE OF FINDING INFORMATION AND KNOWING WOULD WO TURN TO.

WITHIN MY CARRY HOM CARE HOME.

PEOPLE HAVE ALREADY, BECOME RESIGNED IT'S NOT POSSIBLE FOR THEM TO STAY AT HOME ANY MORE.

>>Yunji: TYPICALLY, WHAT IS THAT COST?

YOU OUTLINED BUNCH OF DIFFERENT OPTION FROM ADULT DAY CARE TO FULL SERVICE LIVE IN FACILITIES.

GENERALLY SPEAKING, WHAT IS THE BALLPARK, WHAT DOES THAT COST A FAMILY.

>> TWO METHODS PAYING.

PRIVATE PAY AN RELYING ON STATE PROGRAM LIKE MEDICAID AND SO IF IT'S PRIVATE PAY FACILITY AND FOR SOMEBODY WHO MAY NEED LIKE 24-HOUR A DAY SUPERVISION, IN A CARE HOME, DEPENDING ON LOCATION AND VARIOUS F FACTORS, IT COULD BE AS LOW AS MAYBE 5,000 A MONTH.

ALL THE WAY TO THE SKY'S THE LIMIT.

SO IT'S REALLY DIFFICULT FOR FAMILIES TO SWALLOW THAT COST OR BE ABLE TO PONY UP THE MONEY FOR IT.

SO IMPORTANT FOR THEM TO BE STRATEGIC ABOUT HOW TO SPEND THIS MONEY BECAUSE LIKE DR. FUJIKAMI WAS SAYING WE DON'T KNOW HOW LONG THIS WILL LAST AND THAT'S ALWAYS A CONVERSATION I HAVE WITH FAMILIES WHEN THEY'RE TRYING TO PREPARE IS TO REALLY BE ABLE TO IDENTIFY DIFFERENT PRIORITIES THAT THEY NEED TO FOCUS ON.

>>Yunji: WOW.

YEAH.

THOSE COSTS ARE PRETTY DAUNTING FOR A LOT OFF FOLKS.

STATE DIMENTIA SERVICES COORDINATOR THROUGH DEPARTMENT OF HEALTH.

CANNOT AFFORD THE KIND OF CARE THAT TODD IS TALKING ABOUT, EVEN $5,000 TO SKY'S THE LIMIT PER MONTH, OUT OF REACH FOR MANY FAMILIES HERE IN HAWAII.

WHAT KIND OF SAFETY NET IS THERE?

WHAT ARE THE OPTIONS?

>> THANK YOU FOR THAT QUESTION.

THINK SO IMPORTANT FOR PEOPLE TO KNOW THERE ARE RESOURCES OUT THERE.

WHETHER IT'S APPLYING MORE MED MED-QUEST OR GOING TO THE AREA AGENCIES ON AGING IN EACH COUNTY TO ACCESS SERVICES THROUGH THE KUPUNA CARE PROGRAM, ALSO TO ACCESS SERVICES THROUGH THE MANY LOCAL NONPROFITS IN THE STATE, OFFER SUCH GREAT SERVICES TO OUR KUPUNA.

>>Yunji: KEALI'I LOPES DIRECTOR OF AARP HAWAII HOW ARE WE DOING COMES TO SUPPORTING PATIENT AN CAREGIVERS.

PART OF LARGE NETWORK OF AARP ACROSS THE COUNTRY.

WHERE DO WE RANK IN TERMS OF HOW WELL WE SUPPORT THESE FOLKS AND WHAT COULD WE DO BETTER?

>> I WAS HOPING GOING TO GIVE ME AN EASY QUESTION.

THE TRUTH IN THE MATTER IS BEAUTIFUL THING FOR HAWAII IS THAT WE'RE VERY FAMILY ORIENTED.

TODD TALKED ABOUT PEOPLE BEING CARED FOR IN THE FACILITIES.

LARGE NUMBER OF KUPUNA ARE CARE FOR IN THEIR HOMES.

MY MOTHER HAD VASCULAR DIMENTIA FOR FIVE YEARS.

AGE IN PLACE IN HER OWN HOME IN SURROUNDING SHE WAS FAMILIAR WITH HER LOVED ONES CARING FOR HER.

NOT EVERYONE HAS THAT OPPORTUNITY.

SO I WOULD SAY FROM THE COMMUNITY'S PERSPECTIVE, FOR THE PEOPLE HERE, AND EVERYONE CARING FOR THE LOVED ONE, WE'RE DOING REALLY WELL.

AS RELATES TO GOVERNMENT SUPPORT FOR THAT CARE, I WOULD SAY WINE WE'RE NOT DOING DOING S WELL AS I THINK HAWAII WOULD LIKE TO BE KNOWN FOR AN WHAT WE CAN DO.

BIG PART OF THAT, I'M GOING TO DO A PLUG.

AARP A LOT OF OTHER ORGANIZATIONS ARE TRYING TO GET STATE LEGISLATURE TO DO MORE FOR FAMILY CAREGIVERS.

THAT INCLUDES THINGS LIKE PAID FAMILY LEAVE.

YOU DON'T HAVE TO LEAVE YOUR JOB TO CARE FOR A LOVED ONE.

ANOTHER ONE IS CAREGIVER TAX CREDIT WHERE IF YOU ARE CARING FIRE LOVED ONE IN THEIR HOME, YOU'RE STILL PAYING A LOT OUT OF OUR OWN POCKET FOR THINGS LIKE GETTING WHEELCHAIR, PAD, DIFFERENT TYPES OF THINGS YOU HAVE TO TAKE CARE OF.

SO MOST PEOPLE ON AVERAGE SPEND ABOUT 7,000 OF THEIR OWN FUNDS.

CARING FOR LOVED ONES.

LOOK TAX CREDIT THERE.

REALLY SO MUCH MORE THAT CAN BE DONE.

I APPRECIATED CATHY'S POINT ABOUT PEOPLE DON'T KNOW WHERE GO.

GOVERNMENT OPPORTUNITY WITH OUR AREA AGENCY ON AGING.

MORE RESOURCE.

CATCH 22 I OPEN WE'RE GOING TO EXPLORE SOME OF THAT THIS EVENING.

>>Yunji: I WANT TO GET BACK TO DR. NAKAGAWA.

ONE THING YOU HAD SHARED EARLIER ABOUT THIS PREVENTION PIECE AND THINGS THAT WE CAN DO EARLY ON.

TELL US A LITTLE BIT MORE ABOUT THAT.

WHAT ARE THE STEPS WE CAN TAKE NOW TO HELP OURSELVES AND PERHAPS OUR LOVED ONES DOWN THE ROAD.

>> SURE.

WE LEARN A LOT ABOUT DIMENTIA MORE RECENTLY.

PAST, WE GOT DIMENTIA ONE OF THOSE DISEASE WHERE SORT OF LIKE BAD LUCK.

DON'T KNOW ANYTHING ABOUT IT.

NOW, SCIENCE OF VASCULAR HEALTH, BLOOD VESSEL HEALTH IN THE BRAIN AND DIMENTIA ARE MERGING.

SO LEARNING THAT EVERYTHING THAT WE DO FOR THE HEART, STROKE PREVENTION, BLOOD PRESSURE, EXERCISE, HEALTHY DIET, SLEEP.

SO ON.

AND THEN KNOWING CHOLESTEROL.

DDIABETES LOWER STROKE.

BRAIN CARE COALITION, STOOD UP BY THE HARVARD MEDICAL SCHOOL GENERAL HOSPITAL GROUP.

GLOBAL NOW.

WE'RE ONE OF SITES.

THEY DEVELOPED SCHOOL CALLED BRAIN CARE SCORE.

ALL THE COMPONENTS THAT I JUST MENTIONED BLOOD PRESSURE, EXERCISE, LACK SMOKE ALCOHOL.

TYPICALLY TALK ABOUT CARDIOVASCULAR HEALTH.

LINKED NOW.

IN FACT, EXERCISE PROBABLY THE MOST POWERFUL WAY T KEEP YOUR BRAIN HEALTHY.

NOT SAY WE GO HAVE A CURE FOR ALZHEIMER'S OR DIMENTIA.

EXERCISE PROMOTES FURROW PLASTICITY.

ABILITY FOR BRAIN TO CHANGE REWIRE.

NUANCE CAN EXTEND ROOTS AN TENTICLE AND BRANCHES THAT CAN FORM AND MAKE A NEW CONNECTION AND THAT'S HOW WE CREATE NEW MEMORY OR KEEP MEMORY.

HOW DO WE KEEP THE NEUROPLASTICITY?

WE NEED A BRAIN FERTILIZER BD AND F. OR BRAIN DERIVED KNEW OWE TROPHIC FACTOR.

BRAIN FEA FERTILIZER WHERE NEURS SPROUT OUT FASTER MORE ROBUST AND MAKE NEW CONNECTION HOW DO YOU GET THAT P D AND F?

DON'T WE ALL WANT THAT SUBSTANCE?

YOU DON'T BUY IT.

IT'S BY EXERCISE.

WE EXA EXERCISE THREE WAYS TO PP THAT.

NEUROTRANSMITTER.

BLOOD FLOW.

TO THE BRAIN.

THAT ACTUALLY TURNS ON THE GENE.

LAST THING, TRY TO WRAP UP, MUSCLES.

EXERCISE OUR MUSCLES CREATE HORMONES THAT BOOST THE BN AND F. IRE I SONON MUSCLES AND THIGH BICEPS MAKE THAT GOES INTO THE BRAIN, AND HOPES CLEAR THE AMYLOID PLANNING COMMISSION.

ALZHEIMER'S PLAQUE WE'RE ALA ALAAFRAID.

GUITAR RGET RID OF IT.HELPS CHO.

SCIENCE HIGH-SPEED INTERNET LIFESTYLE MEDICINE.

40 LIFESTYLE MEDICINE.

40 TO 50% E EPIDEMIOLOGICAL STUDY.

PREVENTED THROUGH THE LIFESTYLE CHANGES.

>>Yunji: BACK TO THE WORK YOU'RE DOING AT THE HEALTH CENTER, TALKING ABOUT WHAT THE DR. NAKAGAWA TALKING ABOUT, PRETTY BAKES BASIC HEALTH CARE.

MAKES ANOTHER ARGUMENT FOR WHY WE NEED MORE ACCESS TO HEALTH CARE IN COMMUNITIES LIKE BIG ISLAND AND BEYOND.

>> YEAH.

EXACTLY RIGHT.

THIS IDEA MOVING UPSTREAM AND MEETING PATIENTS WHERE THEY'RE AT, REINFORCING HEALTHY BEHAVIORS AND PRO SOCIAL BEHAVIORS PREVENTION, AND ADDRESSING SOCIAL HEALTH NEEDS IN OUR COMMUNITY, SO IMPORTANT TO WHOLE PERSON CARE.

AND MAKING CHRI KECK CONNECT COH FOLKS.

ADDRESSING THINGS LIKE LONELINESS AND ISOLATION AND SOME OF THE FACTORS BECAME SO PROMINENT DURING AND AFTER COVID.

WE NEED TO ASK THOSE QUESTIONS.

DO THE SCREENING.

WE NEED TO KIND OF UNDERSTAND WHERE PEOPLE ARE AT.

AND MEET THEM WHERE THEY'RE AT.

FIND OUT WHAT THEY NEED AND THEN WRAP AROUND PATIENTS AND AT THE HEALTH CENTER, WE UNDERSTAND IT'S NOT JUST WHAT HAPPENS IN THE VISIT.

WE NEED TO KNOW WHAT IS HAPPENING AT HOME.

WE NEED TO WHAT'S HAPPENING WITH THE FAMILY UNIT AND SOCIAL HEALTH OF THE INDIVIDUAL.

CONNECT THEM WITH THE RESOURCES IN THE COMMUNITY THAT THEY NEED OR TRY TO HELP MEET THOSE NEED.

>>Yunji: TRY TO GET SOME OF THE QUESTIONS FROM THE AUDIENCE.

THANK YOU TO THOSE YOU HAVE CALLING IN AND EMAILING.

THIS ONE IS FOR YOU.

HOW DO YOU DIFFERENTIATE FORGETFULNESS AND WITH AGE AND SCIENCE OF DIMENTIA.

>> GRANDMOTHER HAD 12 CIBLICH H LINKS.

SIN I WILLTY PART OF AINGING.

GETTING OLD.

SIN I WILLTY.

FINDING THAT MEMORY ISSUES IS NOT A NORMAL PART OF AGING.

IT MIGHT US A LITTLE LONGER TO REMEMBER THINGS AND LEARN NOW NW THINGS NOT A NORMAL PART OF AGING.

LOVED ONE EXPERIENCING BASELINE NOT NORMAL BASELINE SOMETHING THAT SHOULD BE ADDRESSED BY THE PRIMARY CARE PHYSICIAN.

OR THE CONCERNED FAMILY SHOULD BRING IN UP TO SEEK MEDICAL ATTENTION REALLY FIGURE OUT YEAH, IS THIS IS THERE SOMETHING LIKE DIMENTIA GOING ON OR COULD BE FROM OTHER THINGS LIKE LACK OF SLEEP, DEPRESSION, MEDICATION SIDE EFFECTSES A LOT OF THINGS THAT CAN AFFECT FORGETFULNESS TOO AND MEMORY.

>>Yunji: WE HAVE SOME QUESTIONS FOR OUR CAREGIVERS.

LET'S START WITH JENNIFER AND THEN GO TO THE DOCTOR.

COMES TO BEING CAREGIVER FOR SOMEONE WITH ALZHEIMER'S, WHAT IS SOMETHING YOU WISH YOU KNEW, WHAT IS YOUR BIGGEST ADVICE?

JENNIFER START WITH YOU.

>> I WOULD SAY THAT I WISH YOU KNEW EARLIER THAT I NEEDED TO BE THE ADVOCATE AND VOICE FOR MY MOM.

MEANING THAT I NEED TO BE RESPONSIBLE, TO ALL THE RESEARCH AND MAKE SURE THAT I WAS WE WERE MEETING WITH VARIOUS DOCTORS BEFORE WE ACTUALLY SETTLED ON ONE.

WE DIDN'T DO THAT.

II WAS SO FOCUSED ON GETTING HER TREATMENT.

AND NOT THINKING THROUGH IS THIS ACTUALLY GOOD FOR HER.

ARE INFUSIONS GOOD FOR HER?

DO WE ALSO NEED TO SEE A DIETITIAN?

ALL OF THESE THINGS PLAY A BIG ROLE.

IN ALZHEIMER'S.

AND I THINK IS THAT ONE OF THE THINGS THAT I WISH I KNEW EARLIER WAS MAKE SURE THAT YOU KNOW TAKE SOME TIME TO LEARN LANDSCAPE FIRST AS MUCH AS YOU CAN, SO THAT YOU'RE BETTER PREPARED WHEN YOU TALK TO PHYSICIANS.

AND GO AND SEE DIFFERENT DOCTORS.

>>Yunji: THAT IS GREAT ADVICE.

GO NOW TO JOINING US V VEED VIA ZOOM.

WHAT IS BEST ADVICE STARTING CAREGIVER JOURNEY?

>> I THINK A LOT OF GREAT PIECE HAVE COME OUT TODAY.

I THINK ALL MY COLLEAGUES.

WHEN I STARTED ON THIS JOURNEY, WE DIDN'T HAVE BIG BOOM LIKE WE'RE HAVING NOWADAYS WITH ALL OF THIS CONVERSATIONS AND TALKING AND NIH FUNDING.

TOOK 2 YEARS FOR MY FATHER TO GET HIS VHA AND VBA BENEFITS.

TOOK ALMOST THAT SAME OF TIME FOR PCP TO GIVE D A DIAGNOSIS.

STARTED THE DOING MORE THAN CLINICAL CARE AND GOING INTO THE COMMUNITY, I DIDN'T WANT PEOPLE TO HAVE TO GO THROUGH WHEN I WENT THROUGH.

FEEL SO LOST.

DON'T KNOW WHAT TO DO.

MEDICINE PREPARED ME FOR THE DISEASE.

IT IN NO WAY PREPARED ME TO BE A CAREGIVER.

SO I THINK THAT CONWAY WOULD SAY IS -- WHAT I WOULD SAY, RESOURCES AND TO FIND YOUR COMMUNITY, LIKE MY COLLEAGUES ARE ALL SITTING THERE.

THEY'RE THE ONES THAT I GET TO CALL AND TALK TO WHEN I'M DOWN, WHEN I'M UP, WHEN I FEED SOMETHING-NEED SOMETHING.

NEED TO UNDERSTAND SOMETHING.

LJ AND KEALI'I, EVERYBODY OUT THERE, WE BUILD A COMMUNITY AND THAT'S WHAT WE SHOULD BE BUILDING IS COMMUNITY TOGETHER, TO SUPPORT EACH OTHER.

WHERE WE KNOW WOU WHO TO CALL, HANG ON TO EACH OTHER.

FOR CAREGIVERS, SOME OF THE DOCS BROUGHT UP GOOD POINTS.

TALK ABOUT LIFESTYLE CHANGES.

CAREGIVERS HAVE NO TIME.

LEFT IN THEIR DAY, I WOULD HAVE TO ME TELL MY PATIENTS EXERCISING DOESN'T MEAN YOU IS TO GO OUT FIVE DAYS A WEEK FOR 30 MINUTES.

I BUY MOTHER PEDALS.

WATCHES FAVORITES SHOWS PEDAL ALONG AND STILL EXERCISE.

LIKE FINDING THINGS FOR THEM TO DO AT THEIR OWN PACE.

IN A ROOM FOR ALL OF US CAREGIVERSES SO WE CAN STILL DO IT AND WE CAN MEET WHAT'S GOOD FOR YOUR HEART IS GOOD FOR YOUR BRAIN.

SOMETIMES I ALSO HAVE TO LIKE CAREGIVERS KNOW, YOU REALLY WANT TO GO IN FOR THE DIAGNOSIS.

BECAUSE ALZHEIMER'S SUCH A HOT TOPIC.

MY FATHER IS HEARING.

A LOT OF MY PATIENTS WITH COME IN AND FAMILY THOUGHT THEY HAD ALZHEIMER'S.

OR SOMETIMES THEY DID.

SOMETIMES THEY JUST NEEDED A HEARING SCREEN.

THEY JUST COULDN'T HEAR.

SO THERE ARE A LOT OF THINGS THAT COMING TO PLAY.

SO KNOWING RESOURCES, BUILDING YOUR COMMUNITY, KNOWING WHERE TO FIND INFORMATION, AND HOLDING DONE THAT AND DO EURO SEARCH, RESEARCH TIME IS SO LIMITED TO US CAREGIVERS.

SO MUCH HAPPENING FOR FOR US IN THE DAY.

LIKE STORM IS COMING.

I SPENT MORE THAN HALF MY DAY TEXTING WITH THE TEAM.

THANKS MOM HI EVERYBODY.

YOU GUYS ARE WATCHING.

>> JOHN.

HOPIO SET UP THE HOUSE.

FATHER'S OXYGEN TANK WORK.

IF THE ELECTRICITY GOES OUT.

HOW IS HIS BED GOING TO MOVE.

SO MUCH HAPPENING.

SO MUCH TO DO.

>>Yunji: LET'S TALK ABOUT THE STIGMA AROUND DISCIPLES ALZHEIMER'SSOME PATIENTS MIGHT E RERELUCTANT TO THEY'RE HAVING DIFFICULTIES.

PEOPLE CAN GET DIAGNOSIS AND TREATMENT AS EARLY AS POSSIBLE.

>> I THINK THANK YOU AGAIN FOR THAT QUESTION.

ONE, PEOPLE THINK THAT ALZHEIMER'S IS ALA AGE RELATED DISEASE.

MORE PEOPLE OF CERTAIN AGE OR ABOVE A CERTAIN AGE HAVE ALZHEIMER'S.

SO DO PEOPLE HAVING DIABETES OR OTHER CHRONIC DISEASES.

HAVING PEOPLE UNDERSTAND THAT IT IS A CHRONIC DISEASE.

AND IT'S A BRAIN DISEASE.

AND SO MAKE SURE THAT PEOPLE UNDERSTAND WHAT ALZHEIMER'S DISEASE IS.

I THINK TALKING ABOUT ALZHEIMER'S LIKE WE TALK ABOUT, DIS DIABETES AND HEART DISEASE IS IMPORTANT TO REMOVE SOME OF THAT STIGMA.

>>Yunji: THERE'S A QUESTION HERE FROM SARAH IN NUUANU.

I'M HOPING THAT YOU CAN TAKE THIS ONE.

PARENTS TALK ABOUT PAID RESPITE CARE SERVICE FOR FAMILY CAREGIVERS THAT ARE NOT WORKING?

IN OTHER WORDS, ARE THERE BAD PLAYERS IN THIS INDUSTRY.

>> AS FAMILY MEMBER, IF YOU'RE GOING OUT TO FIND THESE SERVICES, HOW DO YOU SCREEN FOR FOLKS AND HOW DO YOU KNOW THAT YOU ARE A RIGHT FIT?

I WOULD IMAGINE WITH YOUR WORK WITH KUPUNA CARE PAIR, YOU KNOW THE LANDSCAPE.

YOU DID MENTION THAT OFTENTIMES PEOPLE TO YOU AND THEY'RE DESPERATE JUST WANT SOMEBODY TO HELP.

HOW DO YOU PROPERLY SCREEN FOR SERVICES?

>> THAT'S REALLY, REALLY IMPORTANT QUESTION.

I THINK THAT THERE IS LUCKILY STATE DEPARTMENT OF HEALTH OFFICE OF HEALTH CARE ASSURANCE IS CREATING MORE PROCESSES FOR IN HOME CAREGIVERS.

RECENTLY, CREATED SEPARATE LICENSE FOR HOME CARE AGENCIES.

SO THAT ALL PEOPLE WHO COME INTO THE HOME NEED TO BE WORKING WITH AGOCY THAT IS LICENSED.

AGENCY THAT IS LICENSED I COULD GO OUT FACEBOOK CARE.COM AND FIND AN INDIVIDUAL AND RELY WHATEVER SCREENING PROCESSES THEY HAVE.

BUT GENERALLY SPEAKING, I FIND THAT'S ALMOST LIKE DATING.

EVEN IF THEY'RE NOT BAD PLAYERS, IT STILL COULD BE A POOR FIT.

AND AS A RED KETTLESES TO ALZHEIMER'S SPES-R-RELATES TO ALZHEIMER'S SPECIFICALLY VERY DISTINCT SET OF SKILLS THAT CAREGIVER NEEDS TO HAVE.

TO WORK WITH SOMEBODY WHO HAS MEMBMEMORY LOSS OR COU COGNITIVY CAN'T UNDERSTAND THINGS RETIREE OR COGNITIVELY INTACT PHYSICALLY NEEDS A A LOT OF CARE.

GENERALLY SPEAKING, A LOT OF THE QUOTE, UNQUOTE, BAD PLAYERS WOULD BE USUALLY SOMEBODY DIRECT.

GO TO CRAIG'S LIST TO FIND A CAREGIVER.

BUT NOT TO SAY THERE ARE MANY OF THEM, BUT EVEN IF I MEET SOMEBODY FROM CONTACT CON CRAIGR GO THROUGH AND AGENCY TALKING TO THEM ABOUT THEIR SKILL SET AND TALKING TO THEM ABOUT WHAT THEY WOULD DO FOR MY MOM WOULD MIGHT BE MISTAKING THE STOVE OR THE BATHTUB OR WHATEVER IT COULD BE, IS AN IMPORTANT PROCESS.

IT TAKES TIME TO PREPARE THAT RELATIONSHIP.

>>Yunji: I KNOW YOU WOULD LIKE TO ADD.

>> I WANT TO ADD.

THAT'S GREAT.

REFERENCES.

JUST AS YOU WOULD FOR A LOT OF OTHER THINGS, FIND OUT FROM THAT PROVIDER WHO ELSE OR FIND OUT FROM YOUR FAMILY MEMBERS WHAT THEIR EXPERIENCE MIGHT HAVE BEEN.

I THINK USING WHATEVER NETWORK THAT IS OUT THERE IS IMPORTANT.

HAVING THAT RESPITE ASSISTANCE I THINK IS VERY IMPORTANT FOR FAMILY CAREGIVERS.

BEING ABLE TO HAVE TIME WHERE YOU'RE ABLE TO GO OUT FOR AN EVENING, WITH YOUR SPOUSE, OR PARTNER, AND HAVE YOUR PARENT BEING CARED FOR, NOT LIKE YOU'RE ABANDONING THEM.

YOU'RE BUILDING UP YOUR OWN BATTERY AND SO OTHER THING I WOULD SAY IS THAT SO GETTING THE RESPITE CARE ABSOLUTELY DO THAT.

CATHY COULD TELL YOU WHOLE LOT ABOUT THAT.

BUT GETTING HELP SO THAT YOU CAN MAKE SURE YOU TAKE CARE OF YOURSELF.

IF YOU'RE REALLY BURNED OUT, EXPERIENCE I HAVE FOR EXAMPLE, CARING FOR MY MOM AND SOMEONE HELPED US CARE FOR HER, WAS THIS WOMAN WAS SOMEONE WHO COULD DEAL WITH MOM BEING VERY UNPLEASANT.

AND RUDE AND NASTY AT TIMES BECAUSE SHE, ONE SHE LIVED HER LIFE BUT GOTTEN TO A POINT WHERE WHAT SHE COULD TOLERATE WENT FROM HERE TO HERE.

AND THAT PERSON WAS ABLE TO DO IT.

SHE WOULD ALWAYS TELL YOU, GOSH I'VE HAD WORSE.

OH, MY GOSH.

WE'RE MORTIFIED.

SO FINDING THAT FIT I THINK IS IMPORTANT.

AND THEN OTHER THING I WOULD ADD IS SOMETIMES WHEN YOU'RE LIKE RAISING YOUR CHILD, PUT THEM IN TIMEOUT, SOMETIMES FOR CAREGIVERS WE HAVE TO GIVE OURSELVES A TIMEOUT.

WE'RE AT OUR WIT'S END, CAN'T DEAL WITH MOM.

I'M GOING TO GO.

SHE'S IN THE BED.

NOT GOING ANYWHERE.

I'M GOING TO GO AND TALK A BREATHER AND -- TAKE A BREATHER COLLECT MYSELF SO I CAN BE THE BEST I CAN BE FOR HER.

>>Yunji: THAT EMOTIONAL TOLL AND CATHY I WOULD LOVE FOR YOU AT THAT TAKE MIKE'S QUESTION.

WHAT IS THE HIGHEST COST YOU'VE ENCOUNTERED FOR ADULT CARE.

A LOT FOLKS WONDERING IS THE SCALE, WHAT DO I SAVE FOR THIS?

PREPARE FOR THIS FINANCIALLY AND WHAT KIND OF COST AM I FACING IF IT'S NOT FULL LIVE IN SERVICES THAT TODD IS TALK ABOUT, BUT SOMETHING KIND OF IN BETWEEN, WHAT ARE WE TALKING ABOUT?

>> THAT'S FAVORITE TOPICS.

BECAUSE HAVE A ADULT DAY CARE.

THE FIRST WRUNG ON THE LADDER OF LONGTERM CARE CONTINUUM.

LEAST EXPENSIVE.

IT'S BY WOULD SAY THIRD OF THE COST OF ASSISTED LIVING.

I'M SORRY.

HOME CARE.

AND EXPONENTIALLY LESS THAN THE INSTITUTIONALIZED FACILITIES.

IT CAN ADULT DAY CARE MAYBE $1,900 A MONTH.

CARE HOME IS LIKE YOU SAID, $5,000 IS LOW.

IT'S QUITE ECONOMICAL.

AND THE OTHER THING IS PRETTY SOON, PREDICT WE'RE GOING TO BE OUT OF SKILLED BEDS AND CARE HOME BEDS.

NOT GOING TO BE ANYPLACE FOR PEOPLE TO GO THAT NEED A BED.

SO PEOPLE KEEPING FAMILIES AT HOME BRING THEM TO ADULT DAY CARE, TO KEEP THEM STIMULATED AND SOCIALIZED AND SLOW PROGRESSION OF DISEASE AND GIVE THE FAMILIES RESPITE.

, SO WE'RE PART OF THAT TAKE CARE OF BUSINESS DON'T HAVE ANY BEDS FOR PEOPLE THAT NEED THEM.

>>Yunji: OKAY.

GO TO YOU NOW.

WHAT RESOURCES IS THE QUESTION THAT CAME IN.

WHAT RESOURCES ARE OUT THERE FOR SOMEONE WHO HAS NO FAMILY OR FRIENDS SUPPORT WHEN IT COMES TO DEALING WITH THESE CHALLENGES?

HEARD A LOT TONIGHT.

ABOUT THE IMPORTANCE OF COMMUNITY AND FAMILY.

WHAT IF YOU NEVER HAD KIDS AND HAPPEN TO LIVE ALONE?

>> THAT'S A GOOD QUESTION.

MORE AND MORE, AS TIME PROGRESSES, SOCIETAL CULTURE CHANGES, WE HAVE MORE PEOPLE WHO ARE LIVING ALONE.

WITH DIMENTIA.

AND IT'S IMPORTANT TO ACCESS RESOURCES IN THE COMMUNITY.

WHETHER IT BE AGAIN GOING TO LOCAL AREA AGENCIES ON AGING.

EL THOSE NONPROFITS CAN OFFER SUPPORT.

I KNOW A LOT OF THE HOME CARE AGENCIES HAVE BEEN SUCH A GOD SEND FOR OUR FAMILY TOO.

MY GRANDPARENTS' HAD DIFFERENT FORMS OF DIMENTIA AND WHEN YOU'RE LIVING ALONE, IT'S IMPORTANT TO ALSO ACCESS OUR NEIGHBORS.

WE MIGHT NOT HAVE FAMILIAL OR BLOOD RELATED FAMILIES, BUT IN HAWAII, WE HAVE A LOT OF CHOSEN FAMILY.

THAT OHANA THAT WE CAN RALLY AROUND TO CREATE THAT CARE TEAM TOO.

SOME OF MY PAST PATIENTS, THEIR NEIGHBORS WERE SUCH A HUGE SUPPORT.

I THINK IT'S CREATIVE AND LOOKING AROUND ALL OVER TO CREATE THAT CARE TEAM.

>>Yunji: CAN YOU BUILD ON THAT?

ESPECIALLY FOR FOLKS LIVE IN RURAL COMMUNITIES.

I KNOW THAT YOU'RE REPRESENTING HAWAII ISLAND TONIGHT.

BUT WE HAVE PEOPLE ON KAUAI.

LANAI, MOLOKAI.

THINK ABOUT THE HEALTH CARE SERVICES THAT ARE THERE.

TELL US ABOUT THE IMPORTANCE OF COMMUNITY BEYOND THE HEALTH CARE SETTING FOR THESE KINDS OF PATIENTS?

>> YOU KNOW, COMMUNITY CAN MEAN A LOT OF DIFFERENT THINGS.

AND IF YOU DON'T KNOW WHERE TO START, ASKING YOUR DOCTOR OR NURSE THAT YOU HAVE RELATIONSHIP WITH IS THE RIGHT PLACE TO GO.

AND BECAUSE THAT CARE TEAM THAT WRAPAROUND SERVICE IS JUST SO CRITICALLY IMPORTANT.

WE HAVE AMAZING TEAM OF COMMUNITY HEALTH EDUCATORS, DIETICIANS, PATIENT NAVIGATORS, THAT ARE CONNECTED INTO THE RESOURCES IN THE COMMUNITY.

AND MAYBE IT'S SOMETHING FORMAL AND NONPROFIT AGENCY.

BUT MAYBE IT'S A WALKING GROUP.

MAYBE IT'S COOKING CLASS OR SOMETHING THAT EXISTS THAT YOU WOULDN'T THINK IS TRADITIONALLY KIND OF NEEDED FOR THE INDIVIDUAL.

BUT YOU KNOW, IN THE ET WORK NEK AND ASKING QUESTION, IF YOU DOUBT KNOW WHERE TO START, -- DON'T KNOW WHERE TO START, DOCTOR'S OFFICE GOOD PLACE TO DO THAT.

>>Yunji: I LOVE YOUR POINT WITH THE COOKING CLASS OR NONTRADITIONAL CREATIVE.

I WOULD LOVE TO ASK YOU THIS QUESTION.

BUILD ON THAT.

FROM CLAUDIO, DO ACTIVITIES LIKE PERFORMING MUSIC OR STUDYING ANOTHER LANGUAGE HELP?

YOU TALK ABOUT HE CAN ISIS A LOT EXERCISE.

A LOT OF PEOPLE IN SUDOKU.

CROSSWORDS OR OTHERS BRAIN BUSTERS WOULD BE HELPFUL.

DOES IT ACTUALLY WORK?

>> YES.

AGAIN, GOING BACK TO THE CONCEPT OF NEUROPLASTICITY.

TO KEEP OUR BRAIN CELLS MORE ACTIVE AND SPROUTING.

THAT IS CHALLENGE.

NEW STIMULATION.

SOMETHING NOVEL.

WHERE YOU TRY TO ACQUIRE NEW SKILL AND YOU LEARN ANYTHING.

MIMAKE MISTAKES HAVE THAT INTENTIONAL FEELING I MADE A MISTAKE.

FIX IT.

THAT SUP PROCESS KEEP YOUR BRAIN MORE ACTIVELY OF PUZZLES NEW LANGUAGE, MUSIC, ANY KIND OF ANALYTICAL THINGS OR CREATIVE ART.

GREAT ONE REALLY ENDORSE.

ARTWORK SHOP.

PRINT MAKING.

COLORING BOOKS.

ALL OF THOSE THINGS DIFFERENT PARTS OF BRAIN.

AND WHY I LIKE ART, IS BECAUSE YOU DON'T HAVE TO RELY ON MEMORY.

YOU DON'T HAVE TO WORK, HAVE HAVE TO CONCEPT TO CON-CON SENTRUMP ADMINISTRATN ATTENTION SPAN.

INNATE.

VERY HE EMOTIONAL THAT CAN JUST COME OUT MUCH AND AT THAT MOMENT, SOMETIMES THEY JUST LIGHTEN UP.

DOESN'T REQUIRE VERBAL COMMUNICATION.

IT DOESN'T REQUIRE MEMORY.

AND IT'S A GREAT WAY FOR PEOPLE TO BOND THROUGH INDIVIDUAL EXPRESSION OF THEMSELVES.

>>Yunji: CAN YOU BUILD ON THAT?

ALSO ADD IN THE ASPECTS OF DIET.

INTERESTED TO KNOW ABOUT WHAT YOU EAT CAN PLAY A ROLE IN THIS AS WELL.

>> YEAH.

GO OFF ADVICE.

A LOT OF ACTIVITIES WHAT I COUNCIL MY PATIENTS IS HAS TO BE SOMETHING THAT THEY'LL BE INTERESTED IN DOING TOO.

SO THINKING OUTSIDE THE BOX TOO.

ABOUT LIKE COOKING CLASS.

MENTIONED.

ALSO HAS A BENEFIT OF SOCIAL DISAITIONZ TOO.

WE KNOW IS VERY IMPORTANT FOR BRAIN HEA HEALTH.

SOCIALIZATION.

A LOT OF, RESEARCH DONE ON BENEFITS, HEALTH MENTAL BENEFIT OF MUSIC.

GREAT VVIDEO OUT THERE.

GENTLEMAN NEW YORK CARE HOME HALEHAD DIMENTIA.

SIXTIES MU MUSIC PLAYED.

COMES TO LIVE.

TALKING AN VERBALIZING.

MUSIC IMPORTANT PART.

WITH DIET, MENTIONED WHAT'S GOOD FOR THE HEART S IS GOOD FOR THE BRAIN.

I AGREE, I T I THINK HAVE TO HAE WELL BALANCED DIET.

LOW FAT.

LOTS OF NOT AS MUCH RED MEAT.

KIND OF MORE LIKE THE MEDITERRANEAN DIET.

SOMETHING WHAT I COUNCIL MY PATIENTS ON.

>> IF I COULD ADD TO THAT, SO IMPORTANT WE ENGAGE OUR BRAIN, LIKE WAS SAID, GOOD NUTRITION.

SOMETHING THAT I DIDN'T KNOW BEFORE WAS THAT'S IMPORTANT FOR OUR BRAINS TO BE ACTIVE BUT IMPORTANT FOR US TO GET RESTORATIVE SLEEP AT NIGHT TIME.

SLEEP, CLEANING CYCLE FOUR BRAINS.

OUR BLOOD CAN GO TO THE BRAIN AND WASH OUT THOSE AMYLOID TANGLES AND PHRA*BGS THAT ARE ASSOCIATED WITH ALZHEIMER'S DISEASE.

SO IMPORTANT TO HE WILL GAUGE TR BRAIN AND GET GOOD SLEEP.

>>Yunji: HEARD NOT JUST SOMETHING THAT RESTRICTED TO THE ELDERLY.

AGES FACTOR.

BUT NOT ONLY ONE.

HOW EARLY SHOULD WE START THINKING ABOUT THIS GIVEN WE KNOW HEAR TALK OF THE SILVER TSUNAMI.

WE HAVE ONE OF THE OLDEST POPULATIONS IN THE COUNTRY.

WHEN GO RT IS START PLANNING AN HAVING THESE CONVERSATIONS?

>> I THINK YOU OR SOMEONE IN YOUR FAMILY EXPERIENCES COGNITIVE CONCERNS, WHEN I THINK ABOUT ALZHEIMER'S, I THINK ABOUT IT BEING INABILITY TO RECALL THINGS.

AND SO THAT IS TYPICALLY WHAT IS EXPERIENCED BY PEOPLE WHO HAVE CONCERNS ABOUT THEIR COGNITIVE HEALTH.

THEY'RE ASKING SAME QUESTIONS.

ALL THE TIME.

OR OVER AND OVER AGAIN.

SO I THINK IT'S TALKING TO YOUR DOCTOR WHEN YOU HAVE THOSE CONCERNS.

AND YOU ARE RIGHT.

YOUNGER PEOPLE THAT HAVE ALZHEIMER'S DISEASE.

YOUNGER ON SET ALZHEIMER'S DISEASE MORE AGGRESSIVE THAN THE TYPICAL ALZHEIMER'S DISEASE THAT MOST PATIENTS HAVE.

I KNOW THAT IN THE STATE, IN KAILUA KONA, YOUNGEST PERSON THAT WE WERE PROVIDING SERVICES FOR WAS 39-YEAR-OLD MALE.

SO VERY YOUNG.

>>Yunji: THAT IS UNEXPECTED.

TODD, SIMILAR QUESTION.

FOR FAMILIES WHO HAVE SOMEONE IN CARING FOR AT HOME, IN EARLY DISAI STAGES OF ALZHEIME', HOW EARL DUI THEY START THINKING ABOUT THE LO LONGER TERM?

POTENTIAL LACK OF PLACES TO GO.

HOW EARLY DO I GET ON A LIST AND HOW DOES THAT WORK?

>> I THINK GETTING ON A LIST MAYBE NOT THE IMMEDIATE CONCERN.

I THINK MORE IT'S ABOUT LOOKING AT WHAT MIGHT BE THE PROGRESSION.

LEARNING MORE ABOUT THE DISEASES ITSELF.

AND TEN ALSO, LOOKING AT WHAT SERVICE, THERE ARE IN THE COMMUNITY.

IS GOING TO BE THE NEXT STEP, IF IT'S NO LONGER FEASIBLE FOR ME TO STAY AT HOME, OR LOVED ONE TO STAY AT HOME, WHERE CAN I TURN TO?

ALSO THINK THAT LIKE FOR FAMILIES, THEY'RE JUST A LOT OFTENTIMES REINVENTING THE WHEEL.

SO MANY RESOURCE AND KNOWLEDGE BASIS OUT THERE, IN ALZHEIMER'S, AND SO KNOWING WOUWOULD TURN IT TO, ALL COMMUNITY ORGANIZATIONS WHICH THERE ARE MANY, TO BE ABLE TO LEARN FROM WHAT OTHER PEOPLE EXPERIENCES ARE IS HUGELY IMPORTANT.

SO L DOCTOR AND EVERYONE TALKING ABOUT COMMUNITY, TALKING TO OTHER FAMILY MEMBERS WHO ARE GOING THROUGH THE SAME THING.

AND ALZHEIMER'S ASSOCIATION HAS WORKSHOP ON THIS.

OTHER COMMUNITY GROUPS THAT DO AS WELL.

AND I THINK NOT ONLY ARE WE NOT ALONE IN TERMS OF THINKING ABOUT THE BOXES CHECK OFF IN TERMS CARE, BUT WHAT OTHER PEOPLE GONE THROUGH AND WHAT WORKED WITH THEM GOOD RESOURCE.

>> I WAS JUST GOING TO DO SAY, ONE OF THE THINGS TO THINK ABOUT THINKING ABOUTEL HE SHARED, HAVING THAT SIMPLE CONVERSATION WITH YOUR DOCTOR PROVIDER, AND JUST MENTIONING THERE'S VERY QUICK SCREENING INSTRUMENT THAT WE CAN DO IN THE OFFICE.

TO TRACK YOUR MEMORY FUNCTION OVER TIME.

SO IF THERE'S A QUESTION, JUST SAY SOMETHING.

WE NEED TO START TALKING ABOUT THIS.

AND DEVELOPING THAT RELATIONSHIP WITH OUR DOCTORS AND THOSE SCREENING TOOLS CAN TRACK THAT OVER TIME.

IF YOU HAVE QUESTIONABLE SYMPTOMS POSSIBLY.

IN YOUR LATE 40'S, EARLY FIFTIES.

SOMETHING WE CAN KEEP AN EYE ON AND HELP RULE OUT OTHER CONDITIONS IF THEY EXIST.

>> THING I WOULD ADD, TO YOUR QUESTION, WHEN SHOULD WE START THINKING ABOUT IT, NOW.

BECAUSE AS DOB DOCK WAS TALKING ABOUT HEALTH ISSUES.

SOMETHING I ABSOLUTELY HAVE TO FOCUS ON FOR MYSELF.

SO I THINK RECOGNIZING THAT WHEN I REFER TO NOW, I'M SURE HE LOVED THIS, ISSUE OF WHAT DO WE DO NOW?

FIRST TO PREVENT IT.

SO THE BEST THING WE CAN DO FOR AU OUR FAMILY WHEN WE AGE TAKE CARE OF OURSELVES NOW, SO THAT IT'S NOT SO MUCH OF A CHALLENGE FOR OUR LOVED ONES WHEN WE GET OLDER.

THE OTHER PIECE I WOULD JUST ADD IS LJ POINT ABOUT PLANNING.

THE TRUTH OF THE MATTER IS NOW IS ALSO IT'S TIME TO PLAN.

IF WE'RE LUCKY WE ALL WILL NEED CARE.

WE'LL NEED SOME KIND OF CARE.

WHETHER IT'S ALZHEIMER'S OR SOMETHING ELSE.

IF WE LIVE LONG ENOUGH, WE'LL NEED CARE.

SO HAVING THAT DISCUSSION NOW WITH YOUR FAMILY, ABOUT WHAT IS THAT GOING TO LOOK LIKE, HARD TO VISUALIZE OR SEE.

ABOUT THERE'S PROBABLY LOTS OF DIFFERENT TV SHOWS OR SHOWS OUT THERE THAT HAVE BEEN ABLE TO SEE WHAT IS LIKE WHEN SOMEONE HAS ADVANCED ALZHEIMER'S AND WHAT THOSE CHALLENGES ARE.

AND SIT WITH YOUR FAMILY AND WATCH THAT.

AND TALK ABOUT THAT AFTERWARDS.

SAY, GOSH, OKAY, HOW ARE WE GOING TO DEAL WITH IT?

MOM, WHEN YOU CAN NO LONGER THINK ABOUT THAT, WHO IS GOING TO BE THE PERSON YOU WANT IN CHARGE OF FINANCES?

IN CHARGE HEALTH DIRECTIVE.

MY THING IS NOW.

>>Yunji: THOSE ARE TOUGH CONVERSATIONS TO HAVE.

I WOULD LOVE TO HEAR FROM YOUR DIRECT EXPERIENCE ABOUT HOW YOU NAVIGATED THAT.

>> WHEN MY MOM WAS FIRST DIAGNOSED, I REMEMBER THE PHYSICIAN TELLING US YOU SHOULD HAVE BROUGHT HER IN FIVE YEARS AGO.

AND THAT WAS GUT THE ME BECAUSE I THOUGHT YEAH, I GUTTED ME I THINK THAT I WAS SEEING SIGNS, BACK THEN, FORGOTFULNESS, JUST BRUSHED IT OFF AS OLD AGE OR JUST GETTING OLDER.

BUT REALLY, THAT WAS SIGNS OF ALZHEIMER'S AND SO ONE OF THE FIRST THINGS I DID CALLED ALZHEIMER'S ASSOCIATION ASKING FOR RESOURCES.

AND THEY DIRECTED ME AND SAID, YOU SHOULD SEE AN ATTORNEY.

PLAN FOR SEE AN ESTATE ATTORNEY.

ON GET YOUR MOM'S AFFAIRS IN ORDER.

AND CASIN BEST PIECE OF ADVICE T OUR FAMILY RECEIVED.

AFTER HER DIAGNOSIS THAT'S AWAY DID.

SAW AN ATTORNEY.

>>Yunji: GO TO DOCTOR OVER ZOOM NOW.

AND HEAR FROM HER EXPERIENCE.

WHAT CAN YOU SHARE WITH US ABOUT THAT PROCESS AS AND THOSE CONVERSATIONS THAT YOU HAD ON THE EARLY SIDE OF THE DIAGNOSIS?

>> CONVERSATIONS WITH FAMILY, I THINK AS INDIVIDUALIZED TOO, I TELL A LOT OF MY PATIENT AND FAMILIES, YOU HAVE TO DO IT AT THE PACE WHEN PEOPLE ARE READY.

SOMETIMES PERSON LIVING WITH A DISEASE CAN BE IN DENIAL.

SOMETIMES CAREGIVERS ARE IN DENIAL.

A LOT OF CULTURES MAKE A DIFFERENCE TOO.

MY CULTURE, NATIVE HAWAIIAN.

A LOT OF NATIVE HAWAIIANS SEE STHECHS OURSELVES CAREGIVERS.

BUILT IN OUR CULTURE.

LANGUAGE WE'RE USING, WORDS EAR USING BELIEF SYSTEMS, WE'RE USING BELIEF SYSTEMS DID WE HAVE THOSE CONVERSATIONS WITH MY FATHER?

FATHERRER SWEPT THROUGH THE MIDDLE STAGES VERY FAST.

IT CAME AND IT WENT AND WE DIDN'T GET TO HAVE ALL OF THAT.

HANGFHANGTHANKFULLY HE AND MY MD THOSE CONVERSATION.

STARTED HAVING CONVERSATIONS WITH MY MOTHER.

MOTHER DID MAKE ALL OF HER DECISION.

MADE THOSE DECISION ALSO FOR MYSELF.

AND SO I THINK YOU'LL HEAR A LOT.

HAVING THOSE CONVERSATIONS EARLY WILL HELP A LOT TO UNDERSTAND FOR PLANNING.

YOU ALSO HAVE TO DO IT WHEN PEOPLE ARE READY.

MEET THEM WHERE THEY ARE AND TAKE A LITTLE LIKE TAKE SOME TIME.

HAVING GO TO SOMEBODY SPECIALIZE ELDER LAW VERY HELPFUL.

AND I ALSO WANT TO REMIND EVERYONE WE TALK ABOUT THIS DISEASE A ALWAYS IN THE CONTEXT OF CHALLENGES AND HOW BAD IT IS.

THERE IS SO MUCH LIFE LEFT IN ALZHEIMER'S, PEOPLE LIVING WITH THE DISEASE, AND ALL OF US CAREGIVERS.

DON'T FORGET TO LIVE AND ENJOY HAPPY MOMENTS, SMALL MOMENTS, JOYS, CONVERSATIONS YOU CAN STILL HAVE WITH THE PERSON UNTIL THEY BECOME NONVERBAL.

LIKE THERE IS MUCH MORE TO DISEASE THAN ONLY ALL OF THE CHALLENGES.

OF COURSE, TAKETH TAKE TAKE ET MOMENT.

TAKE A TIMEOUT.

CRY GRIEF CYCLE CONTINUES OVER AND OVER EVERY TIME YOU LOSE A LITTLE BIT MORE OF THAT PERSON.

ABOUT YOU JUST DON'T FORGET THAT THERE IS SO MUCH MORE AND LAST THING I'LL END WITH, APOLOGIZE FOR TAKING SO MUCH OF YOUR TIME.

IS TO LOOK AT IT FROM THE PERSPECTIVE THE PERSON LIVING WITH THE DISEASE.

MANY TIMES, WE REACT BECAUSE WHAT MAKES SENSE TO US.

BUT THEY LIVE IN ANOTHER REALITY, STEP INTO THEIRS, AND FOR A LOT OF THINGS PEOPLE TALK ABOUT, ESPECIALLY NURSING HOMES, I ALWAYS USE THIS EXAMPLE.

>> IF YOU SAW STRANGER COMING AT YOU TRYING TO T TAKE OFF YOUR CLOCLOTHES WHAT WOULD YOU DO?

NOT NONCOMPLIANT.

DON'T HAVE BEHAVIORAL.

>>.

REACTING TO THE REALITY.

ANYONE OF US WOULD ACT SALMAH WAY.

PUSHING KICKING TRYING TO GET SOMEONE OFF.

I WILL END THERE.

PLEASE DON'T FORGET TO LIVE ALSO.

>>Yunji: BEAUTIFUL THING TO SAY.

GO AHEAD.

>> COUPLE OF COMMENTS.

FIRST OF ALL, WHEN YOU SAID THAT YOUR DOCTOR SAID YOU SHOULD HAVE BROUGHT HER FIVE YEARS AGO.

THAT MADE ME SO ANGRY.

HOW DID YOU FEEL WE SAY THAT TO YOU?

>> GUILTY?

VERY GUILTY.

>> THAT WAS, I CAN'T EVEN GO ANY FURTHER WITH THAT.

BEING SO ANGRY.

YOU ARE HUMAN.

I TRY TO TELL CAREGIVERS ALL THE TIME, YOU'RE NOT MAKING MISTAKES.

YOU'RE LEARNING AS YOU GO ALONG.

BECAUSE THERE'S NO WAY TO KNOW EVERYTHING UP FRONT.

FOR HIM TO TELL YOU SHOULD HAVE BROUGHT HER IN FIVE YEARS, WHAT WAS THE POINT FOR HIM TO SAY IS THAT I'M NOT THE ONLY ONE THAT HAD THE REACTION.

LOOK AROUND THE ROOM.

I'M SORRY HE DO IT TO YOU.

DON'T FEEL GUILTY ANY MORE YOU HAVE PERMISSION NOT TO GOAL FEEL GUILTY.

>> WE DO WHAT WE CAN WITH WHAT WE KNOW AND LEARNING DAY BY DAY.

>> WE ARE GETTING BETTER.

RAISING MORE AWARENESS ABOUT THIS DISEASE.

FORTUNATE THAT THIS STATE IS SUPPORTING PUBLIC HEALTH AWARENESS CAMPAIGN THAT WILL REALLY FOCUS ON EARLY EARLY DETECTION.

THAT'S KEY.

PREVENTION IS KEY.

BUT THERE IS THERAPIES ON THE MARKET THAT DOCTOR MENTIONED THAT CAN POTENTIALLY SLOW THIS DISEASE FOR PEOPLE THAT ARE ELIGIBLE TO GET ON THESE NEW THERAPIES IN AVAILABLE IN HAWAII.

NOT A CURE.

FAR FROM IT.

BUT SCIENCE IS WORK.

FOR SOME PEOPLE THAT COULD BENEFIT FROM IT.

AND WE KNOW THAT WE ARE LEADING IN THAT RIGHT DIRECTION.

SO THINK OF PREDIABETES AND TAKE CERTAIN MEDICATIONS TO PREVENT THE ONSET OR DELAYING DIAGNOSIS OF TYPE 2 DIABETES PERHAPS.

IT CASE, REMOVE AMYLOID PLAQUES WHICH IS MARKER FOR ALZHEIMER'S DISEASE.

PRETTY EFFECTIVELY WITH SOME OF THOSE DRUGS.

EARLY SCREENING IS IMPORTANT.

BECAUSE YOU CAN POTENTIALLY SLOW DOWN THE DISEASE.

>> REALITY IS MOM PROBABLY WAS SEEN FIVE YEARS AGO MUCH AND PROBABLY WAS KEEPING UP WITH HER CARE AND WHAT ARE THE RIGHT QUESTIONS BEING ASKED?

WERE KN THOSE ANNUAL WELLNESS VISITS MAXIMIZED BY THE PROVIDER AND CARE TINY HOME TEAM.

TAKING THAT -- CARE TEAM.

TAKE THAT DATA AN OWNING AT THAT CARE FOR THE INDIVIDUAL.

ER.

>> IF I COULD ADD SOMETHING, JUST TO FOLLOW WHAT HAD MENTIONED, WE ARE GOING IN FRONT OF LEGISLATURE THIS YEAR TO WORK ON JUST THAT.

WE WANT TO REQUIRE THAT PATIENTS WOULD GO IF FOR ANNUAL WELLNESS VISITS, MEDICARE PATIENTS, THAT PROVIDERS USE STANDARDIZE FDA TOOLS.

RIGHT NOW, OBSERVATION IS SCREENING TOOL.

UNDER MEDICARE.

GUIDELINES.

SO WE WOULD LIKE TO CHANGE THAT THIS YEAR.

>>Yunji: HEAR FROM DR. FUJIKAMI.

THERE WAS A QUESTION THAT CAME IN HERE.

HEARD A LOT ABOUT GETTING DIAGNOSIS.

WHAT IS THE TESTING PROCESS FOR ALZHEIMER'S DIAGNOSIS?

>> RIGHT.

SO THERE IS, SO TECHNICALLY.

SHORT-TERM MEMORY PROBLEMS THAT AFFECT YOUR ABILITY TO TAKE CARE OF YOURSELF.

DAY-TO-DAY FUNCTIONING.

TAKING MEDICINE.

DRIVING.

PARTICULARLY WITH ALZHEIMER'S.

AGAIN, AMYLOID AND PROTEIN TANGLES THAT ARE THE HALLMARK OF THE DISEASE.

BEFORE, USED TO BE COULDN'T DIAGNOSIS UNTIL AUTOPSY.

ACTUALLY TOOK PIECE OF BRAIN LOOKED FOR THE PROTEINS.

HOW WE USED TO DIAGNOSE.

NOW EXCITING TIME.

THERE ARE SOME BLOOD TESTS LOOKING FOR THESE PROTEIN LEVELS.

SPINAL FLUID CAN HE TAKE OUT, SPECIAL AMYLOID PET SCANS THAT CAN HELP US, PROVIDERS TO HELP TRY TO DIAGNOSE ALZHEIMER'S DISEASE.

A LOT OF RESEARCH PHASE.

SO EXPENSIVE.

I THINK THERE'S A LOT COMING OUT THAT WE HAVE A LOT MORE TOOLS NOW TO DIAGNOSIS THIS DISEASE MORE ACCURATELY.

>>Yunji: I WANT TO GO TO DOCTOR QUICKLY.

WHAT KIND OF DIFFERENCE CAN EEARLY DIAGNOSIS TO MAKE FIRE TREATMENT.

>> START MEDICATION EARL.

>> HAVE DEFINITE DIAGNOSIS BY EARLY PHASE.

NOT EARLY PHASE THEY DON'T QUALIFY.

THAT'S THE BIGGEST REASON.

AMYLOID PET SCAN CURRENTLY DON'T HAVE THAT IN HAWAII.

WE WILL BE GETTING THAT UP AND RETURNING THIS YEAR.

>>Yunji: THAT'S ENCOURAGING.

QUESTION FOR LANCE ON YOUTUBE.

LOVE SOME OF THE FOR TODD, I WANT TO START WITH KEALI'I.

ANSWER THIS ONE.

BECAUSE YOU DID REFERENCE THIS.

IN FOR YOUR OWN FAMILY.

WHAT ARE SOME WAYS TO DEAL WITH A DEAL WITHAGGRESSIVE DIMENTIA?

SOMETIMES GETTING FROM T TRYING TO CARE FOR THEM.

GETTING FRUSTRATED.

WHAT CAN A CAREGIVER DO?

>> I THINK HAD A GOOD WAY OF PUTTING THAT.

OFTENTIMES WE WOULD HAVE INTERACTIONS THAT MAY BE WEREN'T WHAT WE REMEMBER OF MOM, WAS TO SAY THAT THAT WAS THE DISEASE.

AND NOT MOM.

SO I THINK DEGREE TO WHICH THAT IS POSSIBLE, IF THEY'RE BEING VERY PHYSICALLY, WE DIDN'T HAVE THAT SITUATION, I DO KNOW SOME FOLKS CAN HAVE FOLKS VERY PHYSICALLY DEMON DEMONSTRATIVE HOW AGITATE THE THEY ARE.

RYANING THAT I THINK MORE YOU CAN RECOGNIZING THAT.

MORE CAN YOU LEARN ABOUT THE DIFFERENT STAGES AND WHAT, THOSE PEOPLE ARE GOING THROUGH, SO WHEN THEY'RE AJ AGITATED WHAT ARE SO.

TRIGGERS THAT CAUSE THAT.

FOR US WE KNEW OUR MOM DIDN'T LIKE INCLUDE CLUTTER.

WE HAD CLEAN OUT THE CLOSET EVERY WEEK.

WE ALREADY MOVED THAT.

TAKE IT ALL OUT.

WE TOOK IT ALL OUT.

PUT IT ALL BACK IN THERE AGAIN.

BECAUSE IT MADE HER HAPPY.

IS I THINK IT'S GOING TO VARY DEPENDING ON THE SEVERITY OF IT.

SO I CAN'T SPEAK TO IT FROM THE MEDICAL PERSPECTIVE, BUT FOR US, IT WAS FREQUENTLY STOPPING P TO REMEMBER THAT IT WAS THE DISEASE.

AND NOT MOM.

THAT KIND OF HELPS BECAUSE IT'S HARD WHEN YOUR PA PARENT SOMETHING SOMETHING TO YOU NOT VERY PLEASANT IT'S HARD AND IT HURTS.

BECAUSE THIS IS THE MOM WHO LOVES YOU.

SAYING THINGS YOU KNOW THAT ARE HURTFUL TO YOU.

THE TO TRY TO NOT TRY REALLY HARD NOT TO LET THAT BE A PERSONAL AFFRONT TO YOU.

BUT TO RECOGNIZE THAT THAT IS THE DISEASE NOT THE PERSON.

ONE THING I WOULD SAY.

OTHERS MIGHT HAVE BETTER.

>>Yunji: CAN YOU BUILD ON THAT AND ALSO BRINGING IN WHAT DOCTOR WAS SHARING ABOUT THOSE MOMENTS OF LIGHT AND HOW YOU CRY TO TIETRY TO CREATE THOSE FR FAMILY.

PEOPLE VISIT CAN GO HAVE CONNECTION AND SEE LOVED ONCE AS THEY KNOW THEM?

>> APPRECIATE THIS QUESTION REALLY IMPORTANT.

I ALWAYS SAY IT'S MUCH HARD FOR FAMILY CAREGIVERS THAN IT IS FOR PROFESSIONAL CAREGIVERS.

LIKE OURSELVES.

WE DON'T HAVE ALL OF THOSE DECADES OF PERSONAL CONNECTIONS AND KNOWING OUR RESIDENTS AS FAMILY PETER MEL DID AND -- MEMBERS DID AND WHAT THEY WERE WERE AND NOW BEHAVIORS THEY'RE TRYING TO DEAL WITH.

BACK TO THE QUESTION ITSELF, GENERALLY, IS DIMENTIA WILL SAY BEHAVIORS FORM OF COMMUNICATION.

SOME SORT OF UNMET NEED THAT IS THEY'RE NOT ABLE TO VERBALIZE.

SO IT COULD BE HUNGER PAIN, FA SFATIGUE A LOT OF DIFFERENT THING THAT MAY RESULT IN SOMEBODY ACTING AGGRESSIVELY.

OR EVEN JUST BEING A LITTLE BIT AGITATED.

I DON'T LIKE THE CLOSET BEING MESSY.

AND IF WE'RE NOT KNOWING THAT EARLIER ON, FOR PROFESSIONAL CAREGIVERS, IF WE DON'T KNOW THAT ABOUT OUR PERSON EARLY ON, FROM THE FAMILY, IT'S A LITTLE BIT HARDER TO REALLY WORK WITH.

BUT FAMILY MEMBERS PAY A CRUCIAL ROLE TO TAKE OFF THE CAREGIVER HAT.

WHICH SO MANY ARE TRYING TO DO AND JUST PURELY WEAR THE HAT OF THEIR LOVED ONES.

AND KNOWING THAT PERSONAL HISTORY OF WHAT MOM OR DAD OR MY SPOUSE LIKED WHEN THEY WERE NOT LIVING THROUGH THIS DISEASE.

I ALSO THINK THAT'S THERE'S A WHOLE BODY I HAVE KNOWLEDGE OUT THERE IN TERMS OF BEST PRACTICES.

NONMEDICAL INTERVENTIONS AND EVEN SORT OF PREEMPTIVE THINGS THAT PEOPLE AT HOME AND IN FACILITIES SETTING CAN DO.

TO MINIMIZE AGGRESSIVE BEHAVIORS.

MINIMIZING FATIGUE FOR INSTANCE, OR KNOWING THE SIGNS OF WHEN SOMEBODY IS KIND OF BECOMING A LITTLE BIT TIRE AND MAYBE THEY SHOULD TAKE A BREAK OR OR MAYBE GETTING DEHYDRATED AND HAVEN'T HAD A SNACK IN A WHILE.

SO THERE'S SO MANY DIMENTIA CARE EXPERTS GENERALLY LIKE JERON ATOLL JEUS NOT MEDICAL PROVIDERS BUT RATHER, GERONTOLOGISTS PEOPLE WORK WITH SENIORS IN THE FIELD AND, I IMPLORE FAMILIES TO EVEN JUST DO A SIMPLE GOOGLE SEARCH OR ON YOUTUBE.

SO MANY GERONTOLOGISTS HAVE VIDEOS ABOUT HOW BEST TO ADDRESS SOMEBODY'S BEHAVIOR.

OR EVEN JUST SELLING UP SCHEDULE THROUGHOUT THE DAY OF WHAT IS IT THAT MOM AND DAD ARE GOING TO DO.

SOMETIMES AGGRESSIVE BEHAVIORS OR DIFFICULT BEHAVIORS ARE SIMPLY MATTER OF BOREDOM.

THAT PIE LOVED ONE IS JUST IN FRONT OF THE TV ALL DAY AND NOW, THEY'RE FEELING KIND OF UNSETTLED BECAUSE DON'T KNOW WHAT THEY'VE BEEN DOING.

AND FOR FAMILIES TO KIND OF FIGURE THAT OUT WITHOUT THE ASSISTANCE OF SOME EXPERTS CAN BE A CHALLENGE.

>>Yunji: I WANT TO GET TO YOU WITH THIS QUESTION.

>> CAN I ANSWER THAT?

>>Yunji: PLEASE.

>> WHAT WE DEAL, TEACHING CAREGIVERS TO DEAL WITH BEHAVIORS STUFF LIKE THAT, FIRST OF ALL, DON'T ARGUE WITH THEM.

AND DON'T REACT.

SECOND THING IS TRY TO THINK OF SOMETHING, GIVE THEM DISTRACT THEM.

TAKE THEM TO THE LANDRY ROOM AND GIVE THEM EYE TUB OF TOWELS TO FOLD FOR YOU.

GET THEIR MIND OFF WHAT THEY WERE DOING.

DISTRACTING, GREAT STORY WOMAN TAKING CARE OF HER MOM.

AND FOR THE LONGEST TIME, 4:00 EVERY AFTERNOON, MOM WOULD GO BERZERK.

I GOT TO GO HOME.

GOING TO GO HOME.

SHE WAS HOME.

IT FINALLY DAWNED ON THE DAUGHTER THAT HER MOM HAD BEEN A TEACHER FOR 34 YEARS AND 4:00 WAS QU QUITTING TIME.

TIME TO GO HOME.

BUT THE HER IN CAR 4:00.

DRIVING HER AROUND THE BLOCK, BRINGING HER HOME.

HAPPY AS A CLAM.

TRIGGERS THAT CAN CAUSE IT.

>>Yunji: BEING ATTUNED TO YOUR LOVED ONE.

OR THE PERSON IF YOU'RE ACCOUNT NOT RELATE TO PERSON, PERSON YOU'RE CARING FOR.

>> DON'T REACT.

>>Yunji: CALLER HER WANTS TO KNOW, GETTING ACCESS TO PHYSICIANS CAN TAKE A LONG TIME.

WHILE WAITING, WEBSITE, KNOWN NUMBER SPECIFIC ORGANIZATION TO GET STARTED.

CARE FOR YOUNG CHILD AND MORT MOTHER HOA HARD TO KNOW WHERE TO GO COMES TO HER CARE WE HAVE A RESOURCE ON OUR WEB WEB PAGE ALL THE ORGANIZATIONS REPRESENT THE TONIGHT.

PBS HAWAII.ORG.

SECOND PART OF HER QUESTION I FCOMPELLING DISISM GENERATION.

CARING FOR KID AND CARING FOR AGING PARENTS.

DISSANDWICH GENERATIONER.

>> ELDER A AFFAIRS DIVISION.

HAS WONDERFUL BOOKLET ABOUT THIS THICK BE HUNDREDS OF RESOURCES FOR CAREGIVERS AND I RECOMMEND YOU CALL THE ELDER AFFAIRS DIVISION AND ASK FOR THAT BOOK WILL HE.

WE ALL KNOW WHAT IT LOOKS LIKE.

AMAZING.

BOOKLET.

TALKS ABOUT HOME CARE.

TALK ABOUT TRANSPORTATION, TALKS ABOUT MEALS AND TALKS ABOUT ANYTHING YOU NEED.

>>Yunji: THANK YOU SO MUCH.

>> SANDWICH GENERATION BECOME QUITE PREVALENT IN THE COMMUNITY.

PLEASE F GO AHEAD.

>> AARP FOR CAREGIVERS, CAREGIVERS FACEBOOK GAME ROOM.

GROUP.

GET ON ASK EACH OTHER QUESTIONS SHARE THEIR IDEAS.

AND STRATEGIES THAT THEY USED FOR CAREGIVERS.

IS THERE ONE FOR ALZHEIMER'S.

>> >> WE DO.

WE ALSO HAVE A 24-7 HELP LINE.

THAT IS AVAILABLE.

TO ANYONE.

WHO NEEDS ASSISTANCE.

I'M NOT SURE IF ANYONE HERE ACCESS 24-7.

>> CRISIS HOTLINE.

LIKE THE CRISIS HOTLINE AND HAVE SOMEONE HERE IN HAWAII STAFFING THAT, STAFF FOR THE 24-7 HELP LINE.

THEY MAY GET STAFF FROM HAWAII.

>> WONDERFUL SUPPORT GROUPS TOO.

YOU CAN LEARN FROM FOLD FELLOW KAISERSECAREGIVERS.

WHAT WORKING FOR THEM.

WAITING FOR DOCTOR'S APPOINTMENT.

>>Yunji: CONNECTION BETWEEN MENTAL HEALTH DEPRESSION AND ANXIETY AND DEVELOPMENT OF ALZHEIMER'S?

HOW MUCH OF DIFFICULTIES WE HAVE EARLY IN LIFE CAN THEN BE REFLECTED IN THIS DISEASE?

>> I THINK THERE IS SOME LITERATURE OUT THERE LINKING EXISTENCE OF MENTAL HEALTH RISK FACTOR FOR FUTURE DIMENTIA.

NOT ONE OF THOSE STRONG CORAL PLAYED PAPER.

STRONG CORRELATED PAPER.

SOME OF THE, MENTAL HEALTH SUCH AS DEPRESSION, ANXIETY, CAN MANIFEST PSEUDO DIMENTIA.

LOOK LIKE DIMENTIA BUT UNDERGOING PROBLEM DEPRESSION.

MAY NOT BE DISIRMS.

ALZHEIMER'S.

DEPRESSION.

SYMPTOMS OF DIMENTIA CAN GET BETTER.

TREAT THE DEPRESSION.

>>Yunji: ANOTHER LOT OF CAREGIVERS WRYING IN TONIGHT.

EMPHASIZE ARE THE CAREGIVERS ON OUR PANEL.

WRITING IN TONIGHT.

START WITH YOU AND GO TO THE DOCTOR.

ASKS HOW ARE YOU MANAGING YOUR STRESS AND BURNOUT?

TALKED ABOUT THAT A LITTLE BIT BEFORE.

IF YOU CAN GO DEEPER ABOUT HOW YOU DO THAT BALANCE.

>> WELL, OTHER DAY I GOT A FACIAL.

WHICH WAS WONDERFUL.

GIRLFRIEND CALLED ME AND SAID, I BOOKED A FARIBA FACIAL FOUR.

FOUR.

DO I NEED IS NO NO.

YOU JUST NEED F FOR YOURSELF.

NEED TIME FOR YOURSELF.

WISH I EXERCISE MORE.

REALLY IMPORTANT.

SO THAT YOU DON'T GET BURNOUT.

I AGAIN, GO BAY BACK THAT TO COMMUNITY.

IF YOU HAVE STRONG COMMUNITY, PEOPLE THAT YOU CAN CALL ON OR LRELY ON TAKES BURDEN OFF OF YOU.

TREMENDOUSLY.

>>Yunji: GO TO THE DOCTOR.

HOW ARE YOU MANAGE STRESS AND BURNOUT?

>> ALREADY SMILING LAUGHING BECAUSE IT'S CONTINUOUS JOURNEY FOR ME.

I ASK OTHERS TO DO THIS.

AND SUPPORT GROUPS.

JENNIFER BROUGHT UP GOOD POINT COMMUNITYMENT OTHERS ABRUPT WHEN YOU DON'T HAVE.

I CAN SHARE ESPECIALLY WHEN I HOME CARE GIVING AND ALL OF US TOGETHER, WHILE IN ONE HOUSE, THERE'S MY MOTHER, PARTNER JOHN, NEPHEW, HOPIO, ALL OF US REALLY WANT TO TAKE CARE OF MY FATHER.

ALL OF US WORK AND NEPHEW WAS ALSO AUTISTIC.

I HAVE MY FATHER, NEPHEW, MOTHER AGE AND MY NEPHEW AUTISTIC IS ALSO CAREGIVING FOR HIS GRAND FATHER ALSO.

WE COVER IN S IN CAREGIVERS COMN SO MANY DIFFERENT WAYS.

HOW DO I TAKE CARE OF MYSELF?

FULLY OF US TAKE CARE OUR OURSE?

KEEPING IN IN CONTACT JOHN GOES TO SOFTBALL.

WAY MORE SOCIALIZED THAN I HAVE.

MOM GOES TO KUPUNA PROBLEMS PAPAKOLEA MANY OTHER PLACES.

MANY OF FOR US IN THE HOUSE, POINT I'M GETTING TO IS THAT WE DON'T GET TO REALLY HAVE A SOCIAL LIFE AND GO OUT.

JOHN AND I REALLY HARD TO HAVE A RELATIONSHIP.

WHEN YOU CARING FOR SOMEONE 24 24-7.

DATE NIGHTS ON THE ROOM OR PATIO.

FOR ME, I GREW UP GOING TO THE BEACH WITH MY FAMILY.

AND I CAN HAVEN'T BEEN TO THE BEACH IN A LONG TIME.

EVEN WHICH WAS LIVING A HOME.

SO WE GOT A BLOW UP POOL AND PUT IT ON THE BACK PATIO AND THAT BECAME THE BEACH.

TO GO SIT IN THE POOL AND SWIM AND THEN I COULD STILL SEE MY FATHER.

GET UP AND TAKE CARE OF HIM.

ANOTHER THING ABOUT CA CAREGIVIG THINKING OUT OF BOX AND BECOME INNOVATIVE UP WANT TO DO MY NAILS, TALK MY MOM TO THE SALON NO ONE TO WATCH MY FATHER?

I GOT TO BRING IT TO US.

HOW ARE WE GOING TO GO TO THE BEACH?

WATCH A MOVIE?

JOHN PUTTING UP SCREEN BACK PATIO SO WE CAN GO TO THE MOVIES.

SO MANY THINGS THAT WE HAVE TO THINK OF AND DO.

SO THOSE ARE THE LITTLE MOMENTS OF TAKING CARE OF OURSELVES.

GOING TO WATCH NETFLIX FOR FIVE MINUTES.

SOMETIMES CAREGIVERS, ONLY HAVE A FEW MINUTES.

I WOULD TELL CAREGIVERS, OR MY CAREGIVERS, TO PLEASE WRITE DOWN WHAT YOU CAN DO IN BLOCKS OF TIME.

FIVE MINUTES, 15 MINUTES.

HALF AN HOUR.

AND LOOK AT THAT LIST WHEN YOU HAVE THE TIME.

BECAUSE US CAREGIVERS, YOU GIVE US SOME TIME, WE HAVE NO IDEA WHAT TO DO WITH IT.

OUR TIME TRYING TO FIGURE OUT WHAT TO DO WITH IT'S TIME WE HAVE.

IF YOU HAVE A LIST READY AND KNOW WHAT CAN YOU DO FOR AN HOUR, WHOLE ENTIRE DAY, CANNOT BE RUNNING ERRANDS OR DOING CHORES, TAKE A LOOK AT THAT LIST AND DO IT RIGHT AWAY.

>>Yunji: THANK YOU SO MUCH.

I THINK THAT'S ACTUALLY GOOD REMINDER FOR ALL OF US BUSY AND SEEMS LIKE WE ALL ARE.

DR. FUJIKAMI CAN YOU ANSWER THIS ONE?

WE READ ABOUT DIFFERENT CASES SOMEONE WROTE IN.

OF SOMEONE WITH ALZHEIMER'S GETTING MEMORY BACK IN SMALL MOMENTS.

YOU MENTIONED MUSIC THERE.

SOMETHING THAT TRIGGERS IT, WHETHER IT'S FL NAME SMELL OR SONG.

HAVE YOU EXPERIENCED THIS, IS THERE SOMETHING THAT WORKS?

AND WHY IS THIS IMPORTANT TO KIND OF RETRIGGER THAT MEMORY?

,.

>> RIGHT.

GREAT QUESTION.

KIND OF LIKEN BRAIN TO SPACE.

SO MUCH THAT WE DON'T KNOW.

AMAZING ORGAN.

WE DO KNOW SHORT-TERM MEMORY PROGRESSES IN PATIENTS WITH DIMENTIA, REMOTE MEMORY STILL THERE.

MEMORIES OF CHILDHOOD, MEMORIES OF FAVORITE MUSIC GROUP.

MEMORIES OF WHEN THEY WERE WORKING.

WITH OTHER PEOPLE.

THAT IS STILL THERE.

AS A PERSON STILL THERE.

TRYING TO FIND WAYS TO TRIG THAT ARE MEMORY.

WHETHER IT'S PLAYING MUSIC FROM GENERATION, OLD PHOTOGRAPHS, THINGS LIKE THAT.

CAN SOMETIMES HELP TRIGGER SOME OF THE MORE BETTER MOMENTS OF THE MORE LUCID MOMENTS OF THIS DISEASE.

A LOT OF TIMES DON'T KNOW.

SOMEONE MENTIONED, JUST HAVE TO JUST KEEP AN EYE KEEP A GRASP ON GOOD DAYS.

GOOD DAYS AND BAD DAYS HOLD ONTO THE GOOD DAYS.

>>Yunji: AGING POPULATION GROWING PRETTY FAST TALKED ABOUT THROUGHOUT THE PROGRAM.

WHAT IS THE STATE DOING TO MAKE SURE THERE ARE ENOUGH TRAINED PROFESSIONALS, WE HEAR ABOUT THE DOCTOR SHORTAGE.

NURSING SHORTAGE.

CATHY COULD POTENTIALLY BE SHORTAGE OF BED IN THIS AREA.

NOR CAN BE DONE POLICY LEVEL TO MAKE SURE WE ENOUGH TRAIN PROFESSIONALS TO TAKE CARE OF OUR NED.

>> POPULATION ISEE GROWING.

NEED TO BUILD OUR WORKFORCE AND BUILD OUR CAPACITY.

COORDINATING COLIG OF STAKEHOLDERS ACROSS THE STATE WORKING TO IMPLEMENT STATE STRATEGIC PLANNED STRATEGIES THINGS LIKE WORKFORCE DEVELOPMENT, TRAINING WORKFORCE TO BUILD OUR DIMENTIA CAPACITY, A LOT OF TIMES WHEN HE I THINK GO THROUGH OUR TRAINING PROGRAM, DIMENTIA MAY BE SMALL PART OF OUR TRAINING.

WEWE'RE HOPING TOINCREASE THAT.

ASSOCIATION DOING A GREAT JOB LEADING ADVOCACY AND WEARY THINK WE NEED EVERYBODY ON BOARD.

EVERY LEVEL.

STATE LEVEL, PUBLIC/PRIVATE PARTNERSHIP, COMMUNITY LEVEL WITH COMMUNITY HEALTH CENTERS, EVEN IN OUR NEIGHBORHOODS AND FAMILIES.

GOING TO TAKE ALL OF US TO REALLY CARE FOR THIS POPULATION.

AS WE GROW.

>>Yunji: STATE LOOKS TO GROW PROGRAMS LIKE WHAT SHE'S TALKING ABOUT AND RESOURCES, WHAT COULD MAKE YOU THINK BIGGEST DIFFERENCE FOR RURAL COMMUNITIES SPECIFICALLY?

>> REALLY GOOD QUESTION.

CAPACITY BUILDING IS WHAT RESONATES WITH ME.

LOOKING AT NEEDS ARE.

A SELLING EVERY COMMUNITY IS DIFFERENT.

ASSESSING.

SO WHAT WE NEED ON THE BIG ISLAND, MIGHT BE DIFFERENT THAN WHAT THE NEEDS ARE ON MAUI.

NEEDS ASSESSMENTS COMMUNITY LEVEL.

ARE I THINK REALLY IMPORTANT.

AND GROWING OUR OWN IN THE HEALTH CARE FIELD CREATING PIPELINE, WHERE KIDS THAT ARE INTERESTED IN HE HEALTH CARE PROFESSIONS OR SERVICE PROFESSIONS OR SOCIAL HEALTH PROFESSIONS CAN GET EXPOSURE TO THE SERVICE WORK THAT WE DO.

AND NURTURING THAT IN OUR LOCAL KIDS, SO MANY OF US GO AWAY TO THE MAINLAND TO GET EDUCATION AND EXPERIENCE.

BUT WE REALLY NEED TO BE COMING BACK AND PROVIDING THE SERVICES IN THE COMMUNITY.

I THINK THAT IS PIPELINE IS REALLY IMPORTANT.

PROVIDING OPPORTUNITIES FOR EXPOSURE AND EDUCATION AND TRAINING HERE AT HOME.

SO WE CAN TAKE CARE OF OUR KUPUNA.

>>Yunji: KEALI'I, WOULD YOU LIKE TO ADD.

>> EXPAND.

STATE IS ACTUALLY IN THAT REGARD, I THINK DOING A REALLY GOOD JOB.

SO THE D.O.E.

UNIVERSITY OF HAWAII, CARE PROVIDERS HAVE GOTTEN TOGETHER AND LOOKED AT A APPROACH WHERE SOME OF HIGH SCHOOLS NOW HAVE ACADEMIES THAT PREPARE OUR YOUNG PEOPLE TO ACTUALLY GO IN THE HEALTH CARE PROFESSION.

SO THAT IS RELATIVELY NEW AND SO THAT PROGRAM I THINK IS JUST WONDERFUL WAY.

AND EVEN IF THEY DON'T TAKE THAT AS A CAREER READY TO TAKE CARE OF MOM AND DAD OR GRANDMA OR THEIR SPOUSE.

THERE'S THAT PROGRAM.

AND IT'S TIED INTO UNIVERSITY.

OTHER THING IS THAT HAWAII I THINK WAS THE FIRST STATE WITH GOVERNOR GREEN TO CREATE A HELP.

CALLED HELP.

AND IT'S LOAN PROGRAM FOR HEALTH CARE PEOPLE WHO WANT TGOINTO HEALTH CARE YOU'RE.

LOAN OR INTROPICAL DEPRESSION CAREER.

LOAN OR WORK IN RURAL COMMUNITY AND HAVE IT PAID OVER THAT WAY.

IN THAT SENSE HAWAII DOING WELL.

WE JUST NEED MORE PEOPLE TO WANT TO GET INTO THAT PROFESSION.

KNOWING SADLY THAT IF YOU GET INTO HEALTH CARE, PROFESSION.

YOU'RE GOING TO BE EMPLOYED FOR A REALLY LONG TIME.

SO A GOOD CAREER TO GET INTO.

IT'S JUST A BEAUTIFUL WAY TO HELP FAMILIES.

BE ABLE TO CARE FOR THEIR LOVED ONE.

I LOVE HE TALKED ABOUT BEAUTIFUL MONSTER HOME IT'S.

WE DIDN'T GET TO -- MOMENTS.

TWO SISTERS LIVE IN THE MAINLAND AND ONE IN HILO.

MY TWIN AND I WERE THE ONES HERE PRIMARILY CARING FOR OUR MOM.

OTHER TWO WERE JEALOUS.

THEY WOW, YOU POOR THING.

HAVING TO TAKE CARE OF MOM MUCH THEY'RE LIKE, GOSH YOU GET TO BE WITH HER ALL THE TIME.

THERE'S THAT.

BUT JUST WANTED TO ADD HAWAII DOING PRETTY GOOD.

I WANTED TO ADD.

IF ANYBODY ELSE MORE ON THAT.

>>Yunji: WHAT YOU THINK THAT WHAT IS THE SHORT TERM CAN BE DONE FROM POLICY LEVEL.

TALKED A LITTLE BIT ABOUT SUPPORTING CAREGIVERS THROUGH FAMILY LEAVE.

THAT'S SOMETHING THAT'S LEGISLATURE WILL BE DEBATING.

WE'LL DO WHOLE INSIGHTS ON THAT LOOK AT THE LAND CAPE LAND.

WHERE DO YOU THINK BEST CAN BE PUT TO HELP PEOPLE RIGHT NOW.

>> I THINK STATE HAS CONVENED STAKEHOLDERS TO REALLY COME UP WITH STRATEGIC PLAN TO BETTER GET A HANDLE ON THIS PUBLIC HEALTH CRISIS.

WE NEED TO HEAR MORE FROM CAREGIVERS.

SO CAREGIVERS NEED TO CALL ON US AND OTHER STAKEHOLDERS SO WE KNOW WE HAVE THE DATA THAT WOULD SUPPORT BETTER POLICIES.

BECAUSE EVERY COMMUNITY LIKE DR. HANES MENTIONED IS DIFFERENT.

WHAT MAY WORK FOR OAHU MAY NOT WORK FOR HAWAII ISLAND OR MAUI OR KAUAI.

ENCOURAGING CAREGIVERS TO SHARE THEIR EXPERIENCES AND CHALLENGES WITH US, A AND OTHER STAKEHOLDERS, LIKE AARP, SO WE CAN MAKE BETTER POLICY DECISIONS FOR AT LEAST SUPPORT POLICIES THAT OUR LEGISLATORS CAN TAKE A LOOK AT.

I THINK JUST TO ADD, FORTUNATE TO HAVE TAWNY WHO IS LEADING THIS FRONT FOR THE STATE.

AND IT'S JUST BEEN A PLEASURE WORKING WITH YOU.

>> LIKEWISE.

>> I WANT TO GO FROM POLICY TO THE PERSONAL.

DIET, EXERCISE, BRAIN TEASERS.

ALL OF THOSE ASPECTS.

ONE OF THE THINGS WHEN I WAS EXPLORING BHARI WE CAN SITE WAS ARCHITECTURE.

ENVIRONMENT.

HOW CAN THE ENVIRONMENT INFLUENCE OR DELAY THE ON ONSET OF ALZHEIMER'S.

>> WE KNOW SOMEONE WITH SEVERE DIMENTIA.

AGITATED JUST COMBATIVE.

WENT TO MONDAY MONESTARY.

CAME BACK, CALM, LUCID, FOCUSED ABLE TO CALM HOME.

ENVIRONMENT, WAY WE LIVE REALLY MATTERS.

EVERYTHING FROM THE COLOR.

HOW MUCH NATURAL LIGHT EXPOSURE, HOW MUCH GREEN BY OWE FILLIA, TREES SO ON.

ALSO, BACKGROUND SOUND AND ABILITY FOR US TO HAVE A RESTING STATE.

WHEN I SAY RESTING STATE, STATE WHERE WE'RE NOT DISTRACT.

CAN BE IN A ZEN MODE.

SO ALL OF THOSE THINGS ARE CREATED WHEN WE ACTUALLY HAVE THE RIGHT ENVIRONMENT.

I DO THINK THAT YOU WE NEED TO PUT MORE THOUGHTFUL PLANNING FOR HOW WE DESIGN OUR HOUSE AND THE RESIDENTIAL UNIT EVEN CITY PLANNING.

PERHAPS FUTURE SENIOR LIVING FACILITY.

WE NEED TO CREATE DESIGN BASED ON BRAIN HE HEALTH.

HEEASIER FOR PEOPLE TO DO HEALTHY LIFESTYLE HABIT AND ELIMINATE TRIGGERS THAT CAN AGITATE PINE PEOPLE WITH DISIRM.

>>Yunji: REALLY IS THE PEOPLE WITH DIMENTIA.

>>Yunji: HEARING WHOLE PERSON.

NATURAL ENVIRONMENT, ER IS EXER, DIET.

STIMULATION.

ALL FACTORS IN TELL US DIFFERENCE YOU SEE WHEN I LOOK AT A PATIENT FOLLOWING THAT KIND OF MODEL AND PATIENT CANNOT.

WHAT KIND OF OUTCOME AN QUALITY OF LIFE YOU SEE.

>> HIT THE NAIL ON THE HEAD.

QUALITY OF LIFE.

ENTAILS ALL OF THAT COMMUNITY, NO STRESS, LESS STRESS, GOOD NUTRITION, SAFE HOUSING.

LESS WORRIES.

REALLY ENCOMPASSES ALL.

THAT AND I THINK AGAIN, EVERY INDIVIDUAL IS DIFFERENT.

SUFFERS FROM THIS DISEASE.

MEAMENTAL HEALTH GOOD QUALITY OF LIFE.

GOOD SLEEP, REALLY, DOES HELP.

I THINK WITH THE BEHAVIORS THAT CAN HAPPEN, FROM THIS DISEASE, AND I THINK ALSO, YEAH, I AGREE.

HELPS SLOW THE PROGRESSION DOWN.

THERE IS DEFINITELY I DO SEE A DIFFERENCE WITH MY PATIENTS.

>> ONE MORE THING ABOUT ENVIRONMENT.

SOCIAL ENVIRONMENT.

A LOT OF SENIORS SUFFER FROM LONELINESS.

AND IF I'M PARTICULARLY SOCIAL PERSON PRIOR TO THE ONSET OF THIS DISEASE, I'M AT HOME, MAYBE WITH ONE SINGLE CAREGIVER, VERY SOLITARY, IT MIGHT BE VERY TORTUROUS TO ME.

WHEREAS, IF I'M MORE INTROVERTED, SUDDENLY GOING TO SETTING WHERE THERE'S A LOT OF FAMILY MEMBERS WHO ARE THERE MIGHT BE KIND OF TRIGGERING FOR ME.

LOOKING AT WHAT THE SOCIAL ENVIRONMENT IS FOR THE PERSON LIVING WITH DIMENTIA AND WHAT WOULD BE CATER TO THEIR NEEDS, IS SO IMPORTANT.

IN MY CARE HOME, I SEE PEOPLE ALMOST SPRING BACK.

RECENTLY HAD A GENTLEMAN SAID, OH, MY DAD IS JUST KIND OF VERY QUIET AND JUST GOING TO STAY IN HIS ROOM.

WHEN HE MOVED N SUDDENLY STARTED DOING ALL GAMES AND ACTIVITIES AND SINGING.

WHAT HAPPENED?

IT'S SO IMPORTANT TO KIND OF LOOK AT LEVEL OF INTERACTION THAT THE PERSON LIVING WITH ESTIDIMENTIA HAS OR WOULD MATCH THEM WELL AND NOT BE A TRIGGER BAD WAY.

OR BE ER ENCOURAGING THEM OR ENABLING THEM TO BE AT EASE FLOW STATE.

>>Yunji: BACK ABOUT THE COOK CLASS.

BUILD COMMUNITIES IN A WAYS THAT ARE EXCITING AND CREATIVE.

ALSO, CHALLENGE OF PLACE LIKE HAWAII ISLAND.

OR SOME SOME OTHER RURAL COMMUNITIES DRIVES ARE LONG AND DISTANCES MAKE SOME OF THAT PRETTY DIFFICULT.

ARE THERE ENOUGH RESOURCE SO PEOPLE CAN PARTICIPATE IN THE KIND OF ACTIVITIES TODD IS TALKING ABOUT?

>> I THINK DURING COVID, MENTION COVID, WE SAW THE RESOURCES IN OUR COMMUNITY REALLY DWINDLE.

ON HAWAII ISLAND.

I THINK BETWEEN EAST AND WEST HAWAII, DIFFERENCE AVAILABILITY AND PROXIMITY.

JUST FOR SOCIAL ACTIVITIES AND COMMUNITY ENGAGEMENT.

AND SO I DO THINK THAT WE HAVE A WAYS TO GO IN CERTAIN AREAS.

IN HAWAII ISLAND.

AND EVEN IN HAWAII COUNTY, POCKETS THAT ARE VERY, VERY RURAL AND TO ACKNOWLEDGE OF EFFORTS THAT FAMILIES AND CAREGIVERS HAVE TO GO THROUGH TO ACCESS RESOURCES, BUT ALSO, ACCESS OPPORTUNITIES FOR HEALTH AN WELLNESS AND QUALITY OF LIFE.

IS SIGNIFICANT IN CERTAIN PARTS OF WHERE WE LIVE.

BUT ANOTHER THING I WANTED TO MENTION IN TALKING ABOUT THINGS THAT WORK, IS MY HUSBAND IS GOING TO PROBABLY SHAKE HIS HEAD AT HOME, BUT ANIMALS.

THAT'S ONE THING THAT I TALK WITH.

MY PATIENTS ABOUT.

A LOT.

IS IF THE SOCIALIZATION AND ACCESS TO SOCIALIZATION DIFFICULT, A LOT OF FURRY FAMILY OUT THERE THAT NEEDS SOMEBODY TO LOVE ON THEM AND THAT UNCONDITIONAL RECIPROCATION IS REALLY POWERFUL FOR PEOPLE.

AND SO YOU'LL SEE A LOT OF OUR COMMUNITY LIKE GOING OUT AND TAKING CARE OF THE KITTY IT'S IN THE COMMUNITY.

OR GOING TO THE HUMANE SOCIETY AN SPENDING TIME WITH ANIMALS THERE.

THAT CAN BE VERY POWERFUL HEALING SOURCE OF HEALING FOR PEOPLE.

WANTED TO MENTION THAT AS WELL.

>>Yunji: THAT'S A WONDERFUL THING TO THINK ABOUT.

I LOVE THAT.

WE ONLY HAVE A FEW MINUTES LEFT.

I WANT TO MAKE SURE WE HEAR FROM OUR CAREGIVERS TONIGHT.

GO FIRST.

FINAL MESSAGE YOU WOULD HAVE FOR FOLKS.

YOU AND JENNIFER ARE KIND OF ON DIFFERENT SIDES, DIFFERENT ENDS OF SPECTRUM ON THIS.

JENNIFER IS JUST STARTING OUT AND YOU HAD MENTIONED THAT YOUR FATHER ADVANCED STAGE.

WHAT IS YOUR MESSAGE TO FOLKS WATCHING TONIGHT WHO ARE JUST STARTING OUT ON THIS JOURNEY OR MAYBE AT THE SAME PLACE THAT YOU ARE?

>> CAREGIVERS WOULD BE, EVERYTHING YOU'RE HEARING TONIGHT.

THAT THERE IS RESOURCES, THERE IS COMMUNITY, PLACE TO GO, A PLACE TO DON'T FEEL STUCK.

DON'T FEEL LIKE YOU'RE ALONE.

THAT WE ARE ALL HERE.

PROVIDERS, CARE TEAM, THEY'RE WITH YOU FOR THE ENTIRE JOURNEY.

AS ALZHEIMER'S ASSOCIATION, AARP, WE ARE CATHY ALL OF US ARE HERE TO BE WITH YOU.

ALONG THE ENTIRE JOURNEY.

END WITH FOR CAREGIVERS, AS YOU'RE GOING THROUGH THIS JOURNEY WITH YOUR LOVED ONE, PLEASE PAY ATTENTION IT THE EMOTIONAL TRUTH.

A LOT OF TIMES, WHAT THEY'RE FEELING PERSON LIVING WITH THE DISEASE, COMING OUT IN OTHER WAYS.

SO WHAT THEY'RE SAYING, MAY NOT ALWAYS BE WHAT THEY'RE MEANING OR WHAT THEY NEED.

SO TRY TO PAY ATTENTION TO THAT.

EMOTIONAL TRUTH AND UNDER TONE.

CAREGIVERS WE GET ISOLATED TOO.

WORLD SHRINKS.

CAN'T GO OUT BE WITH OUR FRIEND.

DO SELF-CARE.

TAKE CARE OF YOURSELF.

MY MOTHER MAKES HOME HOMEMADE G. ONE DAY WEEK PLAY GAMES.

ENJOY THE TIME YOU HAVE LEFT, LIVE, LAUGH, CRY, REACH OUT TO AANY OF US.

WE'RE ALL HERE FOR US.

>>Yunji: BEAUTIFUL MESSAGE.

LAST WORD TONIGHT JENNIFER.

>> OH, BOY.

I WOULD SAY FOR ME, IT WOULD BE MY MESSAGE TO OTHER CAREGIVERS WOULD BE THAT YOU ARE THE AMBASSADORS AND ADVOCATE FOR YOUR FAMILY MEMBER WHOEVER YOU'RE CAREGIVING FOR.

DO YOUR RESEARCH.

AND TAKE THE TIME TO LEARN ABOUT WHAT RESOURCES ARE OUT THERE.

BECAUSE AS YOU SEE HERE, SO MANY EXPERTS THAT LIVE RIGHT HERE IN HAWAII.

THAT WE HAVE ACCESS TO.

SO TAKE ADVANTAGE OF THAT.

AND BUILD YOUR COMMUNITY.

>>Yunji: I KNOW WHEN YOU MENTIONED YOUR FRIEND, CALLED YOU UP TO ASK YOU GO OUT AND HAVE A SPOTLI SPA DAY REMINDER E YOU'RE NOT A CAREGIVER, YOURSELF, BUT CERTAINLY WE ALL KNOW ONE.

WHAT KIND OF DIFFERENCE DOES THAT MAKE WHEN ONE IS CAREGIVING FOR THE CAREGIVER?

>> EXACTLY.

MEANS SO MUCH.

AND I THINK THAT THEY DON'T HAVE TO -- LITTLE THINGS.

LIKE I CAN TEXT LJ AND SAY, I'M HAVING A BAD DAY.

YOU GOT THIS.

YOU CAN DO IT.

AND JUST LITTLE THINGS OFTEN COLONELMENT LIKE THAT.

OFOFOF ENCOURAGEMENT MAKE A HUGE DIFFERENCE.

>>Yunji: MAHALO TO ALL OF OUR GUESTS BEING PART OF TOWN HALL.

LIST OF RESOURCE ON OUR WEBSITE AT PBS HAWAII.ORG.

AND WE ENCOURAGE YOU TO GO AND VISIT THAT WEBSITE.

WE'LL BE BACK IN FEBRUARY WITH ANOTHER KAKOU EXPLORING SPORTS CONCUSSION THOUGHT TO BE CON CONTACT SPORTS GROWING CONCERN FOR PEOPLE ALL AGES ALL ATHLETES, TO VETERANS.

IMPACT CAN LAST FAR BEYOND FIELD.

DANGERS OF BRAIN INJURIES AND WHAT CAN HE DO PROTECT OUR CHARACTERS KUPUNA AND EVERYONE IN -- KEIKI, KUPUNA AND EVERYONE IN KA PIKI OHANA.

I'M LACY DENIZ TAKE CARE OF YOURSELF.

GOOD NIGHT AND ALOHA.