Paved paradise

“Don't it always seem to go
That you don't know what you've got
Till it's gone
They paved paradise
And put up a parking lot”

--Joni Mitchell, “Big Yellow Taxi” (1970) 

Joni Mitchell was inspired to write those lyrics during her first visit to Hawaii, a two-day trip in 1969.   

My parents have been aging in place, in Hawaii’s paved paradise, in one of the oldest neighborhoods undergoing transformation with higher density monster homes and crowded parking, replacing more traditional single-family dwellings with tropical fruit (mango, papaya, noni, breadfruit, etc.) and nut (kukui, macadamia) trees. 

Due to COVID-19 pandemic, I had not seen my parents in-person since my wikiwiki visit last year in January. When Hawaii Safe Travels Program was revised last month to allow vaccinated (yours truly) to skip COVID-19 test/10-day quarantine, and Hawaiian Airlines offered $250 SFO-HNL roundtrip airfare deal, I was ready to go!  

As my departure drew closer, reports from Hawaii Department of Health (DOH) about skyrocketing COVID-19 cases, hospitalizations and deaths had me considering whether to postpone my trip scheduled this month. Hawaii officials blamed community transmission and residents traveling back from Las Vegas (aka 9^th island, which had COVID-19 positivity rate of 14% last month). Hawaii DOH Director Libby Char warned, “This is a horrible time to travel. Stay home unless you have to travel. You don’t know that the person on the plane sitting next to you doesn’t have this.” 

Earlier this month as San Francisco experienced surge of COVID-19 cases and hospitalizations, SF Department of Public Health Director Grant Colfax projected peak numbers if behaviors remain constant (i.e., no changes to vaccine uptakes and interactions). 

Projected peak numbers did not materialize, thanks to SF public health policies leading to behavioral changes via reinstated indoor mask mandates, as well as vaccine mandates among all city employees, health care workers, plus patrons of bars, restaurants and other indoor establishments. 

“We certainly can try to teach critical thinking but you’re fighting a societal trend. It’s like giving educators too much credit… there’s an educational process in an informal way, it’s people talking to one another, and having institutions that encourage certain behaviors… teach you that you are part of something larger, and that’s a much more important way to change the process of thinking…”—University of Hawaii Professor Emeritus of Political Science Neal Milner, “Lying and Disinformation in America,” Think Tech Hawaii (July 1, 2021)    

Yes, we are part of something larger than ourselves! When I hear people objecting to mask and vaccine mandates (SF provides exemptions based on religious belief and qualifying medical reasons) as a violation of individual civil liberties, my (utilitarian) critical thinking leads me to validate legitimacy of mandates as harm reduction if they further collective civil liberties by protecting the greatest number and most vulnerable (older adults, people with disabilities, especially immunocompromised, essential workers exposed to public, children under age 12 who aren’t eligible for vaccine, etc.). Of course, belief in vaccine protection may be influenced by “inequality-driven mistrust” related to inability to access and evaluate (critical thinking!) trusted sources of information. Wisdom and fear contributed to 90% vaccination rate among older adults in USA!  

This COVID-19 pandemic is projected to continue another year or longer, and I’ve come to view it like the volatile stock market (given unpredictable human behavior) so it’s about risk tolerance. Living is full of risks, so my parents and I decided that investing in psychosocial benefits of a reunion after more than 18 months of physical separation (missed Mum’s home cooking!) outweighed COVID-19 risks, which we’ve mitigated by getting fully vaccinated (mahalo to Queen’s Geriatrics staff who personally delivered vaccines to my parents at home!) and practicing routines like wearing mask when around other people, seeking physical distancing and ventilation when possible, washing hands before touching face, etc.

At SFO Hawaiian Airlines gate, I presented my Safe Travels QR code for orange wristband that allowed me to quickly exit HNL. Boarded nearly full flight, grateful for aisle seat and kept mask on, except to take quick bites and sips (complimentary panini and drink served inflight). SFO is noted to have “some of the most well-behaved travelers” because its vendors do not sell alcohol to-go; Hawaiian Air suspended in-flight alcohol sales so spared unruly behavior by drunk (cognitively impaired) passengers.

Honolulu Star-Advertiser shouted headline (in capital letters): “IGE URGES TOURISTS TO STAY AWAY.” Gov. David Ige seemed to echo Dr. Char when he discouraged travel, at least through October (coinciding with shoulder season): “Now’s not a good time to visit Hawaii…I’m asking all residents and visitors alike to restrict travel, curtail travel, to Hawaii to essential activities only.” Wow, is Haunani-Kay Trask (died from Alzheimer’s last month) smiling from her grave?! 

According to Hawaii’s COVID-19 Data dashboard, majority of COVID-19 cases are “community-associated” (i.e., “most likely infected within the community”); and “travel-associated” (i.e., “most likely infected outside of Hawaii or by having close contact with a confirmed case who had recently traveled”) cases are mostly from residents rather than non-residents. (Perhaps more cases might be from non-residents who shed virus during short-term visits and only test for COVID-19 to be “confirmed case” after they return home?) 

Critical thinking practice: If community spread is the root of surge in coronavirus infections, why not target interventions to mitigate community transmission rather than travel? Restricting travel/limiting number of tourists would harm Hawaii’s economy, which already ranks worst in the nation, and worsen job opportunities for residents who have relied on COVID-19 safety net (expired federal eviction moratorium, expiring federal unemployment aid).

“Hawaiʻi may look like paradise, but it isn’t always for the people who live here.”—Michelle Broder Van Dyke, “Seven months of solitude,” Slate (Oct. 23, 2020) 

COVID-19 pandemic has exposed inequities, including divide between Hawaii residents and visitors/tourists. When Hawaii limited tourism for seven months (by imposing 14-day quarantine) last year due to COVID-19, all was not lost to residents who felt “like going back in time” (pre-jet era) to enjoy more of aina (the land) and healing of nature (perhaps undo climate change damage) without crowds of tourists.

This tranquility was lost as Hawaii reopened for tourism. Perhaps social skills worsened after months of isolation because Hawaii has been run to the ground by disrespectful travelers behaving badly, like disturbing endangered Hawaiian monk seals, and by elitist Bobos in Paradise, like 60-year-old former resident/retired U.S. President who is paving paradise for extravagant beach mansion and controversial renovation of century-old seawall on Waimanalo Bay. 

When “overtourism” created water shortage in Maui, residents were expected to make sacrifices (subject to fines for “non-essential” water use) while water was diverted for tourists staying in resorts that were allowed to fill their pools; why are there pools when beaches are nearby?

“Locals and kanaka maoli are being told to stop gathering, our keiki sports are canceled, while luaus for hundreds of unmasked visitors are taking place every night.  Nothing is sacred with the tourist industry and Hawaii has become a playground for visitors.” –Healani Sonoda-Pale, “Several Native Hawaiian organizations ask leaders to stop prioritizing tourism,” KHON2 News (Aug. 8, 2021) 

Residents, mostly Native Hawaiians (Kanaka Maoli), pushed back, demanding that leaders give consideration to aloha spirit: stop prioritizing tourists over residents, educate tourists to respect aina.

Last December, Hawaii’s Movers and Shakas program launched to seek “brain gain” (reversal of brain drain) by offering remote workers free roundtrip airfare + discounted Waikiki hotel rates + “connect with aloha” (cultural orientation + volunteer 15 hours) for at least one month on Oahu. This visitor control program motivated 90,000 people to apply (no fee, low-barrier) for 50 slots!  

No worries about demand for tourism in Hawaii, which can afford to do better to protect its natural and cultural resources (similar to travel standards set in Bhutan and Galapagos Islands) to promote livable communities. This latest pause on tourism could be an opportunity to reimagine Hawaii’s future beyond economic growth by using Social Progress Index to provide people “with the things they really care about. Are people healthy and safe? Do they have clean water and a roof over their heads? Can they freely access information? Are their rights protected?” 

Lucky you (seniors) live Hawaii, continued … 

Hawaii is ruled by gerontocracy (and Democratic elite who maintain their status quo): David Ige, aka nation’s “least popular” Governor, is age 64 and will be termed out next year; his predecessor Neil Abercrombie, now age 83. At age 65, Vicky Tiu Liu Cayetano (famous for being child star in Elvis Presley film, laundry business operator, former Republican and former First Lady who championed CarePlus long-term care proposal when her hubby Ben was Gov.) decided to run for Governor out of “desire to do more for the community.”  Honolulu Mayor Rick Blangiardi is age 74; his predecessor Kirk Caldwell, now age 69, intends to run for Governor.

Yet, kupuna politicians do not appear any wiser when trying to diversify Hawaii’s economy or accommodate more “sustainable tourism,” facing similar challenges by many Small Island Developing States (SIDS), due to small population size, low capacity, remoteness, narrow resource and export base, high dependence on imported sources of energy, vulnerability to climate change, exposure to natural disasters, historical trauma from colonization, etc.

Runaway tourism has ruined the quality of life for many residents, prompting kupuna to “run away and go live in Las Vegas” after retiring from Hawaii government job. Kupuna give up Hawaii’s humid weather (natural skin moisturizer!) and Pacific Ocean for retirement lifestyle in Las Vegas’ arid desert that offers more affordable housing, lower cost of living, Trader Joe’s, legalized gambling, no state income tax, no tax on retirement income, low property taxes, etc.

Honolulu Star-Advertiser’s Live Well section provided good coverage of healthy aging, though many articles were at least a month old (e.g., Living apart together published last month, and Seniors may need rehab originally published in May).  

Advertiser also had article about shortage of physicians participating in Hawaii’s medical aid-in dying (MAID), and later today I wondered whether this had any bearing on “elderly couple” who died of gunshot wounds at The Plaza Assisted Living in Waikiki, which police are investigating as murder-suicide or two suicides, because lethal prescription under MAID is less violent option but harder to access than firearms.

Guess how old?

In the eyes of the beholder, “young” and “old” are “really” relative terms: in SF Chinatown, 24-year-old Good Samaritan described his “bear-hugging” bystander intervention when "there was this really young guy beating up this really old man.” Turns out “really young guy” was age 44 and “really old man” was age 56!!! 

“Hawai’i seniors look young, so be sure to ask for these discounts before ordering or being served.”—Generations 808 Senior Savings 

Last month, Gov. Ige signed law lowering age from 62 to 60 to apply enhanced penalties for crimes against “our most vulnerable” kupuna, by perpetrators who “reasonably should know” that their victims are age 60+.  

Disturbing video went viral of a 37-year-old man knocking over a woman (race not identified) who falls on her head in Honolulu; woman’s age estimated “80 years old” in Honolulu Star-Advertiser and “appeared to be in her mid-70s to 80s,” in Hawaii News Now. 

“Introverts will inherit the earth”

“10. The introverts will inherit the earth. The virus that has killed 626,000 people in the U.S. and 563 people in Hawaii (as of Saturday) relies on person-to-person transmission. Some people simply cannot stand to be alone. They must venture out to gatherings no matter the cost. They are drawn to coughing, Covid-covered crowds like a moth to the flame, can’t be trusted to work from home, must be part of a herd to feel safe. Those who are happy with solitude greatly reduce their potential for exposure.”—Lee Cataluna, “10 Lessons We Should Have Learned From The Pandemic,” CivilBeat (Aug. 22, 2021) 

Something new every day with record-breaking COVID-19 cases (reported in Local Business section of Star-Advertiser): By mid-August, Hawaii’s COVID-19 cases reached four-digits for the first time (1,167 on Aug. 13, which included backlogged cases; 1,035 on Aug. 27, not including backlog). Hawaii reported over 10,800 COVID-19 cases in last two weeks!

“With the future so unknown…

I’ve just got to stay at home…

Suck it up, stuck at home…

Tour the paths around my home

I’ll just watch travel shows –

Eat exotic takeaways

Wear all my ‘ethnic’ clothes…

Watch a subtitled film

Close my eyes, pretend I’m there…

I’ve got travelling syndrome

But for now, cannot roam

Covid-19, be gone!”

--Shirley Serban, “Stay Away” parody song of COVID travel restrictions, tune of “Orinoco Flow (Sail Away)” (Jul 17, 2020) 

With Delta variant surge and restrictions on gatherings, in-person events were canceled/postponed (e.g., Aging in Place Workshop/National Senior Citizens Day, Made in Hawaii Festival/Statehood Day). My to-do list would have included joining DeTours for more enlightened visit, but decided to “stay home” with my parents. Later I could indulge in armchair travel, Detours: A Decolonial Guide to Hawai'i (2019). 

As homebody choosing “local,” I was careful about maintaining physical distance from my parents (though challenging to hold conversation with Pop who is hard of hearing), doing “essential work” (family business operations with Mum), hanging out in our patio, venturing alone in “best walkable neighborhood” by foot… 

In time for this month’s 12^th Annual Pedestrian Safety Month, U.S. Senator Brian Schatz introduced The Vulnerable Road Users Safety Act. Much welcomed as Hawaii is notorious for being nation’s deadliest for senior pedestrians, and the popularity of large vehicles in Hawaii poses safety risk to “vulnerable road users.” 

Age-friendly small town

“Since statehood, Senate District 10 residents have been among the oldest in the islands, and thus, my top district priority is long-term care for senior citizens.”—Hawaii District 10 (includes Kaimuki) State Senator Les Ihara, age 71 

Red dirt in Kaimuki construction site. NIMBY residents have protested and called cops to halt construction of monster homes built to maximum density. 

Newer monster homes dominate this block. (No street parking here due to TheBus line; last month, TheBus discontinued paper passes/transfers in favor of convenient smart transit card, Holo—functions like SF Bay Area’s ClipperCard.) Developers of monster homes argue they are filling need for affordable and multigenerational living, and perhaps rental units. 

While I favor multigenerational living (especially if this enables more kupuna to age in place), why construct eyesore monster homes that look like motels with window air conditioners (worse than three-family Richmond Specials in SF)?  

Kaimuki is desirable 8-80 model: people-centered with emphasis on sustainable mobility, parks and public spaces that try to work for all ages (“whether age 8 or 80”). My grandparents (who didn’t drive) and I (before getting my driver’s license at age 16) could walk or hop on The Bus to easily access whatever we needed.  Kaimuki was rich with after-school activities for latch-key kids, ranging from team sports (which I avoided, though I competed in Math League during high school) to the public library (which Tiger Mum encouraged and I loved to read magazines).

The real estate adage, “location, location, location” has coupled Kaimuki's stable community of residents who desire to age in place + monster home development. In 2015, Kaimuki was subject of age-friendly study by University of Hawaii at Manoa’s College of Tropical Agriculture & Human Resources Cooperative Extension Service in the Department of Family & Consumer Sciences (chaired by gerontologist Bobbie Yee, who lives near Kaimuki...and classmate of my Aunt Char who married Bobbie's cousin). 

Always eager to support local food, strolled over to Kapiolani Community College (KCC) Farmers’ Market on Saturday morning: at entrance, table with optional sign-in for contact tracing and hand sanitizer dispenser. This popular outdoor market sells all-local produce and prepared foods, attracting lots of tourists. After my visit, KCC decided to temporarily close its Farmers Market over next four Saturdays due to COVID-19 surge.

Similar to Samoan palusami and Hawaiian laulau, these luau bombs made of taro leaves stuffed with generous fillings (choice of beef, pork, mahi mahi, or vegan taro + sweet potato) were ono-licious!

At right, Hawaii 5-0 cop eyeing Luau Bombs booth.

Wanted: Tree huggers, grassroots advocacy

After KCC Farmers Market, planned to volunteer with Trees for Kaimuki at nearby Diamond Head trail (Leahi Peace Garden and Fort Ruger Path) but 9 am event canceled due to COVID-19 spike. 

In my small kid time, I understood the value of trees in facilitating connections between neighbors – literally, tree branches bearing fruits and nuts crossed over to one another’s property, so raking leaves and exchanging of fruits led to sharing recipes and small talk. Permaculture principle of edge effect to increase diversity! My ohana (extended family) would enjoy macadamia nuts (from makai side neighbor) and starfruit (from mauka side neighbor). Mauka neighbor enjoyed mangoes from our tree, so no complaints about raking leaves! Gung-Gung also cultivated trees growing papayas, tangerines, bananas, chili peppers, etc. in abundance to gift to neighbors.

At Kaimuki Neighborhood Board Zoom meeting, Trees for Kaimuki supporter Becky Gardner introduced “RESOLUTION URGING THE CITY & COUNTY OF HONOLULU TO ADOPT AND IMPLEMENT A TREE ORDINANCE TO PROTECT AND PRESERVE TREES THAT MAKE OUR COMMUNITY MORE LIVABLE; MITIGATE THE PROLIFERATION OF MONSTER HOMES; AND ENHANCE OUR ENVIRONMENT - IN THE FACE OF CLIMATE CHANGE.” 

"Trees make Kaimuki home": Kaimuki faces threat of becoming a heat island, as more monster homes are built with heat-trapping concrete replacing trees and green spaces. According to Trees for Kaimuki, the tree canopy in Honolulu is 22%, Kaimuki is 17%, and goal is to increase/double Kaimuki’s tree canopy to 35% by 2035 under plan by City and County of Honolulu! Yay, more shade to cool the neighborhood and protect older adults who are more prone to heat stress (more than 80% of heat-related deaths are people age 60+).  

They took all the trees
Put 'em in a tree museum
And they charged the people
A dollar and a half just to see 'em

--Joni Mitchell, “Big Yellow Taxi” (1970)

Eclectic “vintage charm”

Wore mask for COVID/sunburn protection and limited exposure to indoor air-conditioning during quick trips for shopping and take-out food, revisiting pastime of eating along Waialae Avenue in Kaimuki Town!

Mural of aloha print designs and “Keep it Kaimuki” movement to maintain its “vintage charm” of mom + pop, locally owned independent businesses (including Civil Beat, non-profit and independent news outlet dedicated to watchdog journalism). Kaimuki has few fast food chains, and supermarket and drug store chains anchor Kaimuki Shopping Center (open-air, unlike air-conditioned Kahala Mall, which “postponed” its senior walks during pandemic).

Favorite vegan restaurant Juicy Brew with food prepared by Hee sisters. Connected to Chef Jennifer Hee’s nourishing food and her essay (“Paternal instinct: How can two people so closely related have such different outlooks on life?”) about negotiating expectations of her Asian Parent. 

Juicy Brew’s ready-to-eat bento so colorful and artful! Though not marketed as such, noted that age-friendly menu offers edibles for people who might have chewing difficulties due to missing teeth or dentures. Also, vegan diets benefit older adults, though need to be careful to consume enough calcium, protein, and vitamin B12. 

Mum could not understand spending $6 for purple rice yogurt (calcium-rich; purple forbidden rice chewy like boba but less sugary), like why can’t you DIY: boil rice at home and then drop cooked rice into yogurt blended with red jujube (Chinese date)?

Notably newer to Kaimuki were colorfully painted public parklets and utility boxes. Jennifer Noel’s ARTBOX Kaimuki and streetARThawaii won 2018 Awesome Foundation grants to paint utility boxes on Harding and Waialae Avenues in Kaimuki.

Historic renovation plan for 85+ year-old Queen Theater, vacant blight for at least the past 20 years. Nearby old businesses include hole-in-the-wall, made-to-order bento takeout (cash only, no website) and well-preserved (pun intended!) 70+ year-old crack seed store.

Historic house in Kaimuki: lava rock base, single-story with attic, porch awning, windows that open (no need air-conditioning), lush mango tree, “driveway” parking (no garage). 

Love this fence made from surfboards!

Virtual learning in Hawaii time

Connect+Cities was worth getting up early to attend 7 am program, especially to hear from Jasmine Little of Culdesac Tempe, which is building the 1^st car-free neighborhood from scratch to prioritize people over cars (actually plan includes shared bikes/scooters/cars to get around). 

Former Hawaii resident and Columbia Social Work Policy Professor Jeanette Takamura was subject of American Society on Aging (ASA) Legacy interview. She shared how Hawaii upbringing shaped her: diversity baked in aloha spirit, and preference for being called “auntie” instead of senior citizen. Her proudest accomplishments as caregiving champion: establishing National Family Caregiver Support Program (NFCSP) as Assistant Secretary of Aging (1997-2001), and putting together long-term care financing package (but could not get financing in 1989) as Director of the Executive Office on Aging in Hawaii.

Dorothy Colby, Certified Positive Approach to Care Trainer and Hale Kūʻike Director of Community Engagement, presented virtual workshop, It's All in Your Approach: Making Positive Connections with People Living with Dementia. As dementia progresses, person’s field of active vision gets smaller, and Positive Physical Approach helps facilitate communication. You (without dementia) can follow these steps to connect more effectively with person who has dementia:

1)   bring flat, open palm up near face = visual cue to look at you

2)   say “hi!” and use preferred name = verbal cue to look at you

3)   look friendly: smile, make eye contact

4)   move slowly toward person from front within visual range

5)   move into supportive stance: shift toward side position (instead of standing in front, which can be perceived as confrontational body language)

6)   put your hand-under-their hand (guide and help with movement, offer sense of control)

7)   get to same level eye contact (sit, kneel or squat) and respect intimate space

8)   make connection, then wait for response/acknowledgement before you start your care

Care partnering emphasizes doing “with”: compliment, then ask for help; ask person to try, use visual cues to offer concrete choices, break task down to single steps at a time.

Understanding changes to vision and language inform how we communicate with person who has dementia, in this order: 

1)   Visual – show (gesture/point)

2)   Verbal – tell (limit words, give simple and short pieces of information)

3)   Tactile – touch only if person is aware

Dorothy’s Positive Approach to Dementia Workshop series available at Catholic Charities Hawaii Caregiving for Persons Living with Dementia Trainings online. 

“Raising” parents

AARP Movies for Grownups hosted screening of It’s Not a Burden: The Humor and Heartache of Raising Elderly Parents (2021). 

Filmmaker Michelle Boyaner’s personal journey of caring for her divorced aging parents—mother Elaine with dementia, and father Morris with hoarding disorder—taught her to “appreciate what you have at the moment you have it.”

In addition to documenting the “raising” her own parents, Michelle reached out to feature other families to share their diverse experiences doing the best they can.  Notably, women are primary (unpaid) caregivers/advocates.

Elaine said she “had to give up an awful lot of dignity” for someone to bathe her when she moved into a board and care home. Michelle shared that she had to give up years of anger and “civilized estrangement” towards her mother who divorced Morris and moved away to start a new life. Based on awareness that her mother is different now, particularly with dementia, Michelle practiced forgiveness and bonded through caregiving experience.

In parking lot, Michelle considered "meet people where they're at" advice to try and join her mother’s world.

“Kindneys”

Love “kindneys” (sic) from UCSF geriatrician Dr. Anna Chodos’ presentation on Mobility: Falls and Gait. Her point was aging increases risk of kidney and bladder problems associated with urinary incontinence that can limit mobility. Yet, I wished she addressed the role of "kindneys" (kindness) and connection (“The Rabbit Effect”) in promoting overall health and well-being.

Kindness is like aloha spirit, characterized by benevolence, truth, caring, and tough love. 

“There are three ways to ultimate success: The first way is to be kind, the second way is to be kind and the third way is to be kind.”—Mister Fred Rogers 

Ways to be kind: Look out for one another + sacrifice for the common good!!! Stop paving paradise + cultivate trees!!! Get COVID-19 vaccine + wear mask to protect self and others!!!

“The modern meritocracy is a resentment-generating machine…The ability to perform academic tasks during adolescence is nice to have, but organizing your society around it is absurd. That ability is not as important as the ability to work in teams; to sacrifice for the common good; to be honest, kind, and trustworthy; to be creative and self-motivated. A sensible society would reward such traits by conferring status on them. A sensible society would not celebrate the skills of a corporate consultant while slighting the skills of a home nurse.

Some 60 years after its birth, the meritocracy seems more and more morally vacuous. Does the ability to take tests when you’re young make you a better person than others? Does a society built on that ability become more just and caring?”—David Brooks, “HOW THE BOBOS BROKE AMERICA: The creative class was supposed to foster progressive values and economic growth. Instead we got resentment, alienation, and endless political dysfunction,” The Atlantic (Aug. 2, 2021) 

Kindness could go a long way to see us through the end of this pandemic. With Delta variant surge, KZYX Local Coronavirus Update with Dr. Drew Colfax returned this month (after “grand finale” show on June 28). As emergency room physician directly serving COVID-19 patients and former public defender, he is more passionately outspoken than his older brother (SF DPH Director Dr. Grant Colfax) and love how he closes each week’s program with his timeless prescription, “Be safe, be patient, be kind.”