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Listening to the Voices of Native Hawaiian Elders and ‘Ohana Caregivers: Discussions on Aging, Health, and Care Preferences

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Abstract

Native Hawaiians, the indigenous people of Hawai’i, are affected by varying social and health disparities that result in high prevalence of chronic disease, early onset of disability, and shorter life expectancy compared to other ethnic groups in Hawai’i. Six listening meetings were conducted, involving 41 community-dwelling kūpuna (Native Hawaiian elders) and ‘ohana (family) caregivers to investigate health and care preferences that offer the potential for improving well-being in later life for Native Hawaiian elders. As background, we provide three explanatory perspectives and theories—life course perspective, minority stress theory, and historical trauma—that guided the design of this study and provided the study’s context. A number of overarching themes and subthemes were identified, some of which point to universal concerns with age and caregiving (such as challenges and costs associated with growing old and caregiving) and others that are culturally specific (such as influence of culture and social stressors, including discrimination, on health needs and care preferences). Results give further support to the urgency of affordable, accessible, and acceptable programs and policies that can respond to the growing health and care needs of native elders and family caregivers.

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Notes

  1. Taro, or kalo is a staple food that supplies starchy-carbohydrates calories and vitamins and minerals in the diets of kanaka maoli (Hawaiian ancestors) as well as many present-day Hawaiians. According to Dr. Claire Hughes, kalo was viewed as kino lau (body form) of the god Kane (Hughes, C. (2013)). Keeping the gods close. Ka Wai Ola, Mei (May), 30, 5. p.16.

  2. Poi is a highly nutritious starch, somewhat similar to a potato, made by mashing the kalo (taro) plan’s corm, or root. Among Native Hawaiians, it is considered a highly important and sacred part of Hawaiian life.

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Acknowledgments

We gratefully acknowledge the support of our community partners: the State of Hawai‘i Executive Office on Aging; ALU LIKE, Inc.; the Native Hawaiian Health Care Systems on the island of Hawai‘i (Hui Mālama Ola Nā ‘Oiwi) and Moloka‘i (Na Pu‘uwai); and the County Offices on Aging—the Hawai‘i Office on Aging, the Kaua‘i Agency of Elderly Affairs, and the Moloka‘i (satellite) Office of the Maui County Office of Aging. We also thank the members of our Joint Advisory Council, composed of the Native Advisory Council and the Partner Organizations Advisory Council: The Honorable Daniel K. Akaka, Ms. Nalei Akina, Ms. Deborah Arendale, Dr. J. Kuhio Asam, Dr. Elizabeth Bethea, Dr. Kekuni Blaisdell, Dr. Claire Hughes, Dr. J. Keawe’aimoku Kaholokula, Dr. Shawn Malia Kana’iaupuni, Sister Alicia Damien Lau, Dr. Wesley Lum, Ms. Elizabeth Meahl, Mr. Alan Parker, Ms. Kealoha Takahashi, and Ms. Cheryl Vasconcellos. Additionally, three graduate students in the Myron B. Thompson School of Social Work assisted us with this study: Ms. Georgia Clariza, Ms. Shelly Muneoka, and Ms. Eryn Nakamura. We are grateful for their contributions.

Funding

This project was supported, in part, by the US Administration on Aging, Department of Health and Human Services, Washington, D.C. 20201 by grant number to Hā Kūpuna National Resource Center for Native Hawaiian Elders (90OI0006/01). Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official government policy.

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Authors and Affiliations

  1. Myron B. Thompson School of Social Work, University of Hawai’i at Manoa, Honolulu, HI, USA

    Colette V. Browne, Noreen Mokuau, Lana S. Ka’opua, Bum Jung Kim & Paula Higuchi

  2. Office of Public Health Studies, Hā Kūpuna National Resource Center for Native Hawaiian Elders, Myron B. Thompson School of Social Work, University of Hawai’i at Manoa, Honolulu, HI, USA

    Kathryn L. Braun

  3. Hā Kūpuna National Resource Center for Native Hawaiian Elders, Myron B. Thompson School of Social Work, University of Hawai’i at Manoa, Honolulu, HI, USA

    Colette V. Browne, Noreen Mokuau, Lana S. Ka’opua, Bum Jung Kim & Paula Higuchi

  4. University of Hawai’I, 1800 East West Road, Honolulu, HI, 96822, USA

    Colette V. Browne

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  1. Colette V. Browne
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  2. Noreen Mokuau
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  3. Lana S. Ka’opua
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Correspondence to Colette V. Browne.

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Browne, C.V., Mokuau, N., Ka’opua, L.S. et al. Listening to the Voices of Native Hawaiian Elders and ‘Ohana Caregivers: Discussions on Aging, Health, and Care Preferences. J Cross Cult Gerontol 29, 131–151 (2014). https://doi.org/10.1007/s10823-014-9227-8

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