Assisted Living in Hawaii (HI)

Costs of Assisted Living in Hawaii

Assisted Living Care in Hawaii runs about $4,000 per month, (almost $50,000 a year) although the costs increase depending on the services required by the senior. Costs may also be higher for Hawaii seniors with dementia or Alzheimer's disease.

The cost of Assisted Living in Hawaii is higher than the national average of $3,293 per month, which is to be expected as Hawaii is a state with a higher cost of living than the national average. Assisted living costs in Hawaii are still much lower than the price of a nursing home, where semi-private rooms cost almost $130,000 per year and a private room is around $141,000 per year. Here are assisted living costs in major islands in Hawaii:

• Kahului, HI - $2,625 per month. The costs for assisted living are much cheaper in Kahului than elsewhere in Hawaii, and it is even cheaper than the national U.S. average.
• Urban Honolulu, HI - $5,000 per month

For comparison, the average cost for Adult Day Health Care in Hawaii is $1,460 per month which averages around $17,500 per year (based on 5 days a week for 52 weeks). A Home Health Aide costs, on average $4,800 a month, a little over $57,700 per year, which is about $8,000 higher than care in an Assisted Living Facility would be.

It is important to remember that the cost of a Home Health Aide in Hawaii is based on a 44-hour-week, whereas Hawaiian Assisted Living facilities provide 24-hour care. Furthermore, Home Health Aides usually do not provide much housekeeping, so you may need to hire a Housekeeper as well at a cost of approximately $55,000 per year (that $55,000 is based on a housekeeper working full-time.) It is estimated that by the year 2030, Assisted Living in Hawaii will cost almost $75,000 per year – an increase of around $25,000.

The state of Hawaii is a beautiful state with plenty of activities for older people and people of any age. It is also well known for its beauty, diversity, and beautiful scenic views - both mountains and beaches available in the Hawaii islands. But, even with all the activities that are available in this island paradise, is Hawaii a prime destination for a senior looking to retire?

Services for seniors living in Hawaii

The programs that are available in Hawaii for senior citizens are coordinated by the Hawaii Executive Office on Aging (EOA). The Federal Older Americas Act established and provides federal funding for elderly support services, nutrition services, preventative health services, protection of the rights of seniors, and family caregiver support services. Although Hawaii does have Area Agencies on Aging, Chapter 349 of the Hawaii Revised Statutes has designated the Executive Office on Aging as the focal point for all matters related to older adults and their needs.

Should you need to contact your Area Agency on Aging in Hawaii, here is the contact information:

• Elderly Affairs Division (Honolulu) phone: (808) 768-7705.
• Hawaii: (808) 961-8600;
• Maui/Molokai/Lanai: (808) 270-7774; or
• Kauai: (808) 241-4470

Some of the community-based programs for Hawaiians include:

1. Hawaii Health Aging Partnership (HAP) with the goal to keep Hawaii seniors healthy by educating them to make smart decisions when it comes to their health. Hawaii uses a program that has been tested and proven to work in other communities. The Healthy Aging Partnership (HAP) is co-led by the Executive Office on Aging (EOA), the Department of Health (DOH) Community Health Division, the state’s four Area Agency on Aging (AAA), some of the District Health Offices, and service providers from Aging and Public Health Networks.

Currently the HAP uses Evidence-Based Programs, which include:

• Enhanced Fitness – This is an exercise program for seniors and older adults that was created to keep Hawaii seniors' hearts healthy, as well as enable them to have better balance, be more flexible and even become stronger. Offered on the island of Kauai only;
• Ke Ola Pono Disease Self-Management Programs – this was both created and checked by Stanford University and, Ke Ola Pano or “Living Well” classes both empower and educate Hawaii elderly who participate to deal with their chronic conditions. Classes are available for those who aged 18 and older.
• Ke Ola Pono: Healthy Living – also called General Chronic Disease Management. This program is a 6-week program for seniors living with various types of conditions or more than one chronic condition, including: asthma, high blood pressure, obesity, diabetes, stroke, cancer, arthritis and heart disease. The topics covered by this program include:
  • How Hawaii seniors can effectively communicate with doctors;
  • How to relax properly to handle symptoms and stress;
  • Developing plans for actions;
  • Problem-solving; and
  • How to manage symptoms

Research has found that those older Hawaii residents who take part in and finish these workshops feel that their health has improved. Additionally, they do not feel that their health conditions limit them as much as previously, and do not see doctors as frequently as before. Furthermore, seniors feel better able to manage their symptoms and feel more empowered and comfortable when communicating with health-care professionals and caregivers;

• Arthritis Self-Management (ASMP) – Managing Arthritis and Fibromyalgia – a 6-week workshop that is specifically designed for seniors and other adults who are affected by arthritis and/or fibromyalgia. The workshops help teach participants to look after themselves better, as well as preventive measures that may be helpful or necessary in managing these and related conditions.

Those who have participated in the Living Well with Arthritis Program report feeling better, improved mobility, decreased pain and fatigue. Participants are also able to control their lives in a better way and feel much more confident about it.

The topics that are addressed in the Living Well with Arthritis workshop include:

• Exercise that is appropriate to stay flexible, strong and have high endurance;
• Manage pain;
• Importance of getting good sleep every night;
• How to solve problems; and
• Techniques to help seniors and other sufferers deal with the frustration, pain, fatigue, and isolation that comes along with these conditions;

• Diabetes Self-Management (DSMP)

Living Well with Diabetes is designed for Hawaii seniors who have Type 2 Diabetes or have Pre-diabetes. This program can also be used by seniors' caregivers. Past participants in the program have lowered their HbA1c levels as well as decreased diabetes-related symptoms.

This program includes topics such as:

• Setting goals;
• Preparing and planning for days when you are sick;
• Proper use of medication;
• How to eat healthy; and
• Effective communication with physicians.

1. Senior Medicare Patrol (SMP Hawaii) – this goal of this program is to provide information on how to identify and report Medicare fraud and abuse. Even if you are unsure or do not have proof, you should always report it immediately.

The Senior Medicare Patrol website gives three recommendations on this topic:

• Review your Medicare Summary Notice (MSN) and Part D Explanation of Benefits (EOB) for mistakes.
• Pay specific attention to these three things on your billing statement:

1. Charges for a service or a procedure that you did not receive;
2. Duplicate billing; and
3. Services, tests or procedures that were not ordered by your doctor.

If you suspect fraud, or abuse, you should:

• Call your doctor or health plan first; or
• If you are uncomfortable calling either of these or are unsatisfied with the response that you were given, call SMP Hawaii at (800) 296-9422.

1. Hawaii State Health Insurance Assistance Program (SHIP) – this program provides one-on-one assistance to those with Medicare, families, caregivers, and agencies throughout Hawaii. The program is staffed by volunteers who are trained to provide consultations and presentations to seniors and others at no charge to the public. They are trained to help answer the following questions:

• What amount will Medicare pay and what services will they cover;
• Insurance options that are available through Medigap and Medicare Advantage;
• What prescription drug coverage and/or other options are available;
• What does long-term care insurance cover;
• What are the options to pay for your long-term care; and
• What is an advanced care directive?

Volunteers are always needed and welcome in this program. If this is a program that you are interested in volunteering in, you should contact them via the website or call them at 808-586-0100 (Oahu.)

1. Hawaii Long-Term Care Ombudsman Program (LTCOP) – a program that provides information, outreach, and advocacy for seniors who are residents of long-term care facilities. There are also volunteer opportunities available for this program and to become a certified volunteer you can either click on the link or contact the Long-Term Care Volunteer Coordinator at 808-586-7305 (Oahu);
5. In-Home and Community-Based Services – These are home and community-based services that help seniors age 60 and older remain active and independent. Some of the services covered are:
   • Adult Day Care/Adult Day Health – provides personal care for dependent seniors in a supervised, protected, and group setting;
   • Transportation – provides door-to-door transportation services for those seniors who have difficulties (physical or cognitive);
   • Attendant Care – provides companion assistance/oversight of older adults who are frail or have one or more disabling conditions;
   • Case Management – help identifying needs, explore options, and develop care plans so that the senior can achieve the most independence that they are capable of;
   • Chore – help for those seniors who are unable to perform yard and/or heavy housework;
   • Congregate Meals – meals which are provided to seniors in a group setting;
   • Home-delivered Meals – meals which are delivered to frail and/or vulnerable seniors at their personal homes;
   • Homemaker/Housekeeper – assists in preparing meals, shopping for groceries, managing finances, using the phone, housework, and medication assistance or preparation as necessary;
   • Information and Assistance – provides older adults information on the services that are available within their communities and helps link them to these services;
   • Legal Assistance – provides legal counseling, and representation by an attorney or a legal assistant;
   • Nutrition Education – information about health that is culturally sensitive as well as instructions on how to maintain adequate nutrition;
   • Personal Care – help for older adults who need assistance with activities of daily living such as bathing, eating, dressing, toileting, and transferring;
   • Transportation – help transporting people.

Senior Retirement in Hawaii

Hawaii is an expensive state, both to live in and to retire. It has some of the most beautiful and alternative climates than anywhere else. However, you should do your research, and maybe plan a trip to Hawaii before making your move.

Some things to consider when choosing where to retire in Hawaii:

• Weather – in Hawaii, a cool day is usually around 72°F;
• Location – while people may say that it is far away from family and friends you will soon find out that when you are a senior living in Hawaii, people come to you;
• History and Culture – there are many historical places in Hawaii to visit and explore, from the early Hawaiian ruins to wartime Oahu, Hawaii has something for everyone. Other popular historic attractions in Hawaii are:
  • Lahaina, Maui, Hawaii – until 1845, the royal capital of the Hawaiian kingdom was located here. The history of Lahaina spans ancient Hawaii, the whaling industry of the 1850s, and Maui’s sugar plantation history;
  • Koloa, Kauai, Hawaii – the first Hawaii’s sugar plantation was originally in this town, founded in 1835. This was part of the reason that there was such a massive influx of Chinese, Portuguese, Japanese, Filipino, and Korean plantation workers.

Although sugar is no longer produced here, you can still travel back in time and visit the shops in the restored plantation-style buildings;

• • Downtown Oahu, Hawaii – this is the epicenter of Hawaii and is the home to the Hawaii State Capital, and close to Chinatown;
  • Pearl Harbor, Oahu, Hawaii – the site of the December 7, 1941 attacks on Pearl Harbor by the Japanese. There are many historic sites here for seniors to visit including USS Oklahoma Memorial, The USS Bowfin Submarine Museum & State Park, USS Arizona Memorial, The Battleship Missouri Memorial, The Pacific Aviation Museum. This is definitely a must visit for Hawaii seniors who are veterans.
  • Kona, Hawaii – this island's waters are home to exotic marine life, and it has a plethora of important Hawaiian landmarks.

Cons of seniors living in Hawaii:

• If you are a person who is used to buying everything you like, whenever you like, then Hawaii may not be a location in which you would like to live. There are some high-end shops with unique items that can’t be found elsewhere, but Hawaii is not considered a shopping mecca and the selection is limited. This may be a good fit for those who are particular and may tend to get bored easily;
• Roaches, geckos, and other animals are part of life in Hawaii. If you are someone who fears these creatures – especially if they are inside your home – then you might want to reconsider the island paradise;
• Chances are that you will be a minority on Hawaii - especially as a senior, which makes up about 16.5% of the total population according to the estimates from the latest census). If you do not get along well with those from other cultures, religions, and ethnicity groups, you may have problems assimilating into the Hawaiian culture and people;
• Money – we have discussed that the cost of living is high in Hawaii, but even traveling to the other islands for a short break can cost quite a bit - $40 for a ferry to Maui from Oahu, for example. Are you able to live in one place for relatively long periods of time? Or, can you afford to travel back to the mainland at a price of around $300?
• Dating – dating prospects are limited in Hawaii. Very limited. Even friend opportunities are more limited than you would find on the mainland. So if you are a senior who is looking for a mate, Hawaii may offer very few options for you.

Pros of seniors living in Hawaii:

• Some retirees can find jobs that they love in a place that they love, which will help them afford all the extras that they are likely to want to spend money on while living in Hawaii;
• What’s the worst that could happen? You could just move home. Go for a visit or even try it for a year and see if Hawaii’s lifestyle works for you;
• There is a slower pace of life in Hawaii (although one could argue that is true on almost all island nations or states). Time exists on its own schedule here and, after 40+ years of living in the fast-paced life of working, the slower pace of life may be appealing to you;
• Due to the island location, proximity to the ocean, and fantastic year-long weather – Hawaii offers numerous options to a senior living there, including boating, ocean swimming, surfing, walking, good food - all while living in paradise.

Weather in Hawaii

Although the state of Hawaii is in a tropical climate, the altitude is so varied that is it is almost impossible to choose a climate that covers an entire island, let alone an entire state. For example, the island of Hawaii has 4 out of 5 climate groups in an area that is only 4,028 square miles in area. The islands that receive the most rainfall receive it on the north and east sides, whereas the coastal regions (especially the south and the west) tend to be drier.

Most of the precipitation falls in the winter – between October and April – and the drier conditions are between May to September. The warmer temperatures increase the risk of tropical cyclones it is rare that cyclones impact Hawaii. The temperatures at sea-level range between 85° F to 90° F during the summer and 79° F – 83° F during the winter months. Hawaii rarely sees snow except for on the three highest mountains of Mauna Kea, Mauna Loa, and Haleakala, which often get snow during the winter months.

There are often frequent light showers during the fall in Hawaii, particularly on the windward side, but these “storms” are rarely heavy enough to produce more than 0.01 inches of rain. The major storms in Hawaii happen between the months of October and March where there can be up to seven storms a year. “True Hurricanes” are unusual in Hawaii, partly due to the cooler waters around the islands – only four Hurricanes have affected the island in 63 years. Tropical Storms are more likely, yet they have more moderate winds than Hurricanes or cyclones and are not usually as destructive.

• Honolulu, Hawaii gets approximately 79 inches of rain per year, yet it has 271 sunny days a year.

Hawaii History and Demographics

Although the state of Hawaii comprises eight main islands, there are also 1,500 islands included in the Hawaii archipelago. In this article, we will mainly be talking about the entire state of Hawaii and the eight main islands (although the main islands will be named as necessary.)

The state of Hawaii is the 8^th smallest state in America and ranks 11^th by population, yet it is the 13 most densely populated with 214 people living in every square mile. The coastline is the fourth largest of the states, behind Alaska, Florida, and California. The main islands that we are including when talking about the state of Hawaii are:

• Hawaii – The Big Island – with an area of 4,028 square miles and a population of less than 200,000. The entire island is in Hawaii County, and the largest city, as well as the county seat, is Hilo. There are no incorporated cities in Hawaii County. There are three active volcanos on the island: Mauna Loa, Kilauea, and Hualalai;
• Maui – The Valley Isle – with an area less than 750 square miles and a population less than 150,000.
• O'ahu, or Oahu - the third largest of the Hawaiian Islands and is home to approximately 2/3 of the senior and total population of the state of Hawaii.
• Kaua’i – The Garden Isle – approximately 555 square miles with a population of fewer than 70,000 people. It is the fourth largest of the Hawaiian Islands and is the 21^st largest island in the United States. The most populous town is Kapa’a;
• Moloka’I or Molokai – The Friendly Isle – with a land area of 38 by 10 miles in size, this island has a usable land area of just 260 square miles. This makes it the 5^th largest of the main Hawaiian Islands and the 27^th largest island in the United States. During the 1860s the island was used to quarantine treatment of those with leprosy, but that ended in 1969. This area is now preserved by the Kalaupapa National Historic Park;
• Lana'i – also known as The Pineapple Isle – this is partly because of its history as an island-wide pineapple plantation. There is just one school on this island which serves K-12 grade.
• Ni'ihau – also known as The Forbidden Isle - is the westernmost and seventh largest inhabited island in Hawaii. With a population of less than 200 and an area an area of 69.5 square miles, this island is off-limits to all but the relatives of the owners of the island. The people here are known for their creation of the pupu shell craftsmanship and speak Hawaiian as the primary language;
• Kahoolawe – also called The Target Isle - is the smallest of the eight main volcanic islands in the Hawaiian archipelago. Historically, this island has not been very populated because there's very little fresh water on the island and today the island can only be used for Native Hawaiian cultural, spiritual, and subsistence purposes. There are no permanent residents on this island.

The state of Hawaii is the 8^th smallest populated state in America, with an estimated 1.45 million people and it is the 24^th largest state with an area of 59,425 square miles. The state density is 165 people per square mile, which is 18^th in the country – lower than that of Ohio or Illinois. However, it depends on which island you are talking about as the different islands that make up the state of Hawaii have different populations and therefore different population densities.

The top three religious majorities are: Christianity (including Protestants, Roman Catholics, and Mormons at 29%); Buddhism (9%); and Judaism (0.8%). Regarding religions that are not Christianity based, Buddhism is the second most popular religion, particularly among the Japanese community. Almost 10% of the population self-identifies as “other”. A full 51% (650,000) of Hawaiians claim to be unaffiliated (which include agnostics, atheists, humanists, deists and the irreligious).

By adherents, the largest religious denominations were, The Roman Catholic Church (almost 250,000) and The Church of Jesus Christ of Latter-day Saints with almost 70,000. The third largest is the United Church of Christ with 115 congregations and 20,000 members and the fourth largest is The Southern Baptist Convention with 108 congregations and 18,000 members.

In the Hawaiian constitution, established in 1978, both English and Hawaii are listed as the “official languages” of Hawaii. However, almost 74% of Hawaiians speak English exclusively at home, 21% speak an additional Asian language (unspecified), 2.6% speak Spanish, 1.6% speak another Indo-European language, and 0.2% speak another language. After English, the other languages which are spoken popularly in the state are: Tagalong, Japanese, and Ilokano.

The estimated racial composition of Hawaii (2015) is: 37.3% Asian; 26.7% White (including White Hispanics); approximately 10% Asian; 2.6% Black; and 0.5% American Indian or Alaska Native. Hawaii has the highest percentage of Asian Americans and multiracial Americans and the lowest percentage of White Americans in any state. It is also the only state where Asian-Americans are the largest ethnic group. Hawaii was also the first majority-minority state in America as by 2014 the state will have a majority of people that are non-Hispanic white plurality.

Both English and Hawaiian are listed as the state’s “official languages. Hawaii's Creole English, also called “Pidgin,” is the native language of many native Hawaiians and is a second language for many others. As of 2010, 14.3% of the population were seniors over the age of 65, and that has only grown - as the latest census reports that those over 65 were an estimated 16.5% of the population.

Since the time that Hawaii became a state in 1959, the senior population increased much faster than the rate of the rest of America. However, since 2000, the elderly population has grown only slightly faster than the national rate. Since 1970, the number of elders grew at a rate of between 13%-16%. It is estimated that by 2030, seniors will represent 20% of the total population of Hawaii – one out of every five residents will be 65 or older.

Hawaii has a state income tax using 12 brackets, ranging from 1.4% to 11% on your taxable income. Taxable income is lower than a person’s actual income as it includes deductions and exemptions. The highest income tax of 11% is for those with a taxable income of over $200,001 annually. The top rate ranks about the national average in the nation.

Personal property, such as cars, and boats, for example, are not subject to property taxes. However, real property, land and improvements tax rates depend on the island. Property taxes vary with the county: Honolulu County charges $3.50 per $1000 of net residential property, Maui County charges $5.75, Hawaii $9.10 and Kauai is $4.25. These exemptions are for owner-occupied homes, and there are multiple age-based exemptions.

There is no inheritance or gift tax in Hawaii for those who passed away after January 25, 2012. However, there is an estate tax that ranges from 10% on estates up to $1 million and 15.7% on estates that are valued at more than $5 million.

Finally, if you chose to come to Hawaii to get married, you should have a minister officiate your wedding. If the state determines that your wedding was a non-religious “tourist wedding,” it is subjected to the state’s 4% excise tax.

Hawaii is also considered to be moderately tax-friendly state for seniors, due to the following:

• Social Security Income is not taxed;
• Withdrawals from retirement accounts are fully taxed;
• Wages are taxed at normal rates, with the marginal state tax rate being 7.2%; and
• Public pension income is not taxed, but private pension income is fully taxed.

The purchasing power in Hawaii is considerably lower than the average in the nation. For example, what would get you $100 worth of items in another state, would only get you $85.62 worth of things in Hawaii. Living in Hawaii is much more expensive overall than it is in other states, in every category. On a scale of 100 being the average, Hawaii ranks overall at 186.50 and is higher in every area, with housing being particularly high at 298.

Popular attractions for seniors living in Hawaii:

• Hawaii Volcanoes National Park – located on the island of Hawaii – this is the home of Kilauea, which is one of the most active volcanos on Earth. It’s a popular visitor attraction and a sacred place for Native Hawaiians;
• Haleakala National Park, Maui – located on the island of Maui – Haleakala National Park stretches across East Maui and is home to Haleakala Crater. It is a popular attraction due to the sunsets, which are breathtaking at this altitude;
• Puuhonua o Honaunau National Historic Park, Hawaii – located on the island of Hawaii in Honaunau Bay – this is an area that has held on to the traditional way of Hawaiian Culture and life. It is a 180-acre national historical park and was once a place of refuge for ancient Hawaiian lawbreakers;
• Pearl Harbor National Historical Landmark, Oahu – located on the island of Oahu – it is the only naval base in the United States that has been designated a National Historic Landmark. There are four museums to commemorate the ships located there: The U.S.S. Arizona Memorial, the Battleship Missouri Memoria, The U.S.S. Bowfin Submarine Memorial and the Pacific Aviation Museum;
• Polynesian Cultural Center – located on the island of Oahu – after spending the day exploring the heritage of the Pacific Islands, you can wander through 42 acres of tropical splendor that includes hands-on activities. Seniors can enjoy a traditional Polynesian luau and end the night with an evening show that is unlike any other in the islands;
• Mauna Kea – located on the island of Hawaii – it is a dormant volcano which stands 13,802 feet above sea level (the highest point in the state of Hawaii). It is the only place in the world where you can drive from sea level to 14,000 feet in around 2 hours. It is now used as an observatory;
• Iolani Palace – located on the island of Oahu – a national historic landmark and the only official state residence of royalty in the United States. It was the official residence of the last two monarchs from 1882 to 1893: King Kalukaua and his sister and successor, Queen Lilluokalani; and
• Dole Plantation – located on the island of Oahu – this famous plantation is an attraction for seniors and those of all ages. You can ride the “Pineapple Express” for a narrated ride through the plantation, as well as purchase pineapple. However, the main excitement of this attraction is the famous 3-acre maze with almost two and one-half miles of paths lined with plants that are native to Hawaii. There are eight “secret stations” located within the maze and those who finish the maze – it is one of the few permanent botanical mazes in America – win a prize, are entered into the history of the Dole Plantation and get their names recorded on a sign at the entrance to the maze.

Some places to consider for Hawaii Senior Living:

• Hilo, Hawaii, Hawaii – located on the big island, Hilo is cheaper for seniors to live in than most places in Hawaii and does not have the tourists and commercial development that is common on Oahu;
• Paia, Maui, Hawaii – although it is located on the island of Maui which is quite a tourist magnet, this small seaside town has beautiful beaches and a thriving art scene. This is the city where even the locals go to get away from it all;
• Haleiwa, Oahu, Hawaii – this is located on the island of Oahu which is one of the most highly densely populated areas in America, yet this town, which is located on the North Shore, is described as a sleepy beachside town during the summer and a happening surf mecca in the winter;
• Kailua-Kona, Hawaii, Hawaii – located on the big island, this town is an area that receives little rain and is known for its golf courses, spectacular beaches, and a senior cost of living that is lower than average for Hawaii; and
• Hana, Maui, Hawaii – although it is a tourist attraction due to the natural wonders, it still allows one to live in relatively isolated surroundings. This location is recommended for seniors who want to live in a place that allows them to escape from civilization and truly relax.

Common Questions About Assisted Living in Hawaii

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