Vivia, a service line under Ho‘okele Home Care, recently began offering kupuna clients transportation to appointments along with the personal assistance they need once they get there.
“Families were saying, ‘My mom needs more than just being dropped off.’ Picking them up at their doorstep and taking them to another doorstep wasn’t good enough, especially in cases of dementia, when they don’t even know where to go,” said Vivia CEO Dew-Anne Langcaon.
A few other medical transport companies might offer personal assistance beyond curb-to-curb service, but what makes Vivia unique is the familiarity and trust developed between caregiver and client, she said. The same caregiver a client normally has through the company is the same one who will drive and accompany the kupuna to the destination.
It’s especially helpful during a medical appointment when the caregiver can act as an advocate and speak up about a patient’s dementia, medication needs or other problems, or knows how to communicate with someone who has hearing loss, Langcaon said.
Families often find it difficult to take time off from work to take their parent to the doctor’s office. Once there the Vivia caregiver can facilitate a FaceTime call between the family and the doctor during the examination.
“It really helps the families to still be there, but it doesn’t take three hours out of their day,” Langcaon said.
She cited another common problem faced by disabled clients who ride TheHandi-Van or use other transportation to a dental appointment. Oftentimes no one is trained to transfer a person from a wheelchair into a dental chair, and rather than risk liability, the dentist won’t serve the client, she said.
Langcaon said 15 families have taken advantage of the service since it was launched in March.
The service also can be used for a social outing — “a holoholo excursion” — just to get the kupuna out of the house, whether it’s to go to the park or out to lunch, she said. Costs range anywhere from $140 to $200 for an average two-hour trip. Medical insurance will not cover the service, but sometimes long-term care insurance will, Langcaon said.
Derrick Ariyoshi, an administrator with the city’s Elderly Affairs Division, said his agency uses federal and state funds to pay for assisted transport for adults 60 and older who have limited financial resources and do not qualify for Medicaid. For the past six months, Vivia has been one of the few available contract providers of this type of service, which has been used to help patients being discharged from hospitals, among other needs, he said.
“The majority of transportation services is curb to curb, meaning, it relies on the kupuna to get to curbside … TheHandi-Van does support those folks that have ambulation challenges — they can accommodate wheelchairs, etc. — but really, it is up to the kupuna to be able to get to the curbside,” Ariyoshi said.
“I give them (Vivia) credit and acknowledge them for being innovative and figuratively breaking down walls” to meet the needs of older and disabled adults outside their residences, he said. “Transportation service in so many ways is the mode and vehicle to access other services and supports.”
The Elderly Affairs Division is trying to build its capability to assist adults 60 and older, as they represent one-fourth of the population and by 2040 will make up a third of the total, Ariyoshi said. Hawaii has one of the highest life expectancy rates, but it’s usually accompanied by chronic health conditions or disabilities. Demographics also reflect that Baby Boomers (those born from 1946 to 1964, constituting the second-largest generation group) have fewer or no children, which lessens their family or informal support system.
Ho‘okele Home Care began giving caregivers use of a company car in 2019 when it pioneered a different service model, now called Vivia, of tasked-based home care within a geographic neighborhood. Families didn’t want caregivers to stay for several hours when their older parents just needed help with a bath or preparing a meal for an hour, or if sometimes they’d need a caregiver to return later in the day, Langcaon said.
The model also coincided with the company’s attempt to attract workers at a time when there was such a shortage of caregivers that the company had to turn down requests for service. She said caregivers wanted a guarantee of 40 hours a week but found it difficult to work short shifts at different homes because they relied on the bus, which was too time-consuming — so they were given a company car, she said.
The model became popular throughout Oahu and is used on Maui and in Seattle, where the company is also based.
KUPUNA CARE
Visit hookelehomecare.com and click on “Vivia,” or call 808-784-3049 for information.
