Kōkua Kalihi Valley, a federally qualified community health center that has served Kalihi Valley since 1972, defines health as much more than medical care. For KKV, “health is wholeness,” involving movement, laughter, learning, and the health of the land. Primary among these is social connection.
“Everything we do is face to face,” says Merlita Compton, director of KKV’s beloved elder program. For many of KKV’s seniors, the regular exercise sessions and events were a lifeline to friends, activity, fresh air, and caring community.
When the stay-at-home order rolled out, the senior programs had to stop. “They all became homebound,” says Megan Inada, KKV’s research and evaluation coordinator. The seniors served by KKV are especially vulnerable. Not only do many have preexisting medical conditions and fragile or nonexistent support systems, 98% of them are low income.
When existing regulations around telehealth evolved, KKV acted fast. With a grant from the Hawai‘i Resilience Fund of the Hawai‘i Community Foundation, the health center created a pioneering telehealth and social service check-in program to keep its senior population not only healthy and safe, but connected, both virtually, and—from a safe distance, using appropriate PPE—in person, if needed.
KKV’s new weekly health-and-wellness-check program serves more than 300 kūpuna. It begins with a 30- to 45-minute phone call that aims to assess health and wellness and determine needs for health testing, food, supplies, medical care, and assistance. “We want to connect them to the goods and services they need, and also connect them with the resources they need,” says Inada.
The calls help seniors feel cared for, and that caring connection might be the most valuable thing of all. Inada says it can make all the other assistance possible: “What’s been the most helpful is Merlita and her crew’s relationship with the patients. Right away, when [patients] pick up the phone and they hear their voices, they’ll start crying. They’re so thankful: ‘I’m so glad you’re calling! I thought you’d forgotten about me.’ It’s that relief, to hear a familiar voice. If it had been any other person, those barriers might have been too difficult to overcome to get the care they needed.”
During the calls, KKV’s teams also teach seniors how to be telehealth patients, should the need arise. It’s not easy when many are hard of hearing or have vision troubles, and 92% speak English as a second or third language. What helps KKV’s kūpuna through?
Compton has a simple answer: “Trust.”
After the weekly phone check-in, if necessary, KKV’s teams put together and deliver customized packages that can include a hot meal, medicines, preferred fresh foods, and even traditional medicinals like ‘ōlena (turmeric), long prized in the Pacific for its therapeutic qualities. If ‘ōlena goes in, they’ll tuck lemons in the bag, too, for tea. “It’s good for their health,” Compton says.
KKV’s educational materials are custom-made for their population. That personalized approach has been a success with the diverse kūpuna in KKV’s care. All told, staff members speak 29 languages, and they know each senior.
This pilot program is one of the first of its kind and could become a model for other organizations like KKV. Says Inada: “We’re really excited about the work. Of course, everyone wants this [crisis] to end, but [we now understand] we can connect to our community in a different way.”
Inada and Compton know the check-in effort is not a replacement for the joyous exercise program that ran at KKV three times a week, and will again, one day. Compton says she tells seniors who miss seeing each other each week: “We will open again. We will keep checking on you to see if you’re OK. But everybody has to be safe right now.”