“I kua naʻu, Let Me Carry Out Your Last Wishes,” is a new federally-funded, five-year research program that aims to enhance advance care planning (ACP) for Native Hawaiian elders (kūpuna) and their families/caregivers through the use of video technology. Native Hawaiians are reported to have historically low rates of ACP completion estimated at roughly 40%. COVID-19 has increased their need for ACP as they are one of the most vulnerable groups to develop complications of infection from the virus.
Funded by the National Institutes of Health through the National Institute of Nursing Research, the program is led by Marjorie Mau of the Department of Native Hawaiian Health at the University of Hawaiʻi at Mānoa John A. Burns School of Medicine (JABSOM), along with Michael Paasche-Orlow of Boston Medical Center and Angelo Volandes of Harvard University. Four community partners will also co-lead the project: Kula no nā Poʻe Hawaiʻi (Native Hawaiian homestead of Papakōlea), Lunalilo Home, ʻAhahui o nā Kauka (Association of Native Hawaiian Physicians), and Queen’s Medical Center in North Hawaiʻi and Punchbowl.
Mau, a well-known Native Hawaiian health disparities researcher, summarized her colleagues’ sentiments. “Taking care of our kūpuna in this way, during these uncertain times, has never taken on such urgency for so many families. We are so pleased to be doing something that will bring useful reassurance to our kūpuna and their ʻohana. Working alongside our community partners and providing training along the way means that the program will have a lasting impact,” she said.
The ACP process
ACP entails supporting individuals and their families in gaining a better understanding of their personal beliefs, cultural values and life goals as it relates to future medical care. The ACP process gives our kūpuna a voice by sharing their preferences with their families and health care providers to ensure that they are honored.
ACP is not a new concept, however, having a plan in place and sharing it with your doctor remains a gap in the complex system of health care delivery.
“I kua naʻu” aims to fill that gap by using innovative video technology to improve the ACP process to incorporate our elders preferences for future medical care. The research program will develop a video declaration process designed for Native Hawaiian elders, conduct a clinical trial to test effectiveness of the intervention program and train community-based organizations to effectively use these tools in the future, even after the research program has ended.
Community-based research partners also share the enthusiasm of being part of the program and to bring opportunities to their collective work of serving Native Hawaiian elders and their family-caregivers.
Visit the website or call (808) 692-1019 to learn more about “I kua naʻu, Let me carry out your last wishes.”
—By Paula Bender and Marjorie Mau