For older adults, it can be a challenge just to get from home to the store or a doctor’s appointment. Add in a language barrier and the challenges increase exponentially. Layer on an end-stage illness or debilitating physical limitation and the obstacles feel insurmountable.
For many of the oldest members of the Japanese communities in Southern California, this has been a daily struggle because of a gap in medical and support services that meet their unique needs.
Today, Keiro and Providence Health & Services Southern California (Providence) announced a partnership to bring palliative care services to Japanese American and Japanese-speaking older adults who are living with advanced illness and debilitating symptoms through the end of life. The collaboration leverages Providence’s nationally renowned leadership in palliative medicine and Keiro’s deep experience and history in providing health and support services to older adults in the Japanese community. The program goal is to improve the quality of life for these older adults by enabling them to remain in their homes, and decrease emergency department visits and inpatient hospital admissions.
The partnership establishes a three-year joint program called “Keiro-Providence Whole Person Care Program” and addresses issues regarding pain and symptom management, advance care planning, caregiving planning, safety assessments, psychosocial and spiritual support, medication, health care systems and alternative treatments, transportation and Japanese cultural questions, which affect healthcare decision making.
The service approach is community-based, with a focus on bringing support and care directly to the participant. Outreach will be available through personalized outpatient visits to skilled nursing and assisted living facilities, and to care homes and clinics; home visits; phone consultations and follow up with 24/7 on-call physician availability; and mobile sites at community centers, temples, and churches.
The Keiro-Providence program is the first of its kind in the U.S. to focus on delivering palliative care services to Japanese American and Japanese-speaking older adults, taking into account the cultural preferences, needs and philosophies of life for each individual.
“Keiro has been an integral part of the Japanese community in Southern California for more than 50 years, providing a range of health services, education and resources,” said Leona Hiraoka, president and chief executive officer of Keiro. “We remain focused on improving the quality of life for our community’s older adults, and this partnership with Providence enables us work with a renowned team to address a pressing need for comprehensive support of our community’s older adults facing serious illnesses in the end stages of their lives.”
Dr. Glen Komatsu, chief medical officer for Providence TrinityCare Hospice and Regional Palliative Care, adds, “Our program is the first to focus palliative care services for this particular demographic. Providence’s extensive work in palliative care and the medical and clinical experts who are part of our program, paired with Keiro’s unique insights and perspectives as a leader in caring for older Japanese American and Japanese-speaking adults, give us the ability to significantly improve the quality of life for the oldest, sickest members of this community in a culturally sensitive way.”
A new five-person, interdisciplinary palliative care team, based at Providence’s Torrance campus, will be led by Dr. Komatsu and Dr. Edwin Yanami, a Japanese-speaking physician, born in California, raised in Japan, and who completed his medical school and residency training in the United States. Dr. Yanami worked in hospital and hospice care in Hawaii and Japan for 10 years before completing his palliative care fellowship in Los Angeles in June.
“For older Japanese patients managing serious illnesses, particularly those who don’t speak English, the world outside their door can feel intimidating and present barriers to getting access to the support they need,” said Dr. Yanami. “Through an understanding of their unique needs and a culturally sensitive approach to meet those needs, we can provide them with the resources and support that enable them to live out their lives in their own home, surrounded by family.”
Dr. Yanami and Dr. Komatsu will be joined by a nurse, social worker, administrator and administrative assistant, all Japanese-speaking, if possible, and all dedicated to this program Providence will provide training and ongoing supervision of the program team by senior leadership from Providence TrinityCare Hospice, Edmund R. and Virginia G. Doak Center for Palliative Care and the Institute for Human Caring. The Providence TrinityCare Hospice, Providence Little Company of Mary Medical Center Torrance and Providence Institute for Human Caring, Torrance, just recently received the prestigious Circle of Life award, honoring innovative palliative and one of two programs recognized nationally in 2017.
The program team plans to serve hundreds of older Japanese American and Japanese-speaking adults with chronic illnesses over an introductory three-year period, beginning in August of 2017, with a $1.7 million commitment from Keiro. The program is open initially to all Japanese American and Japanese-speaking older adults and their caregivers living in Southern California. Interested participants will be able to access the program, regardless of their ability to pay, via a local telephone hotline and through community-based outreach efforts by Keiro and Providence.
Throughout the course of the partnership, the intent is to recruit and train additional professional volunteers – including physicians, medical residents and students, nurses, pharmacists, social workers and community clergy – in order to expand the program and serve more participants.
“The partnership between Keiro and Providence will have a profound impact on lives and communities here in Southern California and potentially beyond. I’m proud that this work will be based in the South Bay, "said California Assemblyman Al Muratsuchi. “As a Japanese American and a representative of the South Bay, I am especially excited that this program will focus on closing the gaps in medical and support services for Japanese American and Japanese older adults with serious illnesses.”
To learn more about the Keiro-Providence Whole Person Care Program or how to access the program’s services, please contact Keiro staff at (213) 873-5791.
Keiro is a mission-driven organization engaged in improving the quality of life for older adults and their caregivers in the Japanese communities of Los Angeles, Orange and Ventura counties. Keiro delivers a wide range of resources to address the challenges and barriers that aging presents: isolation, limited financial resources, complex health conditions, and cognitive and memory disabilities. Keiro also partners with companies and organizations that can expand its services and ability to reach seniors and caregivers, and participate in research and innovation work where Keiro can contribute to advancing progress in resolving the challenges of aging. Keiro is based in Los Angeles. For more information, visit Keiro.org.
About Glen Komatsu, M.D.
Dr. Komatsu serves as the Regional Chief Medical Officer for Providence Southern California, Chief Medical Officer for TrinityCare Hospice and Medical Director for Palliative Care for Providence Little Company of Mary Medical Center Torrance. He earned his B.S. degree in biological sciences at the University of Arizona and his M.D. at the Arizona College of Medicine. After a pediatric residency at University of California Irvine and neonatology fellowship at Miller Children’s Hospital, Long Beach Memorial Medical Center, he entered private practice neonatology, primarily as the Director of Neonatology and Newborn Services at Providence Little Company of Mary Medical Center Torrance. He then completed an adult palliative care fellowship at Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Massachusetts General Hospital, under Harvard Medical School before returning to Provident to help build the palliative care and hospice programs which continue to grow and flourish.
About Edwin Yanami, M.D.
Before joining Providence, Dr. Yanami was a staff physician in the Department of Internal Medicine and a chief physician in the Department of Hospice at Adventist Medical Center in Okinawa, Japan. Dr. Yanami earned his B.S. degree in physics at Waseda University in Tokyo, Japan, and his M.D. degree from Loma Linda University, School of Medicine. He conducted his internal medicine residency at St. Luke’s Roosevelt Hospital in New York. Dr. Yanami also recently completed his fellowship in hospice and palliative care from the VA/ Cedar-Sinai Hospital in Los Angeles. He is fluent in medical Japanese and English.