Welcome to Kōkua Mau

Kōkua Mau is a Movement to Improve Care for those with serious illness and their loved ones. We are Hawaii’s trusted resource for accurate information on Advance Care Planning (ACP) including Advance Directives and POLST, palliative care, which provides relief from the symptoms and stress of illness, and hospice care which provides the best care possible at the end of life. (Kōkua Mau means ‘Continuous Care‘ in Hawaiian.)

Our COVID-19 Resources Page provides up-to-date information, webinars, guidelines and materials helpful for our members and supporters.

Thank you to all of our amazing health care professionals and your incredible contributions in the face of the COVID-19 crisis.

Collaborating since 1999: Kōkua Mau – A Movement to Improve Care. As network of organizations and individuals we bring to the forefront meaningful, thoughtful and sensitive conversations on improving care and support for those with serious illness. We are viewed as a thought leader working to ensure that every individual has the right to quality care throughout their lives, including at the end of life. We advocate for quality palliative and hospice care within the medical and legislative communities in Hawai‘i.

Our goal is to create a community in which advance care planning conversations are the norm. We are fostering a movement to change social norms in Hawai‘i regarding conversations and decisions around serious illness and end-of-life care, and to provide all individuals and communities with greater choice and control regarding their quality of life. We do not focus on the end of life, but rather the quality of life.

We hope that you will find useful Hawai‘i-focused information and resources for yourself, your loved ones and those you care for.

Advance care planning (ACP) can take place years before an illness or crisis occurs and is the first part of the continuum of planning for one’s legacy wishes. To make this possible Advance Directives and POLST are key documents and our Let’s Talk Story Program is available for public and professional education.

Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family. 

Hospice is specialized care which focuses on the needs of the person and loved ones in the last weeks and months of life and is seen as best care possible for those at the end of life.

In our Tool Kit you find all Kōkua Mau materials (as PDF files) in one place.

Kōkua Mau’s vision is a community where: the people of Hawai‘i are treated with dignity, compassion and love throughout their lives.

To make that vision a reality, Kōkua Mau’s mission is: to weave a lei of caregiving and support so that the people of Hawai‘i facing serious illness can live in the place of their choice, with relief of pain and suffering and according to their values, beliefs and traditions.

– What’s New in 2021?

Our COVID-19 Resources Page provides up-to-date information, webinars, guidelines and materials helpful for our members and supporters.

Wed. 8/18: 21 Gun Salute: The military culture and traditions surrounding death

Wed August 18
At the Bristol Hospice Hawaii Conference room or on zoom (Meeting ID 81942763791)

Kōkua Mau’s own Dr. Pat Nishimoto will discuss Military Culture on zoom in the context of caring for veterans. Dr. Nishimoto has decades of experience as an oncology nurse specialist with Tripler Army Medical Center and is a nationally known teacher. Email Dr. Joseph Eppink for more information

7/29 Focusing on Transformation: the 2021 Virtual Conference from NHPCO, AAHPM and HPNA

We watched the streamed conference together. The conference organizers, NHPCO, AAHPM and HPNA, recognized the profound and historic impact of the global health pandemic. That is why the 2021 Virtual Conference is focused on transformation. More

6/22 & 23 our Virtual Summit Working Together: Forging the Future of Serious Illness Care

Kōkua Mau collaborated with our partners in California and Arizona on a virtual summit for those working to improve care for those with serious illness. Our partner the Coalition for Compassionate Care of California (CCCC) maintains the dedicated website for the Annual Summit. Registration is CLOSED – more information

6/26 Hawaii MedQuest Palliative Care Summit

We solicited your feedback on a future, first-of-its kind, palliative care benefit for MedQUEST members at our historic Virtual Palliative Care Summit. A MedQUEST palliative care benefit could significantly improve how we in Hawai’i care for some of our most complex and seriously ill family, friends, and neighbors. More

May 2021: Update on POLST nationally, new documents and the national POLST Form

In our May meeting we welcomed Amy Vandenbroucke, Executive Director for National POLST, with her presentation about what is happening with POLST nationally, including new guidance documents and the new National POLST form. Watch the recording on our YouTube Channel.

Communication skills for talking about COVID vaccines 

As you may communicate about vaccination issues, this is a good resource from our colleagues at VitalTalk. Their newest supplement to the COVID-Ready Communication Playbook addresses communication skills for talking about COVID vaccines. https://www.vitaltalk.org/guides/communication-skills-for-the-covid-vaccine/. Details on our COVID-19 page.

In 2020, The Conversation Project updated their Starter Kits and developed new Starter Guides to support and encourage people to have ‘The Conversation’ about what matters most. These newly revised Starter Guides have been thoughtfully curated and edited by Conversation Project Champions across the nation who regularly use The Conversation Project Materials. See the new versions here:

  • Download the new Your Conversation Starter Guide
  • Download the new Your Guide to Choosing a Health Care Agent

April 2021: An Update on Hawaii’s Our Care Our Choice Act

Our April 2021 Kōkua Mau meeting features an update on the Our Care Our Choice Act in Hawaii after the first 2 years by five presenters. Presenters: Laura Arcibal, HI Dept of Health, Jodi Shaw, Kaiser Permanente, Michelle Cantillo, Hawaii Pacific Health, Erin Hamilton, Bristol Hospice, Caryn Ireland, Consultant with Compassion & Choices. Watch the recording with time code for each presenter at ‘show more’ in our YouTube channel.

March 2021: Innovations in Palliative Care

Our partners at Hawaii Care Choices are providing high quality palliative care in their rural community through a series of innovations in Hilo, Hawaii. Our Monthly Meeting in March 2021 is a talk-story session with Lani Weigert, Community Relations Manager and Cara Sadira, Community Liaison implementing the programs and experiencing first hand the real change happening. Watch the video Innovations in Palliative Care.

February 2021

For up-to-date webinars please visit our dedicated webinar webpage

Events from 2020

Please visit our latest addition: Making Decisions Regarding Mortuaries in Hawaii

Making decisions involving mortuaries is never an easy task. This list of current costs – from mortuaries on all islands in Hawai‘i – for cremation, burial, funeral services, caskets and cremation urns, can help to simplify the decision process.

Two reports:
  • The final report on the Palliative Care Summit in Hawai‘i can be downloaded here. More on the Summit webpage.

Kokua Mau (Virtual) Monthly Meeting Sept 2020 – Special TFT Presentation

Are you looking for innovative ways to address and deal with stress and anxiety due to the COVID-19 pandemic? At our virtual Kōkua Mau Meeting, joins us for hands-on (zoom) presentation about TFT or Thought Field Therapy with Dr. Caroline Sakai. More details or watch the recording of the meeting.

Funerals & Memorials are very different these days. What are new ways to grieve, mourn, comfort and honor?

How are we supporting people in our community whose loved ones have died but are not able to go to funerals or memorials in a usual way because of the pandemic? In Hawai‘i, about 1,000 people die a month so nearly 6,000 people have died since gathering restrictions began impacting 10s of 1000s of people have not been able to grieve, mourn and comfort each other.

Watch our (Virtual) Kōkua Mau Monthly Meeting from August 27, 2020:

Learn about what is happening in our community and strategize about solutions. Click on the time code below to jump directly to a specific presentation on our YouTube channel.

  1. 0:03 Context and introductions
    by Jeannette Koijane, Executive Director, Kōkua Mau
  2. 03:15 Military rituals in the time of COVID by Patricia W. Nishimoto, DNS, FAAN, Oncology Clinical Nurse Specialist, Tripler Army Medical Center
  3. 12:01 What resources are available? Support groups and extra support in the time of COVID? by Valerie Payton MA, LCSW, Bereavement Social Worker, Home Hospice, St. Francis Community Health Services
  4. 35:39 What are mortuaries seeing in these times when no one can come together – by Pete Dilwith, Pete Dilwith, CFSP, CPC, CCO, VP of Operations, Mililani Memorial Park & Mortuary.
  5. 54:42 Clarence Liu, Retired chaplain (navian), local boy

‘Zoom Made Easy Page’ updated

Most of the time zoom works like a charm, but there are a million things that can go wrong (if you did not update to the latest version). Visit our Zoom Made Easy page, if you are looking for solutions. This page is updated frequently.

Palliative Care Summit 2020 recording

Our very successful Palliative Care Summit on April 25, 2020 brought key stakeholders together for an overview of the current state of palliative care in Hawai‘i, with focus on:

  • What is working?
  •  What are barriers?
  • What are the opportunities for expanding access?
  • Watch a recording of the entire summit on our YouTube channel.
  • Summit webpage for details and PDF files of the PowerPoint presentations.
  • A final report on the Summit can be downloaded here.  This includes the results of the focus groups, surveys, input from the conference and next steps. 

Our 121 participants represented a diverse array of stakeholders including health plans, health systems, hospices, higher education, state and county government, and non-profits (including AARP and American Cancer Society). Participants from all counties included doctors, nurses, social workers, chaplains, community advocates and administrators. See our

July 30th Mapping Palliative Care in the State of Hawai‘i

  • Where is palliative care available in Hawai‘i?
  • How many people are receiving palliative care and in what settings?
  • What are the gaps and opportunities for improving palliative care?

This is the first time that we have done a statewide mapping project or calculated how much palliative care is being provided where and what the gaps are. View the recording or visit our web page and read the full report.

Chelsea Hirano presented the results of her research over the last 6 months looking at in-patient, out-patient and community based settings. Chelsea is a graduate nursing student in community health at UH Nursing. This is the first time this type of research has been done in Hawai‘i.

What is happening with Advance Care Planning in the time of COVID-19?

National and local experts agree that advance care planning continues to be important to make sure that people’s wishes are known. Here from our local experts on how they are approaching these conversations and what opportunities and challenges they encounter. Join us for our monthly virtual meeting Thursday June 25. Watch the YouTube Video recording.

  • Michelle Cantillo, Advance Care Planning Coordinator at Hawai‘i Pacific Health
  • Amy Hamane, Volunteer at Community First, Hilo
  • Susan Michihara, Interim Manager, Ambulatory Social Work at Kaiser Permanente
  • Lori Protzman, Advance Care Planning Coordinator at Queen’s Medical Center
  • Hope Young, Advance Care Planning Coordinator at Kōkua Mau

April 30, 2020, NPR, Morning Edition: Coronavirus Disrupts Hard Decisions About End-Of-Life Treatment

The coronavirus means more people are dying alone in ICUs. Families are having to make abrupt decisions at a distance about terminal care. Palliative care specialists try to adapt. Listen to the 4 minute NPR program.

April 12, 2020: Kokua Line: Naming a health-care proxy more important than ever

Read the interview with Kōkua Mau’s own Dr. Daniel Fischberg and Jeannette Koijane in the Honolulu Star-Advertiser’s Kokua Line, by Christine Donnely from April 12, 2020. All COVID-19 coverage has free access at the Honolulu Star-Advertiser.

April 2020: Let’s make Personal Protection Equipment for Hawaii

March 18, 2020: We created a COVID-19 Resources page. In a fast changing world, please visit this page frequently as we add resources.

As of 3/18 the Center to Advance Palliative Care (CAPC) has made its resources available for free to the public. Please check out their tailor made: CAPC COVID-19 Response Resources toolklit including crisis communication and symptom management protocols for all clinicians, and guidance to help palliative care teams address high levels of volume and stress during a crisis.

What’s in the Toolkit

  • Communication Tips
  • Symptom Management Protocols
  • Palliative Care Team Tools
  • Telehealth
  • Patient and Family Support Resources from the CDC
  • Medicare COVID-19 Waivers
  • Federal COVID-19 Guidance
  • Setting-Specific Guidance
  • Role of Palliative Care

Since March 2020 we switched our Palliative Pupus to a virtual zoom meeting due to concerns about the spread of the Corona virus that can cause COVID-19.

Since March 26, 2020 all Monthly Kōkua Mau Meetings are virtual via zoom. More

A photo of a traditional Hawaiian lei

– 2019 Highlights –

Nov 2, Dia De Los Muertos – Free Family Event

Thank you to all who to attended this interactive, fun family event. More and map

Legislative Briefing on Hospice

Kōkua Mau invited you to join us: on Sept. 11, 2019 at the Hawai‘i State Capitol. We had a unique opportunity to learn from and talk with two of the most knowledgeable experts in the country on Hospice regulation, compliance, policy, and advocacy. Find out more about the legislative briefing.

Nov. 11, 2019 – The Fine Art & Science of Pain and Palliative Care

Queen’s Medical Center excellent home grown conference.

Trainings in an all-islands collaboration with the Hawaii Catholic Conference

With our Let’s Talk Story Program we want to meet people where they work, play or pray. In collaboration with the Hawaii Catholic Conference we participated in 11 trainings on all islands about the importance of the conversation and Advance Health Care Directives as well as the benefits of hospice and palliative care. For a complete listing of dates and location, please visit our webpage.

July 17 & 18: We hosted “Overcoming the Challenges of Community-Based Palliative Care“, a live-streamed palliative care conference, brought with the generous support of Gary Simon, Chaminade University and Kōkua Mau.

July 2, 2019: Governor Ige signed the Support Palliative Care SB 804 at the Governor’s chambers!!

Governor Ige Signing the Support Palliative Care SB 804 in Hawaii
Signing the Support Palliative Care SB 804 in Hawaii

Great news and thank you to everyone who wrote supportive testimony. Many thanks to Senator Baker, Representative Belatti and Representative Mizuno for their support in shepherding the bill through. This bill is a collaboration with Kōkua Mau, the American Cancer Society – Cancer Action Network (ACS-CAN) and the Department of Health. More

Jan. 2, 2019: The Our Care, Our Choice Act (OCOCA) is a Hawaii law that permits terminally ill adult patients with the capacity to make medical decisions and who meet certain other conditions to be prescribed an aid-in-dying medication. The law went into effect on January 1, 2019. Hawaii is the seventh jurisdiction to enact such a law. Kōkua Mau created a webpage with an overview of the Our Care, Our Choice Act, including information for patients and families and Frequently Asked Questions for Providers. Kōkua Mau is a neutral source for information on the new law.

 Our Care Our Choice Act in Hawaii  

 OCOCA Information for Providers

OCOCA Information for Patients and Families   

DOH webpage: Patients, Family Members, and Care Support Resources

Listen to the webinars: The California Experience or Web-based training: End-of-Life Care Options in Hawai’i

2018 Highlights and Events

Useful documents

Everyone needs an Advance Health Care Directive – Not Everyone needs a POLST

⇒ Let’s Talk Story Program: Kōkua Mau wants to get our community talking about wishes for care at the end of life. Our new Let’s Talk Story Program will go out to community organizations, churches and temples with our free, 2-hour interactive sessions facilitated by Kōkua Mau’s trained experts. Option 2 is a free screening of ‘Being Mortal’.

⇒ Translations of key Kōkua Mau Advance Care Planning materials: The multilingual resources are intended as tools to help members of our community with limited English proficiency. As is common with such complicated issues, these documents do not replace a one-on-one conversation, sometimes with the help of an interpreter, to walk people through the decisions they have to make for themselves or their loved ones. Two ways to access the multilingual PDF files:

  • By Language: Click on the language link for all resources available in that language. We will add selected materials in the language (such as the Conversation Starter Guides) when we become aware of it.
  • By Document: Just click on the “multilingual” link for e.g. POLST and you find all the languages available for POLST on one webpage.

We want to thank all the volunteers who have dedicated countless hours reviewing documents and giving us feedback. It has been a herculean task but our community project is finally a reality thanks to all of you that helped us with your expertise.

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Ongoing Current Events:

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Kōkua Mau’s vision is a community where: the people of Hawai‘i are treated with dignity, compassion and love throughout their lives.

To make that vision a reality, Kōkua Mau’s mission is: to weave a lei of caregiving and support so that the people of Hawai‘i facing serious illness can live in the place of their choice, with relief of pain and suffering and according to their values, beliefs and traditions.

Kōkua Mau depends on donations and annual membership fees to carry on with our work. Please help us improve quality of life for people living with serious illness or at the end of life here in Hawaii. This is a community wide effort that needs everyone’s support.

►  I want to join Kōkua Mau as an individual member
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