The Well-Planned Life: End of Life Planning

For all the complicated emotions that arise when one thinks of end-of-life planning, it's important to remember the goal of that planning—to reduce, as much as possible, the grief and stress your survivors will feel by making clear decisions about these matters now.


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It is also unwise to assume government programs like Medicare and Medicaid will pick up the bill. Medicare will only help pay doctor and prescription drug fees, and only on a short-term basis. Medicaid will pay for everything if you’re 65 and older, but only after you’ve exhausted all of your assets to pay for your care.

“And because Medicaid funding is shared between federal and state governments, services come under pressure when budgets are tight, like now,” says Bruce Bottorff, AARP associate state director.

With government resources being stretched in the struggling economy, and the extremes to which one must go to qualify for Medicare and Medicaid, long-term healthcare insurance might be a better alternative.

“With the high and rising costs of LTC and the concurrent increases in life expectancy and rising number of older adults, LTC insurance is one way to defray the exorbitant cost of services,” says Bottorff.

For more information and a deeper discussion about this topic in last year’s Well-Planned Life, see our October 2008 insert.

Long Term Care Facts

  • Hawaii’s elderly population of 65 years old and above will grow by 78 percent over the next 20 years to be about 327,000 people.
  • Hawaii is number one in the country in nursing facility occupancy rate.
  • About 83 percent of Hawaii’s Medicaid long term care spending is usually spent in nursing homes despite many aging people wanting to spend their remaining years at home.
  • About 69 percent of all 65-year-olds in the United States will require long term care for an average of at least three years in their lifetime.

For more information about long term care, visit

Cremation or Burial

According to Nanette Napoleon, a member of the board of trustees at Oahu Cemetery and a freelance local historical researcher, burying a loved one is the third-highest single expense you’ll ever pay, after buying a house and car. Not only is it something that can’t be avoided, it can also be hard to make wise purchasing decisions when grief stricken over a deceased loved one. “People are not good consumers when it comes to death,” she says. “It’s not like when you shop for a car, a house or clothes.”

There is a price for everything when burying or cremating a body, and, most importantly, there is a price difference if you want to buy services for a recent death (at need) or if you’re purchasing for the future (preneed).

There are various types of insurance that can cover the costs of cremation or burying a body, but if you want to go the cheapest way with the least amount of impact on the land, cremation is the rising trend in the industry.

“We are probably the highest, or one of the highest cremation states in the country,” says Harold Lewis Jr., the superintendent of the cemetery, adding that his organization performs about 2,000 cremations a year. “About 68 percent of all deaths in Hawaii are cremations.”

Cremations at the cemetery start at $750, memorial services in its chapel $895 and the most basic urn is $195. “Burials can cost up to $15,000,” notes Lewis.

There are also several prices for having ashes scattered at sea by a professional, renting out a large boat for a memorial or, if you want to keep the ashes, you can purchase a niche to house the urn.

However, not all people want to incinerate their remains, due to religious beliefs or other reasons. But to accommodate a traditional burial, you will have to look outside of Honolulu if you don’t already have a family plot.

“Nobody in Honolulu has anything left in terms of body burials,” says Lewis. “So all those traditional body-burying families are switching to cremation.”

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Honolulu Magazine June 2018
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