Last Wednesday, a half-dozen state senators publicly shared family experiences with the growing problem of dementia.

It came one day day after a Civil Beat article reported how one of their colleagues, Michelle Kidani, was believed to be suffering from the disease — something several senators confirmed that very day.

“When I spoke to Senator Kidani, it made me think that everyone I know can relate to this story,” Sen. Donovan Dela Cruz said during the floor discussion Feb. 4. “We know of an auntie, an uncle, a cousin. We’re all dealing with this. And it is a good opportunity so that as a state, we can recognize what we have to deal with, how we’re going to take care of our kūpuna.”

There are more than a half-dozen measures proposed this year focused on dementia and Alzheimer’s. They are backed by a sizable number of legislators from both parties and chambers, and their introduction predates the public news of Kidani’s condition.

Several bills have already passed their first round of committee hearings this session. The legislation includes measures to increase funding for existing programs already addressing the disease as well as to set up and pay for new programs.

While often used interchangeably, dementia and Alzheimer’s have different meanings.

Dementia, according to the Mayo Clinic, is “an umbrella term” that describes a wide range of symptoms including decline in memory, poor judgment and reasoning skills, decreased focus and attention, and changes in behavior and language.

Alzheimer’s disease is the most common type of dementia and is “a specific brain disease” marked by symptoms that gradually worsen over time.

Senators have introduced measures this session that would:

• set up a Hawaiʻi Dementia Initiative Business Recognition Program;
• establish a Hanai Memory Network Program within the Executive Office on Aging;
• create an Alzheimer’s Disease and Related Dementias Research Center of Hawaiʻi at UH;
• appropriate money for the establishment of four full-time equivalent state dementia care specialist positions, one in each county.

In his floor remarks, Dela Cruz illustrated how legislators are learning more about dementia and Alzheimer’s to better inform their legislation. He said he had called the Alzheimer’s Association of Hawaiʻi to find out more about the disease in the islands.

“Approximately 31,000 to 35,000 people age 65-plus are living with Alzheimer’s in Hawaiʻi — a number projected to rise as the state has one of the highest life expectancies,” he told his colleagues. “Roughly 16.8% of adults report cognitive decline that are around 45 years old and above. And Alzheimer’s is (one of the) top five leading causes. It’s supported by 60,000 plus unpaid caregivers throughout the state.”

Dela Cruz said that his grandmother had dementia “and it was really hard on my family initially. Back then, they didn’t have the medicines and technologies, the research that they have now.”

The proposed legislation recognizes that dementia is not only personal, it can also affect businesses, economic growth and visitors to Hawaiʻi, according to lawmakers and testifiers on the slate of bills.

“Creating a dementia-friendly business environment would greatly enhance the quality of life for those living with dementia and for their caregivers, while also demonstrating that this is not just a health issue, but also an economic and community development priority,” according to the preamble of one of the bills.

Cost Of Care Expected To Keep Rising

Kealii Lopez, state director for AARP Hawaiʻi, called the financial impact of Alzheimer’s alarming.

In 2020, Medicaid spent $240 million on care for residents with Alzheimer’s, she said in testimony on House Bill 1853, the companion to the Senate’s bill on the Hanai Memory Network Program.

“The 2025 report shows that figure has risen to $309 million, an increase of $69 million in just five years. If no action is taken, Alzheimer’s‑specific Medicaid costs are projected to reach nearly $1 billion annually by 2050.”

Lopez called the trajectory “unsustainable” and said it underscored the need “for upstream investments in caregiver support and coordinated services — precisely what the Hānai Program provides.”

In 2025, legislators approved two other dementia bills that are now law.

Act 286 standardized cognitive assessments for qualified Medicare beneficiaries and set up a two-year Dementia Data Pilot Program within the Executive Office on Aging to collect and analyze assessment data.

Act 283, meanwhile, appropriated just over $1 million to the University of Hawaiʻi to establish positions within the John A. Burns School of Medicine’s Department of Geriatric Medicine.

The money from the latter act is used to coordinate and incorporate training on Alzheimer’s disease and other forms of dementia for health care providers in existing UH programs. A dementia curriculum will also be incorporated unto those programs “with the goal of establishing a local, informed dementia workforce,” according to the act.