Mexicans have an old saying: "The best doorstops are made from the same wood."

It means the hopes and dreams of individuals often are crushed by those who are closest to them. This is the position faced by the elderly in Hawai'i on issues like physician-assisted suicide. Despite having lobbied and pleaded for this measure for more than 10 years, legislation that would have enabled this law to pass has been consistently blocked by people speaking on behalf of the children and grandchildren of some of the very elderly who requested it.

"I don't judge young people," says 82-year-old senior advocate Florence Lau. "They are so busy with their lives. When you are young, you are so busy doing your own thing you don't think about what's going to happen when you get old. But as for me, at my age, I realize that if we don't try to do things for ourselves, no one is going to help us."

As the attendance of the "Silver Legislature," a mock legislature made up of the elderly held last November can attest, these elders are not likely to go away.

More then 150 people attended the two-day session. The purpose of the Silver Legislature was to put into the proper context position papers and legislative bills that address specific needs of Hawai'i's senior population, which would not otherwise be brought forward for public debate.

Many think that the younger legislators, many of whom are in their 20s, can't relate to their problems.

For example, one of the issues the seniors said they wanted addressed was a lengthening of the timing of traffic lights.

This is not a big issue to most younger people — indeed, some find the very idea of extending the time they spend in traffic annoying.

But for seniors, it is a pressing concern. Many recall that only a few weeks ago, William Kobashigawa, 89, a Bronze Star Medal winner and World War II hero, was killed while walking in a crosswalk on Kamehameha Highway by a 26-year-old speeder.

What was most notable about the agenda set forth by Hawai'i seniors at the Silver Legislature was that practically no young reporters were there to cover the issues presented.

For the media, it was like missing the tremors of what soon will be a large social volcano.

One of the most significant issues affecting seniors is their desire not to go into nursing or convalescent homes.

Many equate leaving their own homes with death and insist on remaining independent, either by themselves or with family, for as long as possible. For some policy planners, the point is moot in any case.

For aside from a relative few very expensive nursing or senior convalescent homes, Ha-wai'i is operating at 98 percent capacity for senior- care beds at a time when the number of very old elderly is growing rapidly in the Islands.

To put this in perspective, in 2000, approximately 13 percent of the nation's population was 65 and older compared with 4 percent in 1900.

Due largely to advances in medicine, people are living longer, with the biggest growth expected to be among those over the age of 85, who are most in need of medical and social services.

According to data from the state's Executive Office on Aging, while the total population grew in Hawai'i from 1990 to 2000 at a rate of 9 percent, the number of those in the population 85 and older grew at a rate of 69 percent.

In 2005, there were approximately 230,000 people in Ha-wai'i older than 60. Approximately 25,000 of these individuals are over 85. (There are an estimated 54,248 people in Hawai'i older than 80.)

Because the expenses needed by individuals in this group can be so great — due to diabetes, Alzheimer's, cancer and other problems associated with aging — it is estimated that within a senior population older than 60, only 5 percent of the individuals, who are in need of round-the-clock care known as case management, can absorb as much of the medical costs as half the entire group.

It is not unusual for seniors to have health bills of $10,000 per month. To give an idea of how much is spent on senior care, one only has to recognize that nationwide, $100 billion is spent annually on nursing-home care — almost half of it coming from the federal/state Medicaid program.

NATURAL COMMUNITIES

One way to deal with the tremendous anticipated demand on social services is through strategic planning.

In New York City, which faces similar demographic changes, people created a proactive program called NORC, which stands for Naturally Occurring Retirement Communities.

These are naturally occurring communities, unlike retirement homes, in which the most of the population is older than 50. One need only drive through older neighborhoods in Honolulu — in areas like Manoa, Palolo or East Honolulu — to see that most of the residents there are older and retired as well.

By organizing NORCs and providing them with financing so they could become their own social services providers, the New York experiment made it possible for seniors to help themselves.

The NORC social service programs brought visiting nurses to people's homes and apartments, and created recreational programs for them. These programs did not necessarily save money over other conventional programs, which are based on social service agencies responding whenever there is a health or social crisis in a person's life.

Their goal has been to proactively intervene in peoples' lives to make life better before there is a crisis.

This approach has enabled people to live longer, more securely and happier in their own homes.

To prepare for the social costs of aging before they occur, the people of Hawai'i have to look at every possible solution.

The size of this growing problem in Hawai'i, at a time when federal Medicare and Medicaid reimbursement has been cut, is one of the reasons that this year's state budget surplus must be looked at as "rainy day" money to be saved for presently unmet, but looming, social needs.

Mike Markrich is a Kailua-based researcher and writer. He wrote this commentary for The Advertiser.