The average working class family in Hawaii has about $3500 in retirement savings.  A year in a long term care facility costs about $135,000.  If you have to go to one, you usually end up staying for about 3 years.  As our population rapidly ages we clearly have to find a slew of answers.  217,000 workers in the private sector in Hawaii have no payroll deduction mechanism to save for retirement or for the kind of catastrophic health or disability issues described in this article.  In other words we don't make it easy for people to save.  That ought to be a relatively easy fix that would help people prepare for the last chapter in life.  Another would be to ensure that a significant number of the units built along the rail line are adapted for the elderly and disabled, so they can age in place and get to stores, hospitals etc  - thus reducing (not eliminating) the need for long-term care and costly nursing facilities.  There are other things we can do, but we have to start planning now.