Introduction
Hawai‘i is experiencing a significant demographic shift as its population ages. In 2020, one in every four residents in Hawai‘i was aged 60 years or older, posing an urgent need for enhanced health and social services to accommodate this growing collective.1–2 In response to the growing number of older adults, researchers have called attention to the health benefits of mindfulness meditation practices. A research study conceptualized by Takemoto and Lee, will aim to explore how mindfulness meditation, specifically through shakuhachi and haiku, can promote the well-being of older adults in the Hawai‘i community.
Mindfulness Meditation and Health of Older Adults
Mindfulness meditation involves contemplative attention to the present moment while fostering non-judgmental awareness of thoughts and emotional regulation that aims to reduce stress, improve cognitive function, and enhance the quality of life, which is particularly beneficial to older adults.3–4 With its long history in conjunction with relaxation interventions, music plays an integral role.5 It aids in maintaining homeostasis in various bodily systems and stimulates positive social feelings essential for happiness and well-being. Music naturally draws individuals into social groups, enhancing social cohesion and collective well-being. Additionally, expressing creativity through poetry elicits immersive insight and meaning-making of life experiences, increases self-efficacy, and reduces social isolation.6–7 Haiku is a form of poetry rooted in Japanese culture that uses nature as imagery reflected with symbolic meanings often found in Asian cultural traditions; the structure is based on a 5-7-5 syllable pattern to compose a 3-line poem.8–9
The benefits of mindfulness practices and ongoing creative art expression have been associated with enhanced interpersonal connections and improved self-regulation.6 More specifically, studies have shown that personal attention and social support through music and relaxation provide a healing environment for pain management and emotional well-being.5 Music reduces stress levels, lowers blood pressure, and alleviates postoperative pain, particularly in cancer patients and older adults receiving palliative care.5 By engaging the emotions and influencing the brain’s autonomic nervous system, music reduces stress, distress, and depression in individuals with acute and chronic pain.10 It counteracts negative cognitions, such as helplessness and hopelessness, promoting positive affect and healing.5,10 Music directly impacts the central nervous system, reducing undesired stress, enhancing mood states, and strengthening a sense of control, mediating positive social-emotional processes.5,11 Reflection through haiku offers a creative outlet for expressing experiences and emotions, further supporting mental health and well-being across diverse cultural dimensions with global reach.12 Haiku reflection emphasizes bodily awareness and has shown significant mental health benefits among older adults.13
Application of Mindfulness Meditation with Sounds of Shakuhachi (bamboo flute) and Haiku Reflection among Older Adults in Hawai‘i: An Example from the Community
In June 2023, Takemoto, a University of Hawai‘i at Mānoa Masters in Social Work (MSW) student specializing in gerontology and volunteer instructor at community organizations dedicated to serving kūpuna (adults aged 60 +) in Honolulu, Hawai‘i, implemented the idea to use mindfulness meditation, specifically through the sounds of shakuhachi and haiku reflections with the participating kūpuna. Takemoto is a licensed shakuhachi instructor with emphasis on performance for 40 years and has studied meditation for over 50 years.
About the Intervention: Immersive Shakuhachi Soundscapes and Haiku Reflection
The unique intervention combines meditation and connecting visceral senses through the sounds of shakuhachi. Takemoto has developed her tone and signature of shakuhachi as soundscapes for meditation. The following was composed by Takemoto in 2017, titled, Ahupua‘a (https://hawaiijournalhealth.org/docs/SoundsOfShakuhachi.m4a). The shakuhachi is a vertical bamboo flute introduced to Japan from China in the early 7th century CE.14 Takemoto reports that participants have joined the program due to their interest in meditating with the modulated calming sounds from the shakuhachi. Combining the sounds of the shakuhachi during the meditation session by Takemoto further creates engaged, active listening centered on a visceral experience. Guided by Takemoto, the long, sustained tones of the bamboo instrument have led participants to report a deeper, more intimate connection with nature, accompanied by enhanced inward reflection. Takemoto emphasizes this reflective experience that resonates from the bamboo as soundscapes with a connection that deepens participants’ meditative experience where they are guided by Takemoto to reflections into poignant, nature-inspired poetry. The haiku writing process encourages deep inner contemplation. Along with the natural soundscapes of the shakuhachi, the experience fosters haiku reflection and sharing among participants. Participants have reported positive effects in their lives, such as integrating mindfulness and creativity, enhancing their health, and quality of life.
Takemoto incorporates a foundational theme based on the Aloha Spirit, as defined in Hawai‘i Revised Statutes, section 5–7.5, “Aloha Spirit Law.”15 This theme is enriched by parallels with Japanese culture. For example, akahai, which signifies kindness expressed with tenderness, corresponds to the Asian concept of 心 (kokoro or heart-mind).15 Similarly, lokahi, meaning unity, aligns with the Asian concept of 和 (wa or harmony).15 Takemoto has developed systematic steps to introduce each session with foundational themes, followed by breathwork practice, guided meditation with shakuhachi soundscapes, and concluding with haiku reflection. This structure creates a safe and sacred space for deep reflection and sharing in a supportive environment. Participants report that applying the meditative breathwork practiced in the session has helped them emotionally self-regulate and respond to stressors with increased mindful, calm awareness in their daily lives.
A unique aspect of each session is that the session culminates in quiet meditation accompanied by tones from the bamboo (shakuhachi), followed by haiku writing and sharing. Takemoto facilitates personal reflection that fosters a safe place among participants. It is a beautiful process. As in Turner et al,8 Takemoto’s focus is based on the essence of haiku for reflective meaning and symbolism over strict syllable count as a form of free expression and art. Reflection through haiku offers a creative means for expression, further reported by participants in supporting their well-being.
Conclusion
Guided by the National Association of Social Workers values and ethics, the mission of social workers is to enhance the well-being of older adults.16 Mindfulness meditation can be used as an intervention to promote the health and well-being of older adults, especially in mental and emotional well-being. Yet, there are gaps in the literature due to variations in the implementation approach and limited scientific evidence.17
In Hawai‘i, cultural practices to improve health and well-being are respected and well-received. For example, according to Ho‘i ka Hā, mindfulness practices are rooted in the words Aloha and Hawai‘i.18 Ha, meaning breath, is an important component of the mindfulness meditation process. By properly incorporating and applying mindfulness meditation for older adults in Hawai‘i, more older adults can learn the unique practice to improve their health and well-being. For example, Hoge and colleagues19 found that mindfulness-based stress reduction had comparable effectiveness to an anxiety medication (escitalopram) through a randomized clinical trial.
Offering unique, culturally mindful, and Indigenous programs to promote the health of older adults in Hawai‘i is critical, and training more professionals to implement mindful meditation, such as shakuhachi and haiku reflection, may be beneficial. However, more studies are needed to understand the effects of mindfulness meditation. As such, Takemoto and Lee will be working on an intervention research project to explore how mindfulness meditation through shakuhachi and haiku can promote the well-being of older adults in Hawai‘i. Informed by harmonious aging theory which provides a framework to view each life stage as an opportunity for growth and development with practices such as meditation to promote the benefits of inward-focused contemplation, fostering a peaceful mindset for positive health outcomes,20 Takemoto will explore the following main research questions: (1) what is the association between participation in mindfulness meditation and the level of well-being among older adults? And (2) what are the perceptions and experiences of older adults regarding their well-being after attending meditation sessions? A mixed methods design that includes both quantitative and qualitative components will be used to answer the research questions. With the program set to be implemented in September to November 2024, Takemoto will perform the meditative natural sounds of the shakuhachi in person in each 90-minute session. Takemoto and Lee are excited to learn about the experiences of older adults who attend the meditation sessions. They hope to share the study findings with the community to inform future practice, education, research, and training.
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