Dying At Home Is Harder For These Hospice Patients Stuck On Oʻahu

Robert Granger, an 84-year-old Moloka'i resident, was airlifted to Honolulu’s Queen’s Medical Center in December 2024 after a pneumonia diagnosis. His condition worsened, and doctors discharged him to hospice care, but Granger insisted on returning to Moloka'i to die at home. Insurance denied air ambulance coverage for his fragile condition, and Mokulele Airlines’ commercial flights were unavailable or physically inaccessible due to his weakened state. Granger’s family spent over $4,000 to charter a private plane, a process that took four days—leaving him only an hour alive upon arrival. He died surrounded by family, fulfilling his wish to pass away on Moloka'i. His widow, Elizabeth Johnson, said he ‘let go’ once home, suggesting he had been ‘hanging on’ during the ordeal. Moloka'i, a sparsely populated island with just 7,400 residents, faces chronic healthcare challenges due to limited infrastructure and anti-development policies. The island lacks fast food, hospitals, and reliable transportation, with Mokulele Airlines as its sole air carrier. Residents often rely on air ambulances for emergencies, but returning for end-of-life care is rarely feasible without private funds. Granger’s case underscores the broader struggle of rural Hawai'i, where isolation and limited resources force families to bear financial and emotional burdens for basic healthcare access. Moloka'i’s economic stagnation and reliance on a single airline exacerbate these issues, leaving residents vulnerable when medical needs arise. The island’s remoteness—just 26 miles from Honolulu but culturally and logistically distant—makes even routine care a logistical nightmare.