Koi have a habit of pointing upstream and swimming against the current. When visiting the Boyle Heights Keiro facility over many decades, I would take the short walk to the side of Emil Brown Auditorium to visit with the school of koi placed there 40 years earlier by the community. For me and my direct family, these periodic visits at Keiro start as a child in the late 1970s and ended as a Community Advisory Board member in 2020 due to the emergence of the SARS-2 coronavirus threat.

It is an honor and privilege to have been serving for the past five years on the Community Advisory Board. However, I never anticipated that I would need to chair its functions. I have no conflicted interests. I have no agreements with Keiro, Pacifica, or any related company. I have never received reimbursement or payment for any volunteer service on the CAB. I am a retired, board-certified pediatrician with 25 years of physician licensure in California and ten years of similar credentials in Hawaii.

The photo taken in Manzanar in 1944 shows my Issei great-grandfather Kishiro Sakamoto and great-grandmother Muku Sakamoto with their Nisei son, Louis Sakamoto, in U.S. Army uniform, and my mother and her twin sister, Arlene Kawano Hayashida and Darlene Kawano Mano, who were put in Manzanar as 1-year-olds.

The decisions of the executives in each company are their own responsibility. Our advisory board is tasked with communicating “advice and feedback” to the facility operators (Pacifica, Aspen, and Northstar). Our board’s tasks are made very difficult if community-based organizations are not appropriately informed or, worse, spreading misinformation. When people in one segment of the Southern California Nikkei community do not resolve their conflicted issues, it can create unintended consequences in families and relationships hundreds and even thousands of miles away. The reason is that the residents in these facilities have family members scattered over the entire country.

By the time Keiro sold its facilities in 2016 to Pacifica, management had stated for years that senior care in the United States had shifted from large nursing homes to an “aging in place” paradigm of providing care in a person’s home. However, three generations of my family would need to receive care in various Keiro programs through 2014. It is clear today that there are many families who continue to be served and need service in these facilities.

Thousands of Americans of Japanese ancestry who were raised in Southern California will recall visiting the Keiro facilities in Boyle Heights. My mother would drive our family’s Chevrolet from Long Beach to Los Angeles. The long mid-day drive would end in Boyle Heights at the Keiro facility’s patient care tower, where my issei great-grandmother lived for many years. We would make the trip regularly to see our elder family members.

My memories of Keiro are colorful, scentless, and culturally respectful for a generation that endured decades of sustained discrimination. Coming off the elevator and holding my mother’s hand, we would make our way to a sunny, brightly lit patient care room. My graceful great-grandmother of 90-plus years would sit smiling in her bed and happy to see us visit. She would talk in Japanese with my grandmother and my mom.

Scarcely taller than the top of the bed, I recall reaching up to give my great-grandmother a hug. Turning from the conversation, the windows looked over Los Angeles. Rooms were immaculate. The Japanese staff could speak with these elderly Americans in the language needed to provide care. Appropriate Japanese nutrition and diet were provided while accommodating medical issues. Keiro provided vital services for our family and our community as the baby boomers grew into adulthood and our generation entered the workforce in the 1990s and post-9/11. This was the social engine that made the recovery of our families in this region possible.

Koi illustration by Michelle Koza

My first-, second-, and third-generation family members were split in February 1942 by the War Relocation Authority to Manzanar, Heart Mountain, and Poston. In late 1944, my great-grandmother watched her first-born Nisei son get drafted into the U.S. Army while the family was being held inside the barbed wire of Manzanar. U.S. naturalization laws made Japanese immigrants “ineligible” to apply for U.S. citizenship for decades.

The older sisters of my Nisei grandmother lost their U.S. citizenship by virtue of marrying Japanese men prior to 1938. Like thousands of other Nisei women of the time, they would be made to reapply for U.S. citizenship and naturalization despite their birthplace being in the United States.

By the late 1970s, my Issei great-grandmother, having dealt with these inequities for herself and her children, needed long-term care. Fortunately, in 1971, the founders of Keiro purchased the former Jewish Home for the Aged. For 45 years, the people of Boyle Heights have worked these services for the benefit of the regional Japanese American community. Even to this day, this is the legacy of many residents in these facilities.

My grandmother’s siblings were scattered over many states after the forced dislocations of Executive Order 9066. My grandmother’s brother served in the U.S. Military Intelligence Service in post-war Japan. Like other veterans of the 442/100/MIS, he would visit his mother at Keiro and then drive to my grandmother’s home to discuss over dinner. I would sit at that table as a child and listen to their conversations.

Around 2012, it was my grandmother’s turn to receive care in the Keiro Lincoln Heights facility. However, she did not want to stay long. She wanted to return to her home in Orange County. This was her decision. But, the question in 2021 remains. Will the Sansei and Yonsei have bicultural services, including dietary and nutritional support when we age? What about the thousands of new Issei who speak Japanese and need the care support now? These questions need to be addressed in the community immediately due to the COVID-19 pandemic creating a need for short- and long-term care bed capacity.

Sakura Intermediate Care Facility is a rare nursing home where none of the patients have become COVID-positive over the entire duration of the epidemic. Our community needs COVID-free bed capacity for patients now. Closing 90 beds in the middle of a pandemic would be a very concerning reduction in bed capacity for our community. During this public health emergency, the bed capacity needs to remain open to protect the residents of the ICF from the pandemic. Authorities and the Pacifica Companies need to consider this continuity of care and the safety of the residents as the primary and only guiding factor in decision-making.

Just as it took a community effort to build the Keiro organization itself, it was the Issei and Nisei members of the gardeners’ association who donated the time and resources to build and maintain the koi ponds in the late 1970s and early 1980s. My grandfather, who was part of the association, donated many fish to the Keiro koi pond for the enjoyment of my great-grandmother and the community.

While visiting Keiro around 15 years ago, I stood at the side of the koi pond at the front of the Emil Brown Auditorium looking at the fish. The koi had very similar markings. They looked like the same fish that I used to feed as a child in my grandfather’s backyard koi pond. It was possible that some of the same fish from my grandfather’s backyard were still living in the pond 30 years later. Over the past recent years, those koi have been gradually disappearing.

For me, the koi in Keiro’s ponds were a living connection between generations who called Los Angeles and Boyle Heights home. The petitions to request the extension of conditions are consistent with this cultural respect for the aged. I encourage readers to sign these petitions and to share your thoughts with the Community Advisory Board at I appreciate your thoughts and comments.


Dr. Kenneth Hayashida, Jr. is chair of the Community Advisory Board and a retired board-certified pediatrician. Opinons expressed are not necessarily those of The Rafu Shimpo.

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  1. Being a single aging sansei with no children, I was counting on Keiro to be there for me in my twilight years. Alas it is not to be.