Chinese folk music drowns out the hum of nearby construction trucks moving dirt and flattening ground.

Inside Palolo Chinese Home, 84-year-old Choki Yara leans forward to make his move. He is the king of Chinese checkers around here — or so he says, with a wide smile.

Three tables down, across from bookshelves stacked neatly with a rainbow assortment of construction paper, games and exercise equipment, Ellen Miyashita, also 84, chats as she fingers a newspaper in her hands.

"This is a nice place," Miyashita said, scanning the home's newly renovated activity room. She finishes her cursory inspection with an approving nod.

For 110 years, as the oldest adult-care home founded by Asian-Americans in the country, the senior daycare and residential facility has served as a peaceful, welcoming place in the heart of Palolo Valley. It has helped thousands of all ethnic backgrounds, many of whom couldn't afford other facilities.

But the popularity of the care home coupled with the ballooning population of seniors in the Islands has triggered ever-growing waiting lists for seniors — especially women — who have few other options.

In response, the Palolo Chinese Home's board of directors three years ago embarked on a $17.1 million renovation to expand its programs and services.

A $15 million phase of the renovation effort now under way includes installing 42 skilled-nursing beds for 24-hour care, upgrading facility infrastructure and renovating the home's kitchen, where three large woks and a small oven turn out some 18,000 meals annually.

The installation of the skilled-nursing facility is expected to help relieve a statewide shortage for such care.

NOT ENOUGH BEDS

Federal statistics show there are 22 skilled-nursing beds per 1,000 people over age 65 in the Islands. Nationally, that rate is 52 per 1,000 people over age 65.

"We want to actually fill a void," said Wesley Fong, Palolo Chinese Home president and board chairman. "The board is committed to this vision we have so we can continue our legacy."

When the renovation is complete, the home will provide a continuum of care that starts with helping seniors in their own homes. It then extends opportunities for them to take part in day activities at Palolo Chinese Home. Later, residential care is offered. And lastly, skilled, 24-hour nursing and hospice care is available.

The model is one-of-a-kind in the Islands, and could be unique to the nation, said Palolo Chinese Home Chief Executive Officer Leigh-Wai Doo. When the renovation is completed, the home will be able to serve about 570 people at any one time.

The number of assisted-living spots will jump from 65 to 76. Respite services will triple to 15 beds, and five hospice beds will be installed in a white, turn-of-the-century home near the entrance of the campus.

Also, some 400 seniors a day — up from 80 — will get help in their own homes, with meal delivery, referrals or nurse visits.

The first phase of the project, which cost $2.3 million, was completed in September 2005 and saw the renovation of Lani Booth Hall. Assisted-living rooms and daycare facilities were refurbished and state-of-the-art equipment and nursing stations installed.

The big activity room, where some 30 seniors exercise, listen to music and play games daily, got big glass doors for an expansive view of Palolo Valley. Knee-high planters, designed so the elderly could sit while they garden, were installed on a wide lanai.

Those who live at the home reside in red-and-green buildings, where rows of jalousie windows are opened wide for a breeze, scuffed linoleum floors show their age and room decor consists of beds whose green-blue sheets match privacy drapes.

Compared to the renovated Lani Booth Hall, conditions are wanting. But residents say they are just happy to have secured a spot at the home, given its good reputation and premium on space.

'EVERYTHING IS GOOD'

Florence Oshima has lived on the campus for five years. In the large, airy day room for full-time residents, Oshima plays a round of dominoes with a group of friends while other seniors watch a big television or chat.

"Everything is good," said the 82-year-old, her small shoulders hidden under a black, button-up sweater.

As a light rain starts falling outside, Marjorie Chun sits upright in her chair to talk to Doo, who is greeting residents in the room with handshakes and smiles. She wants to thank him.

The 95-year-old begrudgingly came to the home two months ago, but was soon won over.

"I didn't want to come because I'm so used to being alone," she said, her voice shaking with emotion.

"But no place can beat this place for old people to be taken care of."

Fong, of the board, said the home's renovation and expansion efforts come as Hawai'i is facing growing concerns about how to help seniors, many of whom take great pride in their independence and wince at suggestions that they need full-time care.

About 18.6 percent of O'ahu's population is 60 or older, compared with 16.6 percent nationally, according to 2004 census figures.

Census figures for elderly who are institutionalized on O'ahu, however, mirror the national average: About 27.9 percent of those 85 and older on O'ahu are in care homes, compared with 27.9 percent nationally.

There are 28 nursing homes and six assisted-living facilities on O'ahu, Census 2004 figures show. Also, per 1,000 people older than 65 islandwide, there are 21 nursing-home beds and 10 assisted-living beds.

WAITING LISTS

Doo said there are waiting lists to get into almost all of Palolo Chinese Home's programs, few of which are advertised by anything more than word of mouth.

The home has long been a pillar in Palolo Valley, where it moved in 1917 from Palama. Doo's grandfather helped build the home and he and his father were on the board of directors.

As Doo continues his walk around the residential hall, he runs across a resident he calls a hero: legendary swimmer and baseball star Keo Nakama.

Nakama watches wrestling on television with a friend, who has nodded off in a small sitting area adjacent to the residential hall. The former state legislator and physical education teacher became the first person in 1961 to swim the 27-mile Kaiwi Channel from Moloka'i to O'ahu. He was 41 years old.

Earlier, while describing diversity at the home, Doo said residents range from legislators and athletes to homemakers. Doo's seventh-grade typing teacher, Georgia Miller, is at the home, too.

"He gave me trouble," Miller says, laughing as she held Doo's hand.