Providing compassionate in-home and out-patient care in Plymouth, NH

6th Annual Battle of the Sexes Tennis Tournament Scheduled for September 19th

 

Pemi-Baker Community Health (PBCH) is excited to announce that the Waterville Valley charity event, “Battle of the Sexes Tennis Tournament” will be held on the outdoor, clay courts on Sunday, September 19th 2021. Doubles men’s teams will compete against doubles women’s teams in hour long battles on the court as well as competition for overall moneys raised for PBCH’s Palliative & Hospice Care.

The generosity of our players, sponsors, and donors has raised $30,000 over the past six years for PBCH and hopes are high for bragging rights this year. You can join in the fun by registering your doubles team; players are participating from all over the state. In past years, Pirates, Roaring Twenties Flappers, Cowboys and Pink Diva costumes have added to the fun and given players point advantages. Players can also ‘buy’ mulligans / serves during play which of course adds to the proceeds and fun.

There are many other ways to get involved if you don’t want to battle it out on the tennis court. An auction site has been set up to buy raffle tickets for wine baskets, photography/artwork and more. You can also help your favorite team win the ‘Moneys Raised’ competition by donating on the auction site towards your favorite team: ‘Men’ or ‘Women’. www.32auctions.com/Battle2021

If you would rather be a spectator watching the shenanigans and banter, we encourage you to join us courtside on the 19th. Teams will be competing from 2-5pm and prizes will be given out at the after-party at the Wild Coyote Grill located in the White Mountain Athletic Club. Raffle tickets can also be bought at Pemi-Baker Community Health, courtside during the competitions and at the after-party. Many thanks to our sponsors Waterville Valley Realty and Roper Real Estate!

For more information about how you can get involved, please look on our events page.

With over 50 years of experience, serving clients from 28 towns in central and northern New Hampshire, Pemi-Baker Community Health is committed to creating healthier communities. Services include at-home healthcare (VNA), hospice and palliative care, on-site physical and occupational therapy and aquatic therapy in their 90-degree therapy pool. Providing compassionate care with experienced staff who are trained, certified professionals in the business because of their hearts. In your time of need, we’re right where you need us.

PBCH is located at 101 Boulder Point Drive, Plymouth, NH. To contact us please call: 603-536-2232 or email: info@pbhha.org  Like our Facebook Page: @PBCH4

~written by Anna Swanson

Alzheimer’s at the Movies

Over the past twenty years, several interesting feature films have been produced which explore the significance of Alzheimer’s Disease and its impact on patients and their families and caregivers.

For her performance as Alice Howland in 2014’s “Still Alice”, Julianne Moore received the Academy Award for Best Actress.  The film is based on a novel of the same title by Lisa Genova, herself a neuroscientist.  The film is the story of Alice Howland, an esteemed professor of linguistics at New York City’s Columbia University.  The story takes us from Alice’s first suspicions that something is amiss, through her diagnosis with Early Onset Alzheimer’s Disease, her various losses, and concluding with a touching scene featuring Alice’s free-spirited actress daughter Lydia who has assumed responsibility for her care.

As the story unfolds, we witness Alice and her family confront and come to terms with many of the challenges posed by Alzheimer’s Disease.  Alice’s particular form of the disease is called “familial”, meaning that in her family line, there have already been two or more relatives with the malady.  Since Alice is only fifty, her diagnosis is termed “early onset”.  The question is raised as to whether Alice’s three grown children want to be tested to determine if they are susceptible to the illness.  Daughter Lydia chooses not to.  Son Tom and the elder daughter Anna do want to be tested.  Anna is pregnant.  Though she is positive for the test, she follows through in giving birth to her twins.  This complex of factors are among several story lines in this captivating film.  Others include:  Alice’s secret preparations to end her own life when her memory loss and functioning progress to a certain point, her lingering desire to make a contribution to others living with the same disease, and family decisions around Alice’s care in conflict with the reality that “Life goes on”. Through all this, we see Alice’s progressive deterioration through the loss of her teaching career, her advancing inability to recognize those closest to her, disorientation within her own home, an interrupted suicide attempt, her husband’s decision to relocate in favor of his professional betterment, and the loving self-sacrifice of Lydia to care for her.  Despite the wasting away of the many qualities that made her the person she had been, she remains “still Alice” in a brief moment of recall when she is able to identify the importance of love.

In preparation for her role as Alice, Julianne Moore did extensive research about Alzheimer’s Disease.  Sadly, it also fell to her to dedicate her reception of the Academy Award to the memory of Richard Glatzer, one of the two writers and directors of the movie.  He died of ALS (“Lou Gehrig’s Disease) shortly before the awards ceremony.  “Still Alice” can be accessed on You Tube, Hulu, and Amazon Prime.

Closer to our time, the winner of the 2020 Academy Award for Best Actor was Sir Anthony Hopkins for his performance as Anthony in “The Father”.  Some years ago, Hopkins also won the Oscar in that same category as the infamous Hannibal Lechter in “The Silence of the Lambs”.  “The Father” is based on a French stage play by Florian Zeller who assisted in the adaptation and direction of the work for the screen.  “The Father” features Olivia Colman (currently seen as Queen Elizabeth II in Seasons Three and Four of the series “The Crown”). For her portrayal as Anne, Anthony’s daughter, Colman was nominated for the Academy Award for Best Supporting Actress.

Spoiler alert!  “The Father” immerses us within the thoughts, perceptions, and reactions of a man whose mind is unraveling because of dementia.  There are repeated events with some changes in character and setting that can be quite confusing and disconcerting until we perceive that this is purposefully done to draw us into Anthony’s experience.  It ushers us into the insecurity, denial, resistance, fear, anxiety, anger, and fragility of a man with dementia.

“The Father” begins with a confrontational conversation between Anne and Anthony who has become oppositional toward his paid caregiver.  We are immediately plunged into what becomes a slow-moving but steadily mounting storm system of suspicion, stubbornness, refusal, lapses of memory, disorientation, and eventual breakdown.  The persistent pace of the story’s development raises the sadly familiar challenges of living with and caring for someone with this illness. What to do about emerging potentially aggressive behaviors?  How to live with the strain imposed on other intimate relationships?  When does one arrive at the point of surrendering caregiving to a corps of providers in a setting that may better manage the patient’s needs?  Hopkins’ masterful performance in this intense drama can be seen on You Tube, Amazon Prime, and Vudu.

Obviously, films of this genre do not lend themselves to a family movie night of coziness while sitting in front of the flat screen with popcorn at hand.  They are, perhaps, most useful as a learning experience for mature adults who may be starting to consider addressing some of the serious “What if…” questions emerging in their lives as they age.  The value of these movies as “family drama” will have served a good purpose if they broaden out into thoughtful and serious discussions and actual planning and preparation that might avert being overwhelmed in a later future time of critical need.

Pemi-Baker Community Health offers community support groups for Caregivers and families living with dementia as well as one on one meetings for help filling out those all-important forms for end of life wishes and care. We encourage you to contact us with questions. PBCH is located at 101 Boulder Point Drive, Plymouth, NH. To contact us please call: 603-536-2232 or email: info@pbhha.org   Visit our website: www.pbhha.org  and like our Facebook Page: @PBCH4

With over 50 years of experience, serving clients from 28 towns in central and northern New Hampshire, Pemi-Baker Community Health is committed to creating healthier communities. Services include at-home healthcare (VNA), hospice and palliative care, on-site physical and occupational therapy and aquatic therapy in their 90-degree therapy pool. Providing compassionate care with experienced staff who are trained, certified professionals in the business because of their hearts. In your time of need, we’re right where you need us.

~written by Guy Tillson, MDiv, MA, Hospice Chaplain

New APRN, Jill Hunter, Joins Pemi-Baker Community Health

The term Hospice Care is widely known but many times people shrug their shoulders when asked about Palliative Care. Jill Hunter, APRN, ACHPN has recently joined Pemi-Baker Community Health (PBCH) as their Nurse Practitioner in Palliative and Hospice Care. PBCH is thrilled to have her join their mission to educate Central and Northern NH about Palliative Care and how a Palliative team can help families facing serious illnesses.

Jill Hunter has been a nurse practitioner for 23 years working in primary care, both family practice and internal medicine for the Indian Health Service in New Mexico, Dartmouth Hitchcock Clinic and Concord Hospital. Most recently she has focused on palliative care, after becoming very involved with a particular patient in his late 40s, just diagnosed with renal cell carcinoma (kidney cancer). “I remained his PCP throughout his illness, managing his symptoms, coordinating with his specialists and educating his family. I celebrated his triumphs and supported him through disappointments. I eventually helped him to transition to hospice care 3 years after his initial diagnosis and remained involved in his care until he died. He taught me a lot about caring for seriously ill patients and their families. I feel that experience sparked a passion within me to become a palliative care provider,” said Hunter.

One of the biggest misunderstandings people have is thinking Palliative Care is the same as Hospice Care. Although it is a part of Hospice Care, Palliative care is specialized medical care for anyone living with a serious illness. It is appropriate at any age and at any stage of the illness, and it can be provided along with curative treatment. Pemi-Baker’s specially-trained team of doctors, nurses and other specialists work with a patient’s other doctors to provide an extra layer of support focusing on providing relief from pain, nausea, constipation, diarrhea, insomnia, anxiety, shortness of breath and other stressors of the illness.

“Most of my experiences in palliative care have been in the hospital setting. Unfortunately, the patients I see are often far along in their journey with serious illness and could have benefited from symptom management and goals of care discussions much earlier. I think that there is a growing trend of trying to introduce palliative care earlier and one of the best ways to do so is in the home—meeting patients where they are and most often where they want to remain. Working with Pemi-Baker Community Health is going to allow me to do just that,” said Hunter.

With over 50 years of experience, serving clients from 28 towns in central and northern New Hampshire, Pemi-Baker Community Health is committed to creating healthier communities. Palliative Care Services are just one of the home health services available to you through PBCH. We encourage you to talk to your doctor about getting palliative care and also encourage you to call PBCH with questions.  PBCH is located at 101 Boulder Point Drive, Plymouth, NH. To contact us please call: 603-536-2232 or email: info@pbhha.org   Visit our website: www.pbhha.org  and like our Facebook Page: @PBCH4

Providing compassionate care with experienced staff who are trained, certified professionals

in the business because of their hearts.

In your time of need, we’re right where you need us.

~written by Anna Swanson

Dr. Kristi Saunders Joins Pemi-Baker Community Health

Pemi-Baker Community Health is excited to announce that Dr. Kristi Saunders, MD, has joined the team as their new Hospice Medical Director.

After working over twenty years in Family Medicine as a board certified OB/GYN, Dr. Saunders was drawn to palliative care and hospice by the desire to be more involved with her patients when facing serious illnesses and death. She became board certified in Hospice and Palliative Medicine in 2012 and since then has been educating her patients about living and embracing the normalcy of dying.

Working with other agencies in New Hampshire and recently receiving hospice help for her mother in California, has highlighted common challenges that families face. “My past experiences of different cultures, needs and desires made me realize how important it is to really have the time to listen, watch, and not treat everyone like medicine normally does…like everyone else. We are all different and need our care individualized. We spend too much time medicalizing death and not spending more time in what is the hard part…saying goodbye,” said Saunders. Pemi-Baker Community Health’s mission and philosophy of supporting their patients and families with compassionate care follows closely with Dr. Saunders’ beliefs. “Our goal is to educate families that hospice is really about living, not death. It should be about smiles, hugs and bringing people closer to acceptance as we possibly can,” said Saunders.

“Dr. Saunders has been serving our community as one of our hospice physicians since January and we are delighted that she will be taking over as Hospice Medical Director upon Dr. Arsenault’s retirement. Her commitment to the highest standards of client care blended with her knowledge and compassion make her an ideal fit for Pemi-Baker Community Health,” said Danielle Paquette-Horne, Senior Director of Home Health, Palliative Care & Hospice.

With over 50 years of experience, serving clients from 22 towns in central and northern New Hampshire, Pemi-Baker Community Health is committed to creating healthier communities. Services include at-home healthcare (VNA), hospice and palliative care, on-site physical and occupational therapy and aquatic therapy in their 90-degree therapy pool. Providing compassionate care with experienced staff who are trained, certified professionals in the business because of their hearts. In your time of need, we’re right where you need us.

PBCH is located at 101 Boulder Point Drive, Plymouth, NH. To contact us please call: 603-536-2232 or email: info@pbhha.org   Visit our website: www.pbhha.org  and like our Facebook Page: @PBCH4

~written by Anna Swanson

Dr. Diane Arsenault Retiring as Hospice Medical Director for Pemi-Baker Community Health

Please join Pemi-Baker Community Health (PBCH) in extending best wishes to Diane Arsenault, MD, FAAFP, HPM, HMDC, who is retiring as Hospice Medical Director for PBCH after 23 years of service. She will continue to serve hospice families at PBCH as well as her patients at Mid-State Health on a part time basis.

Dr. Arsenault has had an extraordinary career as a family physician, working in low risk obstetrical care for the first 20 years of her career before changing her focus to the care of the middle aged and the elderly for the last 20+ years. She felt that hospice care was just a natural extension of her role as a family physician providing care from birth to death. “Just as pregnancy and birth involve a process of anticipation, planning and intense work at the end, the end of life and process of dying have a similar journey and work. My personal experience with my father’s death in 1993 and my mother’s death in 2004, both on Hospice, allowed me to experience firsthand the joys and burden of caregiving for a dying loved one. I aspire to care for patients and families on their Hospice journey, as I and my family were supported,” said Dr. Arsenault.

When Dr. Arsenault started as Hospice Medical Director for PBCH in 1998, she had less than 10 patients at any given time. Community awareness of Hospice services and what PBCH can provide has grown over the years, increasing that number four fold. “For many years Dr. Arsenault has been the only Hospice physician in the Pemi-Baker area. Her dedication to our staff and our patients, to be available night and day, has been invaluable,” said Amy Dennis, Interim Executive Director for PBCH.

Dr. Arsenault will continue her role as Family physician at Mid-State Health Center as well as part time Hospice physician for PBCH but her schedule is now 6 weeks working then 6 weeks off. As she eases into retirement she looks forward to traveling with her husband to national parks in the Southwest, Pacific Northwest and the Canadian Maritime provinces, as well as spending as much time as possible with her 3 preschool aged grandchildren and their families.

“Our organization has grown and become stronger thanks to Dr. Arsenault’s commitment to our mission, vision and values. She has touched many lives in the process. Her kindhearted manner, undeniable professionalism and many achievements will not be forgotten. We wish her the best in the next steps of her journey,” said Danielle Paquette-Horne, Senior Director of Home Health, Palliative Care & Hospice at PBCH.

Grief and Bereavement Support Group- 6 Week Session

Pemi-Baker Community Health is pleased to resume offering its in-person community-based support group for grief and bereavement. We will be starting a 6 week series with meetings being held at the Boulder Point Conference room of Speare Memorial Hospital in Plymouth.

Because of COVID19 restrictions on social gatherings, many persons are living with unresolved and unprocessed issues of grief and loss due to abbreviated funeral or memorial services. We hope this will be a first step toward helping people come to terms with that bereavement and other issues of loss that have been neglected during the height of the pandemic. We will be making use of GRIEF ONE DAY AT A TIME by Alan D. Wolfelt, PhD. Dr. Wolfelt is a noted grief educator, having written several books about healing personal grief. His expertise derives from his compassionate interaction and caring service with mourners, listening to and reflecting on their responses to loss. He is the Founding Director of The Center for Loss and Life Transition in Fort Collins, Colorado. Although our group is offered for support rather than clinical intervention, the use of reading materials for the purpose of self-care and personal growth and healing is sometimes called bibliotherapy. The books will be made available at our first session of the group. We ask, if possible, for group members to make a donation toward defraying the cost of purchasing the books which group members will be able to keep for themselves. No one will be turned away if they are unable to make a donation.

Grief and Bereavement Support Group (Six Week Session)

Starting: Tuesday, August 3rd, 2021- September 7th, 2021 (11:30am-1pm)

The first session of the Grief and Bereavement Group will meet on Tuesday, August 3, 2021, at 11:30am. We will meet in the Conference Room at the Boulder Point site of Speare Memorial Hospital. Participants will need to comply with checking in there. We are limiting the group to ten participants in order to allow for ample social distancing in the meeting area. Participants are also asked to have masks with them for use. At our first meeting, we will review some basic guidelines for group participation, introduce ourselves to each other, and share the nature of the loss that brought us to the group. Using Dr. Wolfelt’s book, we will look at the meditation for that day, letting that be the springboard for our discussion and interaction. To prepare for the next session, the “homework” for participants will be to read each daily meditation throughout the following week. Our discussion at each session will emerge from our responses and reactions to the week’s meditations- what we liked or did not like, what was helpful or not. The energy of the group will determine the length of the gathering, but we will conclude before 1:00pm. The Grief and Bereavement Group will meet for six sessions, concluding on September 7, 2021.  After some weeks’ break, we hope to be able to begin a new Grief and Bereavement Group on October 12, 2021.

You MUST pre-register in order to participate.  Please do so BEFORE WEDNESDAY, July 21, 2021. To register, please contact the facilitator, Guy Tillson, PBCH Hospice Spiritual Counselor and Bereavement Counselor, online via email at gtillson@pbhha.org or by phone at 536-2232, XT 318.  He will get back to you as promptly as possible. If you would prefer to participate virtually by ZOOM, please indicate that, and we will attempt to accommodate you. The group is limited to TEN persons, so registrations will be accepted on a “first come, first served” basis.

~written by Guy Tillson

Pemi-Baker Community Health Improving the Lives of Parkinson’s Patients

(Plymouth)– Physical therapists at Pemi-Baker Community Health (PBCH) are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement.  For almost a year, PBCH’s LSVT BIG specialist, Kaity Schwartzer, PT, DPT has been helping those experiencing the symptoms of Parkinson’s disease achieve amazing results, giving them renewed hope. For National Parkinson’s Awareness month, Pemi-Baker Community Health hopes to raise awareness of what can be done NOW if you are experiencing symptoms.

While you’ve likely heard of Parkinson’s disease (PD), many people don’t know exactly what the condition is or how it manifests itself. The condition can occur when there is a loss of brain cells that produce a chemical called dopamine. The four common symptoms are: tremors, limb and trunk stiffness, the slowing down of movement and weak balance or coordination.  About 500,000 people in the U.S. have Parkinson’s disease, with about 50,000 people being diagnosed each year, according to the National Institute of Neurological Disorders and Stroke.

Since PD symptoms increase over time, as they become worse, patients can have trouble with simple tasks such as getting in and out of bed or the bathtub— or even walking and talking. People with PD may also experience “freezing,” where they have extreme difficulty starting to walk again after having stopped, or difficulty stopping walking once started. This may lead to falls in the home and when out in the community. Pemi-Baker Community Health can help.

LSVT BIG

LVST BIG therapy was developed specifically for people with Parkinson’s disease and other neurological conditions. Treatments target whole body movements for activities of daily living. LSVT programs are administered by specially-trained therapists, in an intensive manner — four times per week for four weeks — and are tailored to each patient.

Therapists ask patients to move in BIG or amplified ways, whether they’re walking, buttoning shirts and pants, getting keys or change out of pockets, or writing. These lead to smoother, larger, safer movements and improved quality of life.

Today, there are over 16,000+ physical and occupational therapists trained and certified in LSVT BIG in 42 countries around the world. Here at Pemi-Baker Community Health, Kaity Schwartzer, PT, DPT is certified to administer this technique. Treatments delivered by LSVT-certified clinicians consist of the following:

  • Four LSVT-BIG sessions a week, for four consecutive weeks
  • Sessions are individual one-hour treatment sessions
  • Daily homework practice (all 30 days of the month)
  • Daily carryover assignments (all 30 days of the month)

LSVT therapy benefits

Schwartzer says LSVT BIG patients typically notice improvements in walking, getting in and out of chairs, and rolling in bed as well as overall flexibility, balance, strength and endurance. Because the program is specific to individual patients and their needs, results are based on personal goals.

As for whom it can help, Schwartzer says, “the people with Parkinson’s disease who benefit the most from LSVT BIG therapy are those with minimal to moderate symptoms but as the protocol is customizable, anyone with PD at any stage of the disease may benefit.” Schwartzer can see people who have severe PD, even those who cannot walk or stand well, as all exercises can be modified to be laying down in bed if needed. The program requires cognitive effort to change habits and reprogram the brain to make bigger, more efficient movements, so patients who have little to no cognitive problems are the most successful.

Cynthia Mathews, a LSVT BIG participant, was hoping to slow the progression of her disease and was surprised how quickly she noticed changes. “Prior to BIG program participation, my neurologist was always encouraging me to, ‘Stand up straight’, and ‘Pick up your feet’ while walking, but I saw no way to do this without thinking about what I was doing with my arms, legs, and spine every single second.  It just sounded impossible.  However, after only two weeks participation in LSVT BIG, I noted that I had regained the ability to walk with good posture and no shuffling of my feet with virtually no conscious effort whatsoever.  My husband has commented on my ‘new’ normal walk.  That has made me feel good, and has helped to maximize my motivation” said Mathews.

Assistance at Pemi-Baker Community Health

Pemi-Baker Community Health currently offers LSVT BIG therapy at their location on Boulder Point Drive in Plymouth, NH.  Prospective patients need to obtain a referral from their physician specifying LSVT BIG and Pemi-Baker Community Health.  The LSVT BIG program falls under the same health insurance coverage as typical physical therapy, check with your insurance provider for your specific policy coverages.

What Does an Occupational Therapist Do?

Occupational therapy helps people with an injury, illness, or disability learn or re-learn to do everyday activities. For adults, this could include activities like getting dressed, cooking, and driving. For children, this could include activities like learning or playing. Occupational therapy got its name from its focus on helping patients with everyday activities—or “occupations.”

Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs) are a part of your health care team. They think about your physical abilities, like which parts of your body you can and can’t easily move. They think about your mental abilities, like what your brain can and can’t process. And they think about your environment, like where you live, work, or go to school—and how you get there.

Your OT will ask you questions about what’s important to you, like driving your car or folding your laundry, so treatment focuses on meeting your goals. They might change the way you do an activity, like putting an extension on your steering wheel or suggesting grab bars to help you get in and out of the shower. OTs and OTAs will usually go wherever you need them so you can practice your skills where you’ll actually be doing activities, like your school, house, office, or nursing home.

  • Occupational therapy activities support what you want to do. All of your occupational therapy treatment activities should have meaning and be things you want and need to do. They should help you reach your goals and make you more functional and independent. The following are examples: Self-care or activities of daily living (brushing teeth, buttoning clothes, using eating utensils), Hand-eye coordination (writing on a classroom whiteboard, copying in a notebook what the teacher writes on the board), Fine motor skills (grasping and controlling a pencil, using scissors).

Real Life Example: If you had a stroke, you may still want or need to prepare your own meals while you’re recovering. Your OT or OTA should spend time helping you reach this goal by showing you the best ways to do things like reaching into cupboards and turning on the stove.

  • Occupational therapy activities that challenge your mind have a purpose. Just like your movement-based occupational therapy activities help you reach your physical goals, your mind-based activities should help you reach your cognitive goals. Your OT and OTA will think about how your brain uses information to help you reach your goals.

Real Life Example: If you have a brain injury from an accident, you may still want to do your own grocery shopping. This might include planning your meals, making a grocery list, managing your money, and finding items in the grocery store.

How do I choose an occupational therapist? Your doctor may refer you to an OT, but you can also choose one on your own.

Make sure your OT or OTA is licensed. Federal and state laws license and regulate OTs and OTAs. Contact your state’s Occupational Therapy Licensing Board or Agency to confirm that your OT or OTA is licensed.

Check your insurance coverage. Ask your health insurance plan if they cover occupational therapy. Many do, including Medicare and Affordable Care Act plans. Also ask if the OT and/or OTA you want to see is in your plan’s network, how much you may need to pay, and how many appointments are covered.

Contact Pemi-Baker Community Health today to set up an appointment in your home or at our office on Boulder Point Drive. 603-536-2232

~written by Anna Swanson

PBCH is First Home Health Agency in Central NH Offering Homebound Vaccination Clinics

Emily Reid, Pemi-Baker Community Health RN administering a Covid-19 vaccination to a homebound patient and caregiver in Plymouth, NH

Pemi-Baker Community Health is partnering with the Central NH Regional Public Health Network (RPHN) to bring COVID-19 vaccine to homebound patients within their 22 town service area. This unique collaboration is just one example of many partnerships the Central NH RPHN has throughout the region addressing complex public health issues.

The Central NH RPHN is one of 13 regional public health networks funded by the New Hampshire Department of Health and Human Services (DHHS) to convene, coordinate, and facilitate an ongoing network of partners to address the delivery of public health services. Services can include: public health emergency preparedness, substance use disorder, and other disease prevention and health promotion activities to improve population health and community resilience.

Angel Ekstrom, the Central NH Public Health Network Coordinator, has been instrumental in coordinating partners to vaccinate homebound residents throughout the region reaching the most vulnerable. “Partnering with home health care agencies to vaccinate residents who are homebound affords homebound vaccine recipients to receive their vaccine from a familiar and trusted healthcare provider who, in many cases, regularly enters the recipient’s home. For those who are not clients of the home healthcare provider it connects homebound recipients to available services they may need” says Ekstrom.

Through Central NH RPHN COVID-19 response efforts, Angel has collaborated with partners across sectors in providing situational awareness, aiding partners in obtaining Personal Protective Equipment (PPE), standing up and demobilizing an Alternative Care Site (ACS), coordinating and operating mobile vaccine clinics addressing inequities, securing vaccine to meet Central NH RPHN needs and recently this partnership with PBCH to administer COVID-19 vaccine to homebound residents.

“We are very excited to offer vaccines to our homebound patients and their caregivers. We have been compiling a list of our own patients who cannot leave their homes to travel to a vaccine clinic and 211 NH has also given us names” said Kara Hamill, PBCH Senior Operations Director. Jenn Stewart, Infection Control Nurse, Penny Conlon, RN,  Emily Reid, RN and Macayla Noble, LPN have undergone specialized training and have been conducting homebound vaccination clinics for three weeks, vaccinating over 80 people thus far.

Jenn Stewart, Infection Control LPN preparing vaccines.

To date, Pemi-Baker Community Health is the only Home Health (VNA) agency offering this homebound service in Central NH. “We are honored to collaborate with Angel and the Central NH RPHN and are very proud of the fact that although we have serviced multiple patients with Covid-19, we haven’t had a single Pemi-Baker clinician contract Covid-19 from a patient over the past year. While out in the community our employees have been very diligent following CDC, NH state guidelines and the guidelines that the PBCH Covid taskforce has laid out” said Jenn Stewart, LPN and Pemi-Baker Community Health’s Infection Control Nurse.

If you or a loved one cannot leave the house (homebound) and would like more information about this service please call Pemi-Baker Community Health at 603-536-2232.

~written by Anna Swanson

The Chaplain? What For?

Whenever a person is about to be admitted to hospice end-of-life care, a social worker meets with the patient, family, and other caregivers to advise them of the various supportive services that are part of hospice. One of these services is Spiritual Care, provided by the Spiritual Counselor or Chaplain. The whimsical title used above is a fairly common response to the social worker’s inquiry regarding including Spiritual Care in the treatment plan. Generally speaking, only about a third of our prospective hospice patients and the families are receptive to the visits of the Chaplain. There are a number of factors that figure into this.

First off, when people hear “Spiritual Care” they probably think “Religion” “Church” “Preaching” and “Praying”. We live in a time when these values are not well-accepted. Statistics from some years ago reported that only about 35% of New Hampshire citizens identified themselves as being affiliated with a religious denomination or formal spiritual practice. That percentage squares rather nicely and neatly with the average amount of people who respond positively for spiritual support as part of their hospice care, at least in our area. For whatever reasons, many people choose not to participate in these values that were formerly a major characteristic of our American way of life. Perhaps they had bad experiences associated with religious and spiritual practice. Perhaps they are members of recent younger generations who have never been exposed to these values, and are lacking in knowledge or awareness of what they can mean and signify in our human lives. Recent research has called this group “the Nones” meaning they check “None” on any surveys that inquire about spiritual and religious practice or affiliation.

A second factor is that, since hospice is end-of-life care, the image a Spiritual Counselor or Chaplain conjures up is that of the Angel of Death, or at least one of its minions. Persons and their caregivers have already taken a huge step in agreeing to hospice care. They are already in a mode of mourning as they prepare for the death that will occur. Perhaps declining the services of the Chaplain is perceived as a way to forestall that awesome but inevitable reality, at least for a little bit.

So, what does the Hospice Chaplain do?

The Hospice Chaplain does not interfere in the active religious practice or formal affiliation of those patients and families who subscribe to these things. If they wish to rely on their own clergy for their end-of-life spiritual care that is something hospice care encourages. If they have fallen away from their connection to their religious fellowship and wish to renew it, the Spiritual Counselor can function as a liaison in helping that to happen. In some instances, the patient may wish to have the Chaplain serve as an auxiliary to their own clergy. Hospice will do this in consultation with the clergy person involved. If the patient identifies generally with a religious tradition, but does not wish to reestablish a formal link to that tradition, the Chaplain will try to respect that tradition in his or her service to that patient and care giving system.

In my three years of service as Hospice Chaplain for Pemi-Baker Community Health, I have been able to draw upon the interfaith background of my own family heritage. Although I am most aligned with Roman Catholic, Anglican/Episcopalian, Lutheran, and Eastern Orthodox practices, I have family-­related experience with Methodist, Presbyterian, Baptist, and Pentecostal beliefs and practices. I grew up in a Jewish neighborhood in New York’s mid-Hudson Valley. I have lived in metropolitan areas where religions of other cultures were present. I see ecumenical respect and reverence as a central feature in my responsibilities as the Spiritual Counselor for Pemi-Baker’s Hospice Program. I am not out to convert anyone. I do not preach at anyone. I will pray with anyone, read the Scriptures, and even sing hymns to anyone if that is their request. But I do other things, too- and a patient does not have to be religiously disposed to engage my services.

Hospice practice usually regards Spiritual Care broadly.

That can sound squishy and fluffy to some people, but since hospice is end-of-life care, a great deal of my work is facilitating what is called “life review”. What is the unique story of this person’s life? Where are they from? Where did they grow up? What did they do for work and livelihood? Whom did they love? What was important to them? What did they enjoy and find interesting? Sometimes there are deeper existential questions. “Why is this happening to me?”, “Is God punishing me?”, or “Have I lived a good life?” and “Have I done anything worthwhile?” So I listen a lot. I affirm their accomplishments. I try to soothe any regrets they may have. I celebrate the memory of their joys. If there is “unfinished business” with family members or acquaintances, I can offer to be a bridge toward resolving and healing those things.

To offer you some specific examples, there are these.

For the lady who loved gardening, I will take a book of photographs of flowers and trees and we will look at it together. I will read a book about World War II to the Naval veteran who served in the South Pacific. I will listen to classical music to the patient who loves a particular symphony or opera. I will talk recipes with the woman who likes to watch different TV cooking shows. I will read Morning Prayer for the Episcopalian who can no longer see well enough to use his prayer book. I will spend longer time with a patient whose caregiver may need some time to go out to pick up a few groceries, giving that person some often-needed respite. When a patient is actively dying, I will “sit vigil” with them regardless of whether or not they can engage in conversation with me. I think you can see that the bulk of my work is not what is usually understood as “religious” or “spiritual”.

One of my favorite memories in my service as Hospice Chaplain is about a woman who was initially suspicious about my coming to see her. Before I first met with her, her paid caregiver told me, “She mentioned when I was getting her up that “Some priest or minister is coming to see me. I’ll see what it’s like. I don’t think I’ll want him to come again.” We had a pleasant visit, mostly life review. I did not press her to pray. Somewhat surprisingly, she was willing to have me come back for companionship support. In subsequent visits, she tended to shy away whenever I tried to move toward conversation about faith and belief, so I chose to respect that. After four or five weeks of my seeing her, she had a mini-stroke, but was able to return to her home. When I saw her next, toward the end of the visit, she asked me rather matter-of-factly, “Can you say a prayer for me?” which I naturally did. It was the first opening I had in moving in the direction of assisting her with her faith, but I thought it was an isolated event. The next week, I went for my usual visit. One of her nieces was visiting with her. As the visit came to an end, I stood up to leave, but as I passed by her chair, she reached out and grabbed my forearm tightly, and asked, “No prayer?” I turned and looked at her niece and said, “The lady wants a prayer” so I knelt down right by her chair and offered a prayer.

So, if you’ve read this article, at some time in the future are ever involved in accessing hospice care for a family member (or even yourself), I hope you might pause before asking “The Chaplain? What for?” I’m rather easy to get along with. I’m caring and supportive. I’ll pray with you only if you want me to-though I’ll pray FOR you silently and quietly while I’m with you and as part of my own daily prayer routine and whenever I may think of you.

~written by Guy Tillson, Mdiv, MA, PBCH Hospice Chaplain

The Rewards of Being a Hospice Volunteer

While I was familiar with Hospice for many years, I only have been a hospice volunteer with Pemi Baker Hospice and Home Health (PBHHH) since October 2021.  When I retired, I began searching for volunteer work that would allow me to give back to my community.  A newsletter from PBHHH arrived in my email announcing training for hospice volunteers.  My family had experienced the need for hospice twice, once in Ohio and again in Florida.  The relief my family and I felt when the hospice volunteers arrived was beyond measure.  I want to bring the same kind of assistance to others.  PBHHH given me that opportunity by providing professional training with knowledgeable nurses, doctors, social workers and other health care professionals.  Their guidance has enabled me to meet the challenges of being s hospice volunteer, and I am very glad that I did it.

Connie C.

Pemi-Baker Hospice & Home Health
2022-06-27T12:20:25-04:00

Connie C.

While I was familiar with Hospice for many years, I only have been a hospice volunteer with Pemi Baker Hospice and Home Health (PBHHH) since October 2021.  When I retired, I began searching for volunteer work that would allow me to give back to my community.  A newsletter from PBHHH arrived in my email announcing training for hospice volunteers.  My family had experienced the need for hospice twice, once in Ohio and again in Florida.  The relief my family and I felt when the hospice volunteers arrived was beyond measure.  I want to bring the same kind of assistance to others.  PBHHH given me that opportunity by providing professional training with knowledgeable nurses, doctors, social workers and other health care professionals.  Their guidance has enabled me to meet the challenges of being s hospice volunteer, and I am very glad that I did it.

You give of yourselves day & night without end!

To the Pemi-Baker Hospice Team--Words really can't express my feelings-

Your help during one of the most difficult times of my life is SO appreciated.  I'm so grateful that because of you, Doug was able to get his wish not to spend the last of his days in a hospital, but at home with those of us who loved him.

And to be constantly reassured that if I needed anything you would be there-oh my gosh-ANYTIME!  Well, you people need to know how much you are appreciated.  You give of yourselves day & night without end!  God Bless you and thank you!

Pam O.

Pemi-Baker Hospice & Home Health
2020-06-11T07:31:14-04:00

Pam O.

To the Pemi-Baker Hospice Team--Words really can't express my feelings- Your help during one of the most difficult times of my life is SO appreciated.  I'm so grateful that because of you, Doug was able to get his wish not to spend the last of his days in a hospital, but at home with those of us who loved him. And to be constantly reassured that if I needed anything you would be there-oh my gosh-ANYTIME!  Well, you people need to know how much you are appreciated.  You give of yourselves day & night without end!  God Bless you and thank you!

“My home physical therapy was fantastic.”

Pemi-Baker provided very good home therapy. All their therapists were pleasant, helpful in offering suggestions for better functioning after surgery, and practiced good health protocols. They were also very prompt in showing up for scheduled appointments.

Elizabeth B.

Pemi-Baker Hospice & Home Health
2019-11-07T12:26:12-05:00

Elizabeth B.

Pemi-Baker provided very good home therapy. All their therapists were pleasant, helpful in offering suggestions for better functioning after surgery, and practiced good health protocols. They were also very prompt in showing up for scheduled appointments.

“Your generosity with your time and your loving care is appreciated more than you know.”

Thank you to everyone who played a role in taking care of my mother and giving her the freedom of remaining home while suffering from dementia. Your generosity with your time and your loving care is appreciated more than you know. A special thanks goes to Macayla and Colleen, who visited her on a regular basis, and to Lauren who was helpful in connecting us with state services.

Terry W.

Pemi-Baker Hospice & Home Health
2020-01-17T12:43:19-05:00

Terry W.

Thank you to everyone who played a role in taking care of my mother and giving her the freedom of remaining home while suffering from dementia. Your generosity with your time and your loving care is appreciated more than you know. A special thanks goes to Macayla and Colleen, who visited her on a regular basis, and to Lauren who was helpful in connecting us with state services.

“Pemi-Baker Hospice services provided kind, professional, competent services every step of the way-and even vaccinated us all for Covid/19!””

Our primary nurse, Fred, was outstanding, and others who filled in (Cathy, Penny, Colleen) were wonderful and a credit to your organization. Fred, you were amazing, not only for mom but for my husband and I as well. I will forever be grateful for your support, wisdom, humor and kindness, all along the end of life journey for mom. I am so deeply thankful that circumstances conspired such that mom was able to die at home, and your role made that time as seamless as it could be made.

Paula W.

Pemi-Baker Hospice & Home Health
2020-01-17T12:31:13-05:00

Paula W.

Our primary nurse, Fred, was outstanding, and others who filled in (Cathy, Penny, Colleen) were wonderful and a credit to your organization. Fred, you were amazing, not only for mom but for my husband and I as well. I will forever be grateful for your support, wisdom, humor and kindness, all along the end of life journey for mom. I am so deeply thankful that circumstances conspired such that mom was able to die at home, and your role made that time as seamless as it could be made.

“Everyone is so understanding supportive and kind.”

From the director to the nurses to the health care workers.  So cheerful, helpful and accommodating.  This is our second time receiving assistance from Pemi-Baker and we are very lucky to have found this amazing group!  Thank you for your excellent care and compassion.

Leila L.

Pemi-Baker Hospice & Home Health
2020-01-17T13:19:24-05:00

Leila L.

From the director to the nurses to the health care workers.  So cheerful, helpful and accommodating.  This is our second time receiving assistance from Pemi-Baker and we are very lucky to have found this amazing group!  Thank you for your excellent care and compassion.

Your courage during Covid-19 does not go unnoticed

Hello. We just wanted to take a moment and let you know how much we truly appreciate all that you do for us in these trying times. You're commitment to the health of our community is a special thing, and we know that you are working under stressful conditions due to the Covid 19 crisis. We realize that in order for you to treat those who may be ill, you are putting you're own lives and even you're own families lives in danger, and that is truly a courageous and honorable thing to do. We want you to know that it does not go unnoticed. Thank you all for all that you do!

Bryan and Renee C., and our mom Joan

Pemi-Baker Hospice & Home Health
2020-06-11T06:27:43-04:00

Bryan and Renee C., and our mom Joan

Hello. We just wanted to take a moment and let you know how much we truly appreciate all that you do for us in these trying times. You're commitment to the health of our community is a special thing, and we know that you are working under stressful conditions due to the Covid 19 crisis. We realize that in order for you to treat those who may be ill, you are putting you're own lives and even you're own families lives in danger, and that is truly a courageous and honorable thing to do. We want you to know that it does not go unnoticed. Thank you all for all that you do!
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