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

July 1, 2021

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

June 24, 2021

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 3^rd, 2021- September 7^th, 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

April 23, 2021

(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?

April 1, 2021

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

March 30, 2021

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?

February 12, 2021

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

Thank You for 12 Amazing Years of Leadership!

February 1, 2021

We are at once happy and sad to announce the retirement of our CEO, Chandra Engelbert. She has been an outstanding leader for more than 12 years of dedicated service at Pemi-Baker Community Health and a true inspiration for all of us.

The entire Central NH/Plymouth community has benefitted from Chandra’s leadership for much longer than that though. Chandra began her career earning a B.S. in Nursing at Northeastern University in Boston, MA and her MBA from UNH’s Whittemore School of Business and Economics. Chandra’s professional expertise included: Nursing in Medical Surgery, Intensive Care Unit, Emergency Department, Recovery Room, Home care and Hospice. Profit and nonprofit administrative background included management of home care and hospice, Vice President of Diagnostic Services at LRGHealthcare and ICU/ED Manager at Weeks Medical Center in Lancaster, NH.

Over the years she served on the Home Care, Palliative Care and Hospice Alliance of NH and the Central New Hampshire Chamber of Commerce Boards, Central NH Health Partnership, Rural Healthcare Association, Plymouth State University Nursing Honor Society and Nursing Advisory Board and the Central Service Health Network; participating in emergency preparedness efforts and public health initiatives in NH.

Creating a collaborative effort between PBCH, Mid-State Health Center and Speare Memorial Hospital is one of her most proud accomplishments and instilling the ‘Ubuntu’ philosophy for the employees of Pemi-Baker Community Health, creating a culture for them filled with respect, honesty and value.

She will be deeply missed but we can only feel happy for her after many years of service to our community and hope that she enjoys her well-deserved retirement.

~written by Anna Swanson

PBCH Receives Generous Donation from Service Credit Union

December 28, 2020

The holidays came early for Pemi-Baker Community Health(PBCH) thanks to a generous donation from Service Credit Union. Both non-profit companies have strong missions to support the communities they serve and PBCH plans to use the donation for much needed training supplies for their nurses.

Since 1967, Pemi-Baker Community Health has brought compassionate health care into the homes of Central and Northern New Hampshire, delivering much needed home health, palliative, hospice and therapeutic care to patients in 22 towns.

Service Credit Union was established in 1957 to support military personnel and their families at what was then Pease Air Force Base in New Hampshire. Since then, they have grown to serve members all over the world. Their 800+ employees provide financial services at 50 walk-in locations throughout New Hampshire, North Dakota, Massachusetts and Germany.

“Without the generous support of community partners like Service Credit Union, we would have a difficult time continuing our mission and we wish to extend our thanks to Jenn Duncan, Branch Manager at the Plymouth Service Credit Union” said Danielle Paquette-Horne, Home Health, Palliative Care & Hospice Director, at Pemi-Baker Community Health.

Please consider donating to Pemi-Baker Community Health during the New Year by visiting their website, www.pbhha.org. If you order online, Amazon will give a percentage of your purchases directly to Pemi-Baker Community health by using Amazon Smile. Visit www.smile.amazon.com and choose Pemi-Baker Community Health. Or perhaps you would like to donate your time instead. There is room in their Free Hospice Volunteer Training starting January 5th via Zoom. Contact Lauren Bell, SW and Volunteer Coordinator at info@pbhha.org or 603-536-2232.

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

Plymouth Service Credit Union branch is conveniently located inside the Plymouth Walmart. They offer numerous member tailored lending options including mortgages, auto loans, credit cards as well as savings, checking and business banking services. 1-800-936-7730, www.servicecu.org

~written by Anna Swanson

Soothing Seasonal Sadness

December 14, 2020

In my years working as a clinical mental health counselor, I could always count on having a few clients who suffered with Seasonal Affective Disorder. That’s psychiatric lingo for mood disturbances worsened by seasonal changes. Appropriately, its acronym is SAD. Particularly as we lose daylight hours, especially when we turn the clocks back as the fall moves into becoming winter, some people get in a sad and funky mood. At the mental health center I worked for, we purchased a device called a light box which patients could borrow for short spaces of time. The light box radiates light which helps the patients in elevating their mood so that the sadness would not be so pervasive or overwhelming.

Currently, we are experiencing stretches of time besides this season of fall turning into winter. It is the holiday season. It is a season of caution and care as we try to safeguard ourselves against the coronavirus. It also an ongoing season of grief and mourning for those whose loved ones have died, whether from COVID19 or other causes. So, perhaps, we are enduring multiple seasons of compounded sadness in varying degrees of intensity. Sorry to say, there are no easy remedies to “the blahs” that may befall us at the present time, though there may be some temporary relief to turn our awareness from it all so that we do not become overshadowed by a moody cloud. Here, I will suggest some short, simple practices.

First of all, fresh air and physical movement are valuable. Naturally, as the weather gets colder, we need to moderate our exposure to the outside air. A brief walk around your yard or on your porch or deck for ten or fifteen minutes, breathing normally, with some movement of your limbs will help to “clear house” and “keep the motor going”.

Secondly, the simple act of washing your face two or three times a day can be very refreshing. You can experiment with what seems to work best for you- water temperature that is hot, lukewarm, or cold and a facecloth that is thin or plush. The temperature of the water and the texture of the fabric revitalizes our pores, wakening up our complexion.

Following on this, there are the practices of hand and head massages. Start by rubbing your hands together as you would if you were washing your hands at your sink. Allow each hand to move over its partner, gently rubbing over the back of the hand, then the palm, and moving through the fingers. Starting at the wrist of one hand, let your thumb and fingers of the other hand softly massage the wrist, and then move across the back of the hand, and continue to gently massage each knuckle and joint of each finger. As you finish, use your fingertips to move in a circle in your palm. Then attend to the other hand. You may also want to lightly rub your palms together or even to softly clap your hands. To massage your head, gently let your fingertips move through your hair (or what you have left of it!). Do this a few times. Then gently tap your fingertips throughout and across your whole scalp, not forgetting the areas around your ears or at the base of your skull down to your neck. This also stimulates the movement of energy in our cranial area.

I began this sharing by mentioning the use of a light box, so I will close with a suggestion that is more meditative and reflective. The winter holidays of this time of year (Advent, Christmas, Epiphany, Hanukkah, and the Winter Solstice) all focus on the element of light, hoping for its return and emergence from the darkness. Most craft supply stores and even some pharmacies sell small LED light battery-powered candles of various sizes. Some even have flickering flames. Though there is a lot to be said for actual candles, these are a bit safer to use. For the purpose of focusing and directing your attention, only one is necessary. Use it as the daylight is ending. Simply direct your attention to the light, bringing to mind thoughts of past good times and the joy of affection shared with loved ones. The length of time you do this for does not matter too much, but respect the rhythm of your ability to concentrate easily. This isn’t supposed to be a chore or an assignment! It seems to be more profitable to do this in a quiet time without the distraction of other noise. This can be settling to the soul and bring your day to a peaceful end.

As I indicated earlier, these are not “cures” for seasonal sadness- only suggestions for momentary relief that may help the next stretch be more tolerable and bearable. As always, take care of yourself, respecting both your own strengths and limits.

Regretfully, we are still unable to gather for our Bereavement groups due to COVID19 restrictions but Guy Tillson can meet with you one on one via ZOOM or in person following CDC guidelines for safety. To contact Guy please email him at gtillson@pbhha.org. Please visit our website for other monthly ZOOM meetings: Coffee with Caregivers and Fill Out Your Forms.

~Guy Tillson, MDiv, MA, PBCH Hospice Chaplain and Bereavement Counselor

Six Common Myths About Physical Therapy Explained

December 8, 2020

While physical therapist’s roles are both broad and diverse, several misconceptions still exist about what physical therapy is, what it isn’t, and the various ways it can help people improve the health and lives of people at all stages in life.

Matt Scagliarini uses dry needling to reduce his patient’s pain, release scar tissue adhesions and treat muscle trigger points.

“When a lot of people think about physical therapy, they think rehabilitation from injury or surgery. But that’s just part of what we do,” said Matt Scagliarini, PT, DPT and Director of Outpatient Physical Therapy at Pemi-Baker Community Health. “Physical therapists can improve the lives of people of all ages dealing with biomechanical faults that could lead to injury, sports performance, balance impairments and nervous system conditions to name a few. We use innovative testing to work with our clients to develop a personalized plan of health for people of all ages and abilities.”

According to the American Physical Therapy Association (APTA), physical therapists (PTs) are highly educated and licensed health care professionals who can help patients reduce pain and improve or restore mobility. Sure, this includes those who’ve suffered musculoskeletal injuries, Scagliarini says, but it’s much more than that.

Here are six common misconceptions about physical therapy:

I need to be injured to see a physical therapist. Rehabilitation following an injury or surgery is just a portion of what physical therapists may provide. It’s common for a PT to treat other common ailments like balance and vestibular issues, headaches, pelvic pain, chronic pain, incontinence, and basic joint and muscle discomfort. They also work with clients to prevent injuries and improve athletic performance.
It’s going to hurt. The “no pain, no gain” philosophy has no place in physical therapy. In fact, PTs are trained to work within one’s pain threshold to ensure her or his musculoskeletal gains are safe and incremental. PT’s at Pemi-Baker are trained to analyze the biomechanics of movement. Therefore, they are able to replace painful movement patterns with less painful and more efficient alternatives that improve performance.
Surgery/medication are better options. Both have a place as medical treatments, but multiple studies have shown that physical therapy is more effective and safer than options like subscription painkillers, as well as common surgeries for lumbar spinal stenosis, degenerative disk disease, and even meniscus tears.
Physical therapy is expensive. Physical therapy is a bargain when compared with surgery and the cost of medical imaging. But more than that, studies have shown that for the treatment of one of the most common ailments, non-specific back pain, patients can save up to 60 percent on their medical bills if they first visit a physical therapist.
Any health care provider can offer physical therapy. This is simply not true, though the APTA estimates 37 percent of all consumers believe it to be the case. The fact is only licensed physical therapists have received the post-graduate education and training necessary to provide physical therapy services.
I can’t see a PT without a prescription or referral. According to the APTA, this myth is shared by 70 percent of all health care consumers. In most states, patients are allowed to be evaluated by a PT and receive visits prior to needing a physician referral. Every private health insurance is different. Contact Pemi-Baker Community Health or your insurance company directly for more details.

To learn more about how physical therapy can benefit a particular ailment, condition or wellness goal – or for an injury, pain or movement evaluation – contact the physical therapy team at Pemi-Baker Community Health.

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.

~written by Anna Swanson