The Full Impact of Grief

January 16, 2020

The word “bereavement” is something that we normally associate with our experience of the death of someone we have known, loved, and cared for. The word, however, is actually connected with the adjective “bereft” which means “deprived of” or “left without”, so it can actually refer to any experience of loss, whether small or great, temporary or permanent. The great pioneer in the field of death and dying, Elizabeth Kubler-Ross, frequently said, “All of life is loss”. Our experience of life is filled with change and change moves us from various sets of experiences to others.

When I found it needful and helpful for myself to attend a Bereavement Group following the deaths of my father (2011) and my brother (2013), the grief counselor who facilitated the group said, “A loss is any experience of the absence of someone or something that has been a part of your world. That absence has changed your vision and perception of your world as you had known it and your experience of it.”

If you think about that for a bit, we are experiencing loss frequently in our lives on all sorts of levels. These can be seemingly small and temporary. There is a commercial currently running on television of a thirty- or forty-something year old white collar worker (wearing a necktie) probably just ready to leave for work. He is peering at the faucet in his kitchen sink which is NOT running. His exasperated remark is, “THIS isn’t on the schedule!” Maybe to make this more personal, consider your own reaction and behavior when you cannot find your car keys! Relatively small, insignificant, and temporary losses, perhaps- but they alter the individual’s perception of an efficient and smoothly-running world.

When we do endure the death of someone we have loved, or if we are the victim of a crime or a natural disaster, or if we have lost our job, or if we are coming to terms with the loss of our personal powers through illness or aging, we are in a state of bereavement whether we are conscious of it or accepting of it or not. Kubler-Ross also used the word “denial” to describe an experience where we avoid recognizing the loss. It is a way of defending ourselves against our own feelings of powerlessness in not knowing how to handle the change of our world-view. Sadly, many persons decide simply to “Soldier on” or “Return to business as usual”.

After a death, a very common reaction is “It’s all over now. I don’t need to bother with anything more.” But loss has far-reaching effects on our lives, touching on our emotions, our physical health, our material and financial security, our social interactions and relationships with others, our occupational and recreational involvements, and our spirituality or life-direction. These effects can be uncomfortable, stressful, and even debilitating.

Beginning on Monday, February 3, 2020, Pemi-Baker Community Health will be offering a new Bereavement Group series entitled “THE FULL IMPACT OF GRIEF”. Each session will look at a particular aspect of our lives to gain a greater understanding of how our loss has affected that area of our existence. We will explore ways we can process our responses and reactions. The group will meet in the Grady Conference Room at Speare Memorial Hospital, beginning promptly at 12:30pm and concluding by 2:00pm. The group will meet weekly through Monday, March 16, 2020. There is no fee for attendance.

Pemi-Baker Community Health will also be resuming its monthly Drop-In Bereavement Group which meets on the LAST WEDNESDAY of each month in the Main Conference Room at Pemi-Baker’s offices at Boulder Point in Plymouth. This group is less formal with no set curriculum or session topics, though take-home reading materials are made available. The first session of the Drop-In Bereavement group for this new year is on Wednesday, January 29, 2020, beginning promptly at 5:30pm and wrapping up by 7:00pm. Again, there is no fee for attendance.

Both Groups are facilitated by Guy Tillson, MDiv, MA, Bereavement Counselor and Hospice Spiritual Counselor for Pemi-Baker Community Health. He may be contacted at gtillson@pbhha.org or at 603 536-2232, Extension 206, if you have any questions or concerns.

~by Guy Tillson

Self Care for Caregivers

January 16, 2020

When Alison’s Dad fell, she moved in with her parents to help out around the house and make sure they were taking their medications and getting proper meals. With a full time job to manage, what started out as a good deed soon became overwhelming as her parents’ health declined.

The Cost of Compassion

It is our nature to care for loved ones and, for many of us, it brings great satisfaction. Empathy and compassion are desirable character qualities, present in people to varying degrees. These enable us to identify, and in some cases, actually experience the feelings, thoughts, or attitudes of others we care about.

Compassion can come with an emotional cost when caring for someone with a long-term illness. The distress resulting from the constant demands of caring for another, consistently witnessing pain or cognitive decline, can have serious consequences.

In the book, “Overcoming Compassion Fatigue,” author Sharise M. Nance, LCW, CCTP, details how caregiver burnout can manifest itself in exhaustion, depression, apathy, and even physical or emotional disability. “People in ‘helping professions’ are regularly exposed to a range of emotions, from hope to dread, from gratitude to anger, from patience to frustration, and from grief to sorrow.”

One elderly woman had experienced several falls. She lives with her husband who is in advancing stage of dementia. He wakes up several times each night, turns the lights on and gets dressed. Each time, she has to wake up and guide him back to bed often unable to sleep herself. Before getting help, she found herself exhausted, discouraged, and at a greater risk for additional falls.

Some caregivers can internalize the issues of those under their watch, hoping by some herculean effort to fix everything. The sense of responsibility can become disproportionately burdensome and they may lose perspective about what they can and cannot do. This is particularly daunting when a patient has dementia and cannot communicate effectively, or acts out physically.

Making a Plan for Self Care

Prolonged stress is associated with distinct physiological responses that can have long term effects on both physical and emotional health. Often referred to as the fight, flight or freeze response, these chemical reactions are effective in urgent, life-threatening situations, but not sustainable over time.

Ms. Nance noted several emotional states that can accompany caregiver stress:

Guilt: A sense of being responsible for the illness
Anger: Frustration with family members or health care workers
Sadness: Loss of the person as they once were
Fatigue: Exhaustion from extra work and irregular sleep
Apathy: Lack of energy to keep up with needed tasks

When these emotions arise, it can be a signal that the caregiver needs to take better care of themselves in order to do what is needed to care for their loved one. If you are in this situation, here are a few suggestions that might help:

Pace yourself: Take advantage of family or friends who offer to help. Home Care agencies like Pemi-Baker Community Health can provide a volunteer companion or home health aide for a few hours a day to take on the more challenging tasks.
Set boundaries: Make it clear to the patient and family members what you can and cannot do.
Seek support: Pemi-Baker Community Health and many churches or senior centers offer support groups for caregivers. While it may not alleviate the challenges you are facing, it can be helpful to know how others are coping.
Create a self-care plan: As impossible as it might seem, you need a plan for exercise, sleep and proper nutrition. If you are a spiritual person, spending time in prayer or meditation can be helpful.

“Self-care is not a selfish act, but a necessity and priority,” writes Ms. Nance.

Even health care professionals can become overwhelmed at times. Pemi-Baker Community Health employs home health aides and homemaker companions serving clients in 18 central and northern NH towns. “As a licensed home care agency, we are vigilant about providing support to our caregivers,” said Chandra Engelbert, CEO. “We encourage them to practice their own self-care so they can provide the best possible care and attention to our clients.”

Caring for another person can be a gift but also a burden. Anyone in that role has to be mindful of the potential risks, and remember to monitor their own well-being at times, too. All are welcome to our Drop-in Caregiver Support Groups on every 3^rd Wednesday of the Month at the Plymouth Regional Senior Center.

~by Anna Swanson

Chocoroa Masonic Lodge Makes Generous Contribution

January 6, 2020

Even in this season of giving, CEO, Chandra Engelbert was pleasantly surprised when she received a phone call from Masonic Master, David Hughes about a donation to Pemi-Baker Community Health.

For centuries, Freemasons have contributed to the communities in which they live through the principles of Brotherly Love, Relief and Truth. Freemasonry has existed in New Hampshire since 1735, and many of the leading citizens of our state have been Freemasons. Their charitable activities are many and varied: the Shriners’ Hospitals for Children, support of medical research, scholarships, programs for child identification and combating drug abuse, the Scottish Rite Learning Centers, and local charity. Freemasons are committed to helping those who are less fortunate, and in the process they improve themselves and
hope to build a better world.

With 52 years of experience, serving over 900 clients from 18 towns in central and northern New Hampshire, Pemi-Baker Community Health is the home care provider of choice for Grafton County. Services include at-home healthcare (VNA), hospice and palliative care, on-site physical and occupational therapy and fitness memberships including a fitness gym and fitness classes in our 90-degree therapy pool. As a nonprofit, Pemi-Baker Community Health offers many free programs to the community including bereavement and caregiver support groups.

ASK Pemi-Baker, is a new program held at the Plymouth Regional Senior Center, every 2nd and 4th Thursdays from 11-12pm with a nurse and social worker on hand to answer any questions one might have.

Thank you to the Chocorua Masonic Lodge, in Holderness, for helping us continue to offer these free services!

~By Anna Swanson

Grieving In a Season of Celebration

November 6, 2019

Christmas decorations started being displayed in stores as early as August. It’s now autumn, so the awareness that “the holidays” will soon be upon us is unavoidable. Pumpkins sold in October became Halloween Jack-o-lanterns. Pumpkins sold in November will become the fixings for the pies for our Thanksgiving dinner dessert. Some years ago, a now-deceased friend of mine made the comment that “the holidays” were “The Bermuda Triangle of heightened family dysfunction.” Though we’ve usually thought of the holidays as Thanksgiving, Christmas, and New Year’s; traditions with the winter celebrations of the Solstice, Yule, Hanukkah, and Kwanzaa probably have their own versions of holiday angst.
The Christmas movies that seem to run perpetually on the Hallmark Channel seem to poke at the discomfort of holiday stress with their standard and predictable happy endings. TV series will also portray something of holiday craziness. In 1995, the movie “Home For the Holidays’ unfolded the story of a museum restoration artist flying home for Thanksgiving with her affable parents, an eccentric maiden aunt, a black-sheep-of-the-family gay son, and an embittered sister. The star-studded cast included Holly Hunter, Anne Bancroft, Charles Durning, Geraldine Chaplain, and Robert Downey, Jr. Further back in 1968, there was a cinematic telling of a highly-conflicted medieval Christmas, “The Lion In Winter.” It won Katharine Hepburn her third Academy Award, and its own star-studded cast also featured Peter O’Toole, Anthony Hopkins, and Timothy Dalton. These powerful characters engage in some very brutal backbiting and hostile verbal exchange that is memorable in its cleverness. As entertaining as these portrayals might be, the element of recognition that strikes us is the familiar experience of holiday-related stress.

Lest you think I’m a “Bah! Humbug!” Scrooge-like person, I want to assure you that I normally enjoy the holidays, despite the pressures of preparation and the cranked-up party-going that is a challenge to my normally introverted personality. In my forty-plus years of work in various helping professions, I have noticed that the holidays are sometimes dreaded rather than welcomed by more people than we might imagine. In our own lived real experience, the holidays become even more difficult if we have endured a significant loss. These losses can include the death of someone we have loved, the breakup of a relationship, the loss of employment, relocation, witnessing the debilitating disability of someone we are caring for, or financial or material disaster. It’s not for nothing that Elvis sang of a “Blue Christmas” in his throaty and soulful baritone.

Because the holidays can be especially difficult for persons grieving losses such as those noted above, Pemi-Baker Community Health & Hospice will be offering TWO Monday times to meet with those in need of support throughout the holiday season. The groups will start before Thanksgiving and conclude after New Year’s: November 18 and 25; December 2, 9, 16, 23, and 30, 2019; and, January 6, 2020. The daytime afternoon group (12:30-2pm), will meet in the Grady Conference Room at Speare Memorial Hospital, 16 Hospital Road, Plymouth, NH. The early evening group (5:30-7pm), will gather in the Main Conference Room at Pemi-Baker Community Health, 101 Boulder Point Drive, Suite 3, Plymouth, NH. There is no cost for attendance.

Topics at the sessions will include: emotional self-care during the holiday season; choosing (or NOT choosing) to attend gatherings and celebrations; not feeling like “making merry”; recollections and reminiscences of previous holidays; suggestions for home rituals to remember loved ones; and, entering upon a new year without someone who is no longer present.

The groups will be facilitated by Guy Tillson, MDiv, MA, Bereavement Counselor for Pemi-Baker Community Health. If you have questions about the program or are interested in participating in one of the groups, please contact Guy by email at gtillson@pbhha.org or by phone at (603) 536-2232, Extension 206 so that adequate preparations for the groups can be made.

Please consider donating to Pemi-Baker Community Health as the holidays approach. If you order gifts on line, 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. Giving Tuesday, December 3rd, is the Tuesday after Thanksgiving and is a movement to create an international day of charitable giving at the beginning of the Christmas and holiday season. Visit our website to give: www.pbhha.org. Thank you from the team at Pemi-Baker!

~By Guy Tillson, MDiv, MA