Thank You Veterans!

November 12, 2020

Pemi-Baker Community Health would like to thank our employee veterans: Dori Freer, Rebecca Curran and Sandra Coleman for their service to our country! We also would like to thank the veterans in our community.

On Veteran’s Day, PBCH delivers appreciation bags to all of our Hospice, Home Care and Physical Therapy patients as well as our neighbors at the Veteran’s Housing on Boulder Point. We were very fortunate to be able to speak with Mr. Paul Ash, a PBCH patient and veteran who served in the Marine Corps before, during and after the Korean War. He shared stories of fellow New Hampshire and Vermont marines he met during his service.

We are so fortunate to be protected by those who accept the risk, make the sacrifice and dare to serve. We honor them today, on Veteran’s Day but are grateful to them always!

November is National Home Care & Hospice Month

November 2, 2020

During the month of November, the home care and hospice community honor the millions of nurses, home care aides, therapists, and social workers who make a remarkable difference for the patients and families they serve. These heroic caregivers play a central role in our health care system and in homes across the nation. To recognize their efforts, we call upon all Americans to commemorate the power of caring, both at the home and in their local communities and ask them to join with Pemi-Baker Community Health in celebrating November as Home Care and Hospice Month.

In addition, Home Care Aide Week takes place the second full week of November. Join us in honoring these compassionate, tireless workers who play an invaluable role for their clients as caregivers, companions, and friends.

“Home care and hospice nurses, therapists, aides, and other providers choose to use their lives to serve our country’s aged, disabled, and dying. This noble work deserves our recognition and praise and we celebrate November as home care and hospice month for that very reason,” said National Association for Home Care & Hospice (NAHC) President William A. Dombi.

With 10 thousand Americans turning 65 every day, the need for health care will continue to rise, and costs will continue to skyrocket. This is where home care and hospice come in. As the preferred choice for most patients, it also offers the greatest cost savings. For example, Medicare pays nearly $2,000 per day for a typical hospital stay and $450 per day for a typical nursing home stay. Meanwhile, home care costs less than $100 a day and helps many U.S. seniors remain independent at home, enriching their lives, and staying in touch with those they love.

Fast Facts

Home care providers will travel about 8 billion miles to deliver the best health care in the world.
Ninety percent of Americans want to age in place, and home care is the preferred method of health care delivery among the disabled, elderly, and chronically ill.
Home care provides high-quality, compassionate care to more than 5 million Americans annually.

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, occupational and aquatic therapy as well as free community educational/support groups via zoom.

~by Anna Swanson

Chaplains and the Role of Spiritual Care in Healthcare

October 26, 2020

In celebration of National Pastoral/Spiritual Care Week, Pemi-Baker Community Health would like to acknowledge and thank Guy Tillson, MDiv, MA for being our Hospice Chaplain, an integral part of our hospice team. This year’s theme is ‘Collaborative Health Care: Chaplains Complete the Picture.’ By collaborating to provide holistic interdisciplinary care, our patients and families directly benefit from his presence and spiritual care services.

What a Home Care Chaplain Does A home care chaplain is a professionally trained clergy member who supports patients and staff with spiritual and religious concerns. He or she is clinically trained to help navigate the healthcare experience. Chaplains have similar skill sets to social workers, but are specially trained to support belief systems across faiths and cultures. In order to better meet the needs of patients, chaplains receive more than 1,600 hours of training focused specifically in healthcare settings.

Chaplains act not only as spiritual counselors, but as advocates for patients and staff. Dedicated chaplains influence better decisions about care, improve clinical outcomes, and enhance staff morale. The trust they establish with patients transfers to other members of the care team, leading to better care and better outcomes.

Expert guidance during serious illness (Palliative Care) A serious illness in your family includes coping with symptoms, stress and uncertainty. The experienced team from PBCH Palliative Care provides guidance and support focused on relieving physical, emotional and spiritual suffering of the patient as well as their entire family – so patients and families can enjoy life to the fullest despite the illness.

Expert guidance during life’s final months (Hospice Care) The final months of life can be more fulfilling if you or a loved one can focus on goals and wishes. The experienced team from PBCH Hospice Care will guide you with receiving expert medical care, as well as emotional and spiritual support.

Because chaplains are unbiased and part of the care team, they are valuable in providing a safe harbor and bridging difficult conversations. Guy Tillson, Chaplain at Pemi-Baker Community Health says, “Our most fundamental human condition is when we come face-to-face with our own mortality. As chaplains, we walk into some dark places and help bring in light.”

If you have more questions about Palliative Care, Hospice Care or what a home health Chaplain can do for you and your family, please call Pemi-Baker Community Health for more information today.

~Anna Swanson

Pemi-Baker Community Health Helping Breast Cancer Survivors

October 16, 2020

October is National Physical Therapy month as well as Breast Cancer Awareness month and the physical therapists at Pemi-Baker Community Health (PBCH) can assist patients with breast cancer to live a more functional life. Often there is a missing link once a person is diagnosed with breast cancer. A patient can go through the whole diagnosis, yet have many questions about how to return to their prior level of function or how to progress themselves into strength training or exercises.

After a person undergoes surgery, there can be significant scar tissue, which causes limitations of everyday movement. If a person is feeling tightness, pain, loss of range of motion or strength, or feel like their posture is being impaired, these can be signs identifying the need for physical therapy. Treatment for breast cancer is saving lives. Let us help you with these side effects of breast cancer treatment so you can regain your health in motion!

Together, through physical therapy, we can:

Restore your mobility and posture
Decrease or eliminate your pain
Rebuild your strength and endurance
Return you to work and play
Boost your energy
Prevent or combat the effects of lymphedema

Research shows that physical exercise and activity are key factors in breast cancer survivors regaining vitality and returning to optimal health. While medical treatment for breast cancer is saving more lives, the disease may leave patients with significant limitations.

Breast cancer rehabilitation can help patients with:

Post lumpectomy or mastectomy
Breast reconstruction
Scar tissue restrictions
Lymphedema
Lymphatic cording or “Axillary Web Syndrome”
Shoulder, neck, or back pain
Side effects from chemotherapy and radiation
Treatment induced fatigue

Our team of physical therapy specialists are your partners in this journey back to health and enjoying the activities you love. At Pemi-Baker Community Health, you will benefit from a combination of advanced exercise prescription and manual therapy intervention to restore your range of motion, decrease swelling, and reduce pain. We are ready to help you move better and feel better, while regaining strength and energy.

Call today to learn more about our home care and outpatient, expert providers.

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.

~Anna Swanson

LVST BIG Program Helping Those With Parkinson’s Disease

October 8, 2020

Every October we celebrate National Physical Therapy Month, an annual opportunity to raise awareness about the benefits of physical therapy. Regular physical activity is one of the most important things that you can do for your health. Unfortunately, more than 80% of adults and adolescents do not get enough. Physical therapists at Pemi-Baker Community Health are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. It’s never too late to get moving and this article explains how physical therapy can help those experiencing the symptoms of Parkinson’s disease.

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.

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.

With over 50 years of experience, serving clients from 20+ 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

Preventing Falls with Occupational & Physical Therapy

September 18, 2020

September is National Falls Prevention month! At least one out of every three adults over the age of 65 falls each year, resulting in almost 2 million older adults ending up in an emergency room. Out of those 2 million, 15,000 die from their injuries. That equals 1 death every 35 minutes as a direct result of a fall. With the help of Pemi-Baker Community Health’s therapy practitioners, older adults can take steps to reduce fall risk and safely increase their involvement in activities they value.

What Causes Falls?

Falls result from personal, environmental, and activity-based factors. Personal factors include such things as illness, behaviors, capabilities, medications, and fear of falling. Environmental factors are those outside of the older adult, such as hazards in the home, the stability of the shoes he or she wears, and the availability and use of mobility devices like canes or walkers. Finally, specific activities can place someone at risk for a fall when the demands of the activity exceed his or her abilities. For example, when someone who has poor balance stands on top of a step stool to reach into a cabinet, fall risk increases. “It is the interaction of these factors that typically leads to a fall,” says Pam Hixon, Occupational Therapist at Pemi-Baker Community Health.

https://youtu.be/t7lC5Pdpx_k

How Occupational Therapy Can Help

The role of occupational therapy in fall prevention has been widely and increasingly recognized. “Occupational therapy practitioners consider how the individual functions in his or her day-to-day environment,” says Hixon. “They actively involve the client in the fall prevention process to better understand individual fall risk factors and intervention priorities. Teaching clients how to identify and solve problems is an important part of the occupational therapy process.”

Occupational therapy practitioners working in home health have a unique opportunity to understand factors that increase fall risk. They usually start creating a fall prevention plan by discussing the older adult’s typical and desired daily activities. To understand a client’s capabilities, the practitioner might ask the client to perform some typical activities, such as climbing stairs or getting in and out of the bathtub.

To make activities safer and easier, the practitioner might suggest new ways to do things or recommend the use of adaptive equipment. They will help clients select which assistive devices would be most appropriate- walkers vs canes for example. The practitioner also helps to identify and address hazards in the home such as loose rugs, stairways cluttered with items and slippery tubs and showers. They can also help procure items such as grab bars, tub seats, raised toilet seats…all of which increase safety.

How Physical Therapy Can Help

Preventing falls is key, but reducing the chance of injury in the case of a fall is also extremely important. Screening for osteoporosis through a painless bone density test can be very helpful. Older adults who have low bone mass are at greater risk for a fracture if a fall occurs. Osteoporosis can be managed medically with a physician’s help, and physical therapy practitioners can help clients who have osteoporosis build bone mass through activity, thus increasing their ability to engage in day-to-day activities more easily.

When you first meet your physical therapist, he or she will assess your balance. If it is impaired due to visual, inner ear or muscular reasons, your physical therapist will give you exercises to safely challenge and improve your balance. For those with very high fall-risk factors, doing exercises waist to chest deep in Pemi-Baker’s warm therapy pool creates a very safe setting for a client to be in control, without the risk of falling. On land or in the water, physical therapy will help improve your mobility, and provide an important boost to your confidence when walking so you can minimize your risk of falling and enjoy your normal everyday activities.

Accessing Occupational or Physical Therapy

Older adults can access therapy services for fall prevention in various settings, such as acute care hospitals, rehabilitation centers, outpatient clinics, and in the home via home health services. Pemi-Baker Community Health offers services in the home as well as at their facility on 101 Boulder Point Road in Plymouth, NH.

If you are concerned about falling, or have had a fall recently, talk to your Primary Care Physician (PCP) about getting a referral to see an Occupational or Physical Therapist with Pemi-Baker Community Health. With over 50 years of experience, serving clients from 20+ 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 and on-site physical, occupational and aquatic therapy at their Boulder Point Facility.

To contact us please call: 603-536-2232 or email: info@pbhha.org

~Anna Swanson

Why Become a Hospice Volunteer?

September 11, 2020

Hospice volunteers know that helping others at the end of their lives is tremendously rewarding. Being part of a hospice team gives you the profound privilege of bringing comfort, peace and care to patients, caregivers, and their families during their transitional journey.

Volunteers feel a greater appreciation of life itself, a deeper understanding of what’s truly important, and an authentic sense of fulfillment.

Why volunteer? As a hospice volunteer, you become part of a person’s life when you are needed most. That sense of fulfillment is priceless. Also, without caring volunteers like you, there would be no Medicare-certified hospice programs. Medicare law requires that 5% of hospice care hours are provided by volunteers.

Who volunteers? People just like you. Adults, young adults, and in some cases mature teens from all backgrounds, experiences, and cultures. Effective hospice volunteers embrace the fact that their role is one of compassionate service.

What skills do I need? Most agencies like Pemi-Baker Community Health, will provide the training and orientation you need to feel confident and comfortable with whatever level of support you choose to give. Training can include things such as grief counseling, boundaries between the volunteer, the patient and the family, and emergency medical support.

Do you love music? Sharing stories? Playing cards? Whatever passions, talents, or interests you bring can also be valuable assets. The most precious asset, of course, is simply caring.

What does a hospice volunteer do? Ultimately, hospice care is about providing patients, caregivers, and families with the most comfortable and compassionate end-of-life experience possible.

Your responsibilities will vary. In many cases it’s as simple as companionship. Sitting and talking. Or just listening. Or playing a patient’s favorite music.

You may also assist patients with tasks they can no longer perform for themselves. It may include anything from light household chores to lending emotional support to the patient’s family during this difficult time.

If you prefer to work in a different capacity, some hospice providers have opportunities to help with administrative office tasks.

What is the time commitment? As with most things around hospice volunteering, your commitment can vary. It depends a lot on the time you’re willing to commit and the needs of the patients you are matched with. You can work all that out in advance when you apply.

I’m interested; how do I apply? The next free VIRTUAL Hospice Volunteer training will start Tuesday, October 6^thand run 5 weeks through November 3^rd. All the training is done via zoom meetings in the comfort of your own home. Contact Lauren Bell, Pemi-Baker Community Health’s Hospice Volunteer Coordinator at 603-536-2232 or email her at lbell@pbhha.org.

~Anna Swanson

Grieving Ahead of Time

August 26, 2020

The old adage “Forewarned is forearmed” is a way of saying “If you’re aware something is going to happen, you can prepare yourself for it”. As with any cliché, there is an element of truth contained in it, but it certainly doesn’t tell the whole story. We know that life is messy and that there are so many variables in any one given circumstance that fool-proof preparation is unlikely.

In considering the wide range of experience of human loss, there is a phenomenon called “anticipatory grief”. It refers to the grieving and mourning that one undergoes when there is an expected and impending loss. A common example is learning that the end-point of treatment for a terminal illness has been reached, that further treatment would be ineffectual (and even painful), and that the patient is at the end of their life. If the patient is able to comprehend this news, both they and their support system (family, friends and acquaintances, and other caregivers) will probably experience anticipatory grief. Death is likely, but when? How much time is there before that happens? What can we expect as part of the process of getting to that moment? Is there anything we can do?

Because there is a big element of “not knowing” to this experience, the grieving BEFORE the ultimate loss has features that distinguish it from the grief AFTER the actual loss. Added to the now familiar categories popularized by Elizabeth Kubler-Ross (denial, anger, bargaining, depression, and acceptance) are feelings of dread, uncertainty, powerlessness, and disorientation. There is often the feeling that this has no shape, form, or definition. It is ambiguous and nebulous. We might even use the word “squishy”, like Silly Putty. At first there might be something that feels like temporary relief (“We’re OK for now. We’re not at the end yet.”) which, depending on the duration of the “in between” experience, can morph into weary frustration (“When is this going to be over?”). It can also include the ache and horror of witnessing the progressive alteration of our image of the loved one (“It hurts so much to see her like this. That’s not my sister.”) As time stretches out, the burden of caregiving and endurance become heavier. These auxiliary losses of awareness, independence, strength, and functionality deepen our vulnerability to an event that has not yet happened. Fatigue, impatience, avoidance, reluctance, and an overall depletion of emotional and physical resources can occur. (“Waiting for the other shoe to drop”) can feel endless.

In a best-case scenario, the “in between time” can offer opportunities for the patient to get their affairs in order, to address “unfinished business” in personal and family relationships, to say goodbye, to prepare spiritually for death, and even to plan their own memorial service. Caregivers can educate themselves about their loved one’s illness, seek out resources to help and support themselves and the loved one, and to plan for their own self-care for however long. There is no guarantee, however, that these opportunities will be acted upon. One or the other (or both) may not want or choose to do these things which can make the time more challenging.

It is helpful to know that anticipatory grief is not restricted to the event of an impending death. You’ve been told that the company you work for is folding and that you will be out of work in sixty days. Your diabetes has progressed to the point where it’s become necessary to amputate your right leg. You and your spouse have come to the realization that there’s nothing more you can do to salvage your marriage and have decided to divorce. After one too many fender benders, your physician and your family are advising you to stop driving. Such experiences may not be life-threatening, but they curtail our familiar patterns of functioning in significant ways. They summon us to relearning how to live our lives as we await the particular event of loss and change.

In our current circumstances of living through the COVID19 pandemic, it’s as if we’ve been hit with a “double whammy”. As with the experience of a death, something has definitely happened to alter our lives. We’ve had to adapt and adjust as we hope for a resolution which hasn’t been discovered yet. We are living with various losses imposed on us by this event. There is this uncomfortable vagueness which arouses all sorts of reactivity- some cooperative, some hostile. With a death, we know there are things to be done- settling the estate, canceling credit cards, closing bank accounts, etcetera. With the ongoing pandemic, things aren’t that clean, direct, or explicit. The notion of a “new normal” brings with it the possibility that there may be some patterns of living we might not be able to recover. We are enduring a prolonged time of “not yet”. It is an experience of anticipatory grief on a global scale. It’s a hard place to be, and it may be awhile before we have any answers.

As with any grief reaction, there are things we can do that can help to carry us through the process. Reaching out to others for support is essential to assuage feelings of isolation and aloneness. Sustaining your patterns of self-care is also important- make sure you’re eating, sleeping and resting, and exercising. Indulging yourself in your recreational interests and activities keeps alive your vitality and creativity- walk, run, shoot hoops, do your woodworking, listen to music, read a junky novel, work on your craft projects, try that recipe you saw in a magazine, watch movies, play board games. or weed your garden.

This is only a smattering of information about anticipatory grief. If you’re interested in learning more, Google will open up for you a wealth of articles and items about this topic and Pemi-Baker Community Health’s Palliative Care team and Caregiver support groups are also fantastic resources.

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

Guy’s professional background includes ministry, teaching, and mental healthcare. He can be reached at gtillson@pbhha.org or at (603) 536-2232, Extension 218.

Would Aquatic Physical Therapy Benefit You?

August 18, 2020

Aquatic Physical Therapy is physical therapy that takes place in a pool under the supervision of a trained healthcare professional. Aquatic Physical Therapy is also known as aquatic therapy, water therapy, aquatic rehabilitation, aqua therapy, pool therapy, or hydrotherapy. Aquatic therapy continues to grow in popularity as a safe complement or alternative to traditional land-based therapy and it is suitable for children and adults of all ages and fitness levels. You do not need any swimming experience to gain benefits of the water.

Water therapy has been used for thousands of years throughout the world. Consider the following examples:

Ancient Greeks and Romans bathed in hot springs to improve circulation and promote relaxation.
Hippocrates recommended bathing in spring water as a way to treat sickness.
Swiss monks were known to use thermal waters to treat sick or disabled people in their community.
Japanese hot springs, or onsens, are said to have medicinal effects that include healing chronic pain, treating skin problems, and relieving constipation.

“The biggest benefit of aquatic therapy is that people who are injured, disabled or otherwise not capable of comfortably or safely performing exercises on land can easily do so in the water,” said Kaity Schwartzer, PT, DPT for Pemi-Baker Community Health. The natural buoyancy of water reduces stress on the body and helps patients exercise easier with less pain. Plus the natural pressure of water in therapy pools reduces joint and soft-tissue swelling and provides enough resistance to strengthen muscle.

Compared to other forms of physical therapy, aquatic therapy results in a higher client compliance rate and less pain throughout the recovery process. “Any opportunity to significantly minimize the pain a client experiences should be taken seriously because with less pain, a client can enjoy a higher quality of life,” said Schwartzer.

Another important advantage of aquatic therapy is that it can often begin before land-based therapy. For athletes looking to get back into competition, or busy professionals who want to recover from surgery as quickly as possible, this makes a water-based program the natural choice.

Pemi-Baker Community Health’s specialty-trained aquatic therapists will help you reach your goals. They provide safe, hands-on effective, customized care for patients with any of the following:

Difficulty walking or limited weight-bearing capacity
Fibromyalgia, Bursitis, Tendonitis
Extremity injuries which prevent regular conditioning on normal surfaces or in athletic participation
Spinal cord injury, Scoliosis, lower back pain
Arthritis, Osteoarthritis, Rheumatoid arthritis
Total hip/knee/shoulder joint replacements or reconstruction recovery
Pregnancy-related musculoskeletal pain
Cerebral palsy, Parkinson’s disease, Multiple sclerosis, Stroke, Traumatic Brain Injury

Aquatic therapy is different from aquatic exercise because it is a physical medicine and rehabilitation specialty that requires the involvement of a trained professional. Aquatic Therapy is covered by most insurance providers and you do not have to know how to swim. Common goals of aqua therapy programs include improving flexibility, balance and coordination, building muscle strength and endurance, enhancing aerobic capacity, assisting with gait and locomotion and reducing stress while promoting relaxation.

PBCH’s licensed therapists will meet one on one with you, orienting you to the pool and changing rooms and assisting you around the perimeter of the therapy pool. COVID-19, CDC guidelines are strictly followed with clinicians and clients wearing masks and therapy sessions scheduled to prevent overlapping of clients in the locker rooms. We invite you to come by our facility to view the pool and get a tour!

~Anna Swanson