If You Live With a Serious Illness, Learn How to Improve Your Quality of Life

June 14, 2021

If you have cancer, lung, heart or kidney disease, Alzheimer’s, or another serious illness, you should know about a medical team that can address your symptoms and stress.

The medical team is called palliative care and they’re available in a variety of medical settings. Pemi-Baker Community Health (PBCH) offers palliative care in your home, making it easy for you and your family members to ask questions and relay concerns. Their focus is on relieving the symptoms and stress of your illness. The goal is to improve quality of life for both the patient and the family. This is done by coordinating the patient’s care as well as providing support for the caregivers if they are experiencing caregiver burnout.

Pemi-Baker Community Health’s palliative care is provided by a specially trained team of doctors, nurses and other specialists who work together with your other doctors to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in your illness, and it can be provided along with curative treatment.

Is Palliative Care right for you?

Answer the following questions to determine whether palliative care might be right for you or someone close to you. Remember, you can receive palliative care at any point in your illness.

Do you have one or more serious illnesses such as:

Cancer
Congestive heart failure (CHF)
Chronic obstructive pulmonary disease (COPD), emphysema, lung disease
Kidney failure
Liver failure
Neurological diseases (e.g., ALS, Parkinson’s)
Dementia

Do you have symptoms that make it difficult to be as active as you would like to be, or impact your quality of life? These symptoms might include:

Pain or discomfort
Shortness of breath
Fatigue
Anxiety
Depression
Lack of appetite
Nausea
Constipation

Have you, or someone close to you, experienced the following:

Difficult side effects from treatment
Eating problems due to a serious illness
Frequent emergency room visits
Three or more admissions to the hospital within 12 months, and with the same symptoms

Do you, or someone close to you, need help with:

Knowing what to expect
Knowing what programs and resources are available
Making medical decisions about treatment choices/options
Matching your goals and values to your medical care
Understanding the pros and cons (benefits/burdens) of treatments (e.g., dialysis, additional cancer treatments, surgery, etc.)

Do you, or someone close to you, need help with:

Coping with the stress of a serious illness
Emotional support
Spiritual or religious support
Talking with your family about your illness and what is important to you

If you answered yes to any of the questions above, you can benefit from palliative care. Ask your doctor for a palliative care referral with Pemi-Baker Community Health. Once PBCH receives the referral from your doctor they will contact you via phone to answer and ask questions and set up a meeting with you at your home.

What happens at a first visit with a palliative care team?

The first step is for the palliative care team to get to know you as a person and find out who else is important in your care. They will want to hear your narrative – who you are, what you enjoy doing, and what is most important to you in your day-to-day life. They’ll review your medical information, ask what symptoms are of concern, and how much these affect your quality of life. They’ll ask questions to see if there are any care needs at home. They may also ask questions to learn what you know about your medical condition, and what concerns you about the future so they can plan how to help over time. The team will also ask questions about who you would want to help make decisions if you aren’t able to do so for yourself. This person is called a health care agent or proxy.

For more information on how Pemi-Baker Community Health can help please call 603-536-2232 or email us at info@pbhha.org.

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. Visit our website: www.pbhha.org and like our Facebook Page: @PBCH4

~written by Anna Swanson

2021 Spring Auction a Success!

June 14, 2021

Thank you to all of our sponsors, local businesses and high bidders for helping us raise close to $12,000 for all of our neighbors in need. ‘It takes a village’ and our community did not disappoint.

Don’t forget to pick up your items at Boulder Point.

PBCH Kicks Off 2021 Spring Auction! Over 90 Items!

May 4, 2021

For a second year, Pemi-Baker Community Health has decided to forgo their annual in person Brunch/Live Auction Fundraiser out of concern for the health and safety of their community, replacing it with a month long ON-LINE auction in the hopes of replicating last year’s success.

The auction has something for everyone with gift certificates and specialty services from local businesses, gift baskets with toys for the kids, champagne and chocolate picnics and spa day ingredient get-aways. Pontoon boat rides, NASCAR dream drives, golf packages, the items are endless and with bidding and buy now options you can walk away with a steal!

The auction is on-line for the month of May at www.32auctions.com/PBCH2021. All of the items have been donated by local businesses and friends of PBCH allowing all money raised to go to their uninsured or under-insured patients as well as toward their free community programs they offer: Coffee w/ Caregivers, Loss & Grief Support, Fill Out Your Forms.

“It is important for us to continue our important work in supporting the members of our community who need medical aid at home and we are so appreciative of the businesses who helped us by being sponsors or by donating items to make this auction possible,” said Amy Dennis, Interim Executive Director and Senior HR Director.

PBCH would like to thank Dumont Construction, Mid-State Health Center, Waterville Valley Realty, Speare Memorial Hospital, Squam Lakes Financial Advisors, Noyes Insurance, R.M. Piper General Contractors, Meredith Village Savings Bank, NEEBCO and Mainstay Technologies for their sponsorships.

~written by Anna Swanson

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.

Learning About Caring For Dementia

April 16, 2021

When I first came on to Hospice work, my supervisor encouraged me to maintain ongoing self-study about various topics relevant to the work. One day, I pulled a book from the shelf in our office. An observant co-worker noticed and commented that I had grabbed “the Bible for caring for dementia.” The book is THE 36-HOUR DAY: A Family Guide to Caring for People Who Have Alzheimer Disease, Other Dementias, and Memory Loss. The title itself, as does the book, pulls no punches. Providing ongoing care for a person with dementia is time-consuming, emotionally demanding, stressful, and exhausting, so that one’s days feel like they are longer than they are and packed with too much to do and remember.

The task can also be loving and rewarding, especially when the caregivers learn to take care of themselves as well. The book is also what it says it is- a guide to caregiving. The authors are Nancy L. Mace and Peter V. Rabins, both affiliated with the Department of Psychiatry and Behavioral Sciences at the John’s Hopkins University School of Medicine. Don’t think, though, that it is written with sophisticated terminology or an excess of medical jargon, making it heavy and dense. To its credit, the style is easily understandable and presented in a conversational, caring, and concerned tone directly to the reader who may already feel overwhelmed when first facing the challenge of caring for a spouse, a parent or grandparent, a sibling, or another acquaintance living with dementia. Above all, it is a practical volume, with all sorts of advice when confronting the many challenges of this type of care. Since its appearance in 1981, the book has been revised and edited six times to keep up with new information as it emerges. Over three million copies have been sold worldwide as of the publication of the 2017 edition.

The reader/caregiver is immediately immersed into the experience as the first chapter opens with the case history of a woman who begins to notice her memory is slipping and moves along as her limitations compound. The focus is first on her. What is she experiencing? What is she feeling? What can she do? Woven through this are brief accounts of her family members’ attempts to care for her and their experiences and feelings as their involvement becomes more complex. It recounts a loss of skills around self-care and social interaction, moving us all the way through her journey which ultimately end with her admission to a long-term care facility when her family arrives at the point of no longer being able to care for her.

In this introductory section, there is a brief presentation raising the question “What Is Dementia?” The book is careful to explore all sides of the challenges of caring for someone with dementia. The authors really walk alongside the readers/caregivers in taking the first steps toward assuming the responsibility of caregiving. Having read the book, I am hard-pressed to discover any stone that has been left unturned. Let me be quick to say that not all dementia patients end up in nursing homes. Caregiving story endings vary from case to case, very much the result of the many factors both patients and caregivers bring to their own unique circumstances.

The practicality of the book is manifest in addressing particular experiences from both positive and negative perspectives. This is done throughout the book as it anticipates a wide variety of responses and reactions from patients and caregivers alike. It progresses from dealing with initial manifestations of the disease through its more serious and complex concerns and on to end-of-life care. The development of this style moves from what to do about things like home safety, nutritional needs, medical needs, and personal hygiene on to “sun downing” (worsening behavior as a day moves toward its end) and “shadowing” (a clinging trailing after the caregiver) and on to more serious behaviors as wandering, combativeness, and inappropriate sexual behavior. These are only a smattering of the features presented throughout the book. The work is chock-full of all sorts of valuable information. A very simplified example of considering various sides of a problem might go something like this: “If your father is doing X, try redirecting him toward trying Y. If it works, and you can keep reinforcing it, all well and good. If he is unsuccessful or refuses to try Y, try Z. If the problem persists and remains unresolved, you may have to learn to tolerate X to avoid frustrating and angering the both of you.” (Not a direct quote)

What comes through quite clearly is that the caregiver/s must make changes in themselves as their loved ones become less and less the persons we knew them to be. Our intervention helps to support them and compensate for what they have lost. This is not easy. It is emotionally costly. It becomes the nub for the necessity of self-care for the caregiver/s. There is a whole chapter on “Getting Outside Help”. The authors draw on a tremendous fund of knowledge and experience in their offerings of factual knowledge about dementia and practical suggestions pertinent to caregiving. In many places, there are “Who to call or contact” directives regarding particular concerns. Of course, readers/caregivers will need to locate those types of resources available in their own area.

The chapter entitled “Special Arrangements If You Become Ill” and its subsection “In the Event of Your Death” both contain practical information for anyone whether or not they are currently in a caregiving role. The COVID pandemic has served to heighten our awareness for the need of preparedness in the possibility of emergency. It is to be hoped that it also has brought home to us the preciousness of our loving connections so that we do not over-burden our loved ones through our lack of practical foresight. There is another whole chapter “Caring for Yourself”. There is also a chapter regarding the needs of children and teenagers who may be living in a home setting where caregiving is being done. There are also sections and chapters on end-of-life care, financial and legal issues, and considerations about relocating care outside the home.

It is not until Chapter 17 (“Preventing and Delaying Cognitive Decline”) that the book returns to a more specifically medical and scientific consideration of dementia and its causes (Chapter 18) and research about dementia (Chapter 19).

Click here and learn more about our PBCH support groups!

In drafting this review, it was challenging for me to try to choose items that might grab a reader’s/caregiver’s attention in order to reveal the book’s appeal. I do hope I have done it enough justice so that you might consider borrowing a copy through the library you patronize or purchasing a copy for yourself. I have seen copies of the book on the shelves of our independent bookstores (Innisfree Bookshop in Meredith, Bayswater Books in Center Harbor, and Gibson’s Bookstore in Concord). Of course, it is readily available through Amazon and Books A Million. Quite simply, it is a superb guide, and I recommend it most highly.

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

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

March is National Nutrition Month- Are you programming your biology for health or disease?

March 1, 2021

March is National Nutrition Month and Pemi-Baker Community Health’s newest Community Partner, Denise Poudrier Normandin, founder, and CEO of Enlighten Nutrition & Wellness wants us to make every bite count. In December, the updated Dietary Guidelines for Americans 2020-2025 were released, and the aim is to promote health and prevent disease. With over two decades of experience as a Registered/Licensed Dietitian and Health Education, Denise helps make sense of the new findings.

Choosing a healthy lifestyle is key to promoting, maintaining and/or regaining health. Therefore, it is important to consider if your lifestyle choices are programming your biology for health or disease. One of the most significant ways we impact our biology is by the food choices we make on a regular basis. Food can be healing or harmful to our bodies. That is why it is important to choose whole, real foods, the way they are intended from nature. “Let Food Be Thy Medicine and Medicine Be Thy Food” – Hippocrates. Hippocrates of Kos was a Greek physician of the Age of Pericles, who is considered one of the most outstanding figures in the history of medicine. He is often referred to as the “Father of Medicine.”

Just about everyone, no matter their health status, can benefit from shifting food and beverage choices to better support health.

The review of the scientific evidence on diet and health that informs the Dietary Guidelines is representative of the U.S. population—it includes people who are healthy, people at risk for diet-related chronic conditions and diseases, such as cardiovascular disease, type 2 diabetes, and obesity, and some people who are living with one or more of these diet-related chronic diseases.

The Dietary Guidelines is not intended to contain clinical guidelines for treating chronic diseases. Chronic diseases result from a complex mix of genetic, biological, behavioral, socioeconomic, and environmental factors, and people with these conditions have unique health care requirements that require careful oversight by a health professional. These largely preventable chronic diseases put people at a greater risk for illness, including COVID-19.

Are you ready to make every bite count and start programming your biology for HEALTH?

Here are a few tips for the dietary guidelines to get you started:

Follow a healthy dietary pattern at every life stage.
Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.
Focus on meeting food group needs with nutrient-dense foods and beverages and stay within calorie limits.
Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages.

A healthy dietary pattern consists of nutrient-dense forms of foods and beverages across all food groups, in recommended amounts, and within calorie limits.

The core elements that make up a healthy dietary pattern include:

Vegetables of all types—dark green; red and orange; beans, peas, and lentils; starchy; and other vegetables
Fruits, especially whole fruit
Grains, at least half of which are whole grain
Dairy, including fat-free or low-fat milk, yogurt, and cheese, and/or plant-based
sources
Protein foods, including high quality proteins; beans, peas, and lentils; lean meats,
poultry, and eggs; and nuts, seeds, and soy products
Oils, including vegetable oils and oils in food, such as seafood and nuts

Denise is accepting new patients and is a preferred provider of Medical Nutrition Therapy (MNT) and is available to meet one-on-one to create a healthy eating plan that works for YOU! She is committed to building stronger, healthier individuals, families and communities through face-to-face individual and group nutrition consultations, telehealth, corporate training workshops, wellness retreats, health, and lifestyle coaching, and speaking engagements. Most recently, she became a board-certified diplomat in Lifestyle Medicine by the American College of Lifestyle Medicine and the International Board of Lifestyle Medicine. “My passion is to inspire healthy living practices to improve health and transform lives!” Private insurance and Medicare accepted. To learn more email Denise or visit her website: denise@enlightenlivewell.com or enlightenlivewell.com

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

Benefits and Considerations for In-Home Physical Therapy

February 19, 2021

A physical therapist (PT) is a specialist trained to work with you to restore your activity, strength, and motion following an injury or surgery. Physical therapists can teach specific exercises, stretches, and techniques and use specialized equipment to address problems you might be experiencing. Pemi-Baker Community Health’s compassionate, experienced PT’s will come to your home for your therapy and once you are able, you can transition to Outpatient Physical Therapy(OPT), where you travel to them at their clinic in Plymouth, NH.

Physical therapy care may be provided in a variety of different settings. Obviously, if you are hospitalized, your therapy may be provided by a physical therapist who works at the hospital. If you require sports therapy, you may go to an OPT clinic. Some patients have difficulty leaving the house to go to physical therapy. In-home physical therapy is the perfect solution.

So what is in-home physical therapy, and how might you benefit from PT in your home?

Physical therapists are trained to identify deficiencies in the bio-mechanics of the body. Working with a physical therapist can target specific areas of weakness in the way our bodies work. They can relieve stress and help the body function without pain.

Physical therapists are knowledgeable about surgical procedures and treatment goals and can tailor their efforts to improve your well-being. After surgical procedures, it is important that therapy is guided by the surgical procedure. Physical therapists are knowledgeable about your body’s limitations after surgery and can help ensure a successful outcome.

Stretching Tight Muscles and Joints: Stretching is vital in maintaining a good range of motion with joints and the flexibility of muscles. If you have stiff joints or tight muscles, normal activities, such as climbing stairs or reaching overhead, can be severely affected. With proper stretching, these functions can be preserved.

After an injury or surgery, scar tissue forms and soft tissue contracts. It is important to regularly stretch in these situations to ensure that scar formation does not get in the way of your rehabilitation.

Exercises to Strengthen Your Body: Strengthening exercises are performed to help you improve the function of your muscles. The goal is to improve strength, increase endurance and maintain or improve range of motion. Post-operative exercises should always be guided by your doctor and physical therapist, as there may be specific restrictions for your injury. One of the most recent developments in physical therapy is the emphasis on core strengthening and stability. The core of your body is like the foundation of your house. If you were to build your house on a weak foundation, you could risk damage and collapse. Similarly, bodies with a weak core are susceptible to acute injury and chronic overuse syndromes.

Who Benefits from In-home PT?

Anyone experiencing:

Knee injuries, shoulder injuries, back injuries, and neck injuries
Parkinson’s disease
Multiple sclerosis
Stroke
Amyotrophic lateral sclerosis (ALS)
Any cardiac event like a heart attack
Trauma such as fracture.

Is In-Home PT Effective?

Many people wonder if home-care physical therapy is effective. Why? Because many believe that you need expensive, heavy equipment and exercise tools to engage in an effective rehab program. This is not necessarily true. Your home-care physical therapist is trained to utilize available resources to maximize your rehab experience. He or she can also bring light equipment to your home to ensure you get the most out of your physical therapy.

How Do You Get Home care PT?

Most patients who receive home-care physical therapy are referred to the service by their physician. Your doctor can make the referral to a local visiting nurse service that offers physical therapy, and he or she can attest that home services are medically necessary. This medical necessity report will likely also state that home-care physical therapy is needed because you are unable to leave the house due to your condition or circumstances. Patients can choose who they go to for services, they just need to mention the organization to their physician. (Keep in mind if you have insurance you should always check to confirm what providers are included).

If you feel you may benefit from physical therapy at home, you can also call your local physical therapy clinic or visiting nurse association like Pemi-Baker Community Health. Those organizations can help you navigate the pathway to receiving home-care PT.

~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.