Providing compassionate in-home and out-patient care in Plymouth, NH
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As your family member or loved one grows older, you treasure each moment spent with them. When the time is right for hospice care, you want to find compassionate people to help your loved one cope with illness and feel safe and comfortable. Likewise, you — and each member of your family — deserve the support of a whole team of people to guide you through this challenging time.
Hospice care is not merely a service that helps you and your loved one make the most of your time together. It also offers emotional and spiritual healing for the whole family. Having a hospice care team means your family can lean on the deep compassion and endless support of a group of specialists who will guide you through this journey.
Meet Your PBCH Hospice Care Team—As you prepare to help your loved one transition into hospice care, take comfort in knowing that your family will be supported every step of the way. Your hospice care team is made up of health care experts and compassionate people who can help your loved one feel whole physically, mentally and spiritually. Each person on your hospice team — from doctors to hospice staff to trained volunteers — will work with your family to ensure you are always the leading voice in your loved one’s hospice experience.
Your Loved One’s Primary Caregiver–You may be your loved one’s primary caregiver, or it may be another family member, a loyal friend or a hired caregiver. This person provides necessary daily care to your loved one with the support of the entire hospice care team.
Your Physician–Your doctor has been there with your loved one every step of the way. He or she may continue to do so throughout hospice care, if you so choose. Your loved one’s physician is already intimately familiar with their medical history, which helps them to care for your loved one during hospice, too.
Hospice Physicians/APRNs–Hospice physicians are the compassionate people who coordinate your loved one’s care plan. These doctors work closely with other hospice team members and your loved one’s physician to manage physical symptoms with care.
Hospice Nurses–Hospice nurses coordinate your loved one’s care plan with the physician and the rest of the hospice team. They manage symptoms and pain to ensure that your loved one is as comfortable as possible. Your hospice nurse also educates your family members on the use of medical supplies and equipment, along with how to properly administer medications.
Home Health Aides–If your loved one is seriously ill, even a simple task can become challenging. Home health aides fill an important role by providing personal, in-home care to your loved one. Your aide may help with bathing, grooming, preparing light meals, changing bed linens and bandage changes.
Chaplains–Spiritual caregivers are key parts of your hospice care team and support the traditions and beliefs of all cultures and religions. Your chaplain can discuss spiritual matters, answer questions, pray with you or help meet religious or spiritual obligations. If needed, they can also assist with funeral plans and services.
Social Workers–Depending on your loved one’s needs and concerns, they may want to talk about their priorities, may need help resolving a family or personal conflict, or may need help understanding their illness or health condition. A social worker can help your loved one in each of these areas, as well as help complete advance care planning, connect families to community resources and provide emotional support and counseling for increased emotional comfort.
Trained Volunteers–Specially trained Hospice volunteers may assist with many needs and tasks that make your day just a little bit easier. They can do activities such as run errands, do light housekeeping, provide companionship and play cards or read a book to your loved one. If necessary, volunteers can stay with your loved one, allowing you to take a breather before returning to your loved one’s care.
Bereavement Counselors–When you or another family member needs guidance in navigating grief, even before the loss of a loved one, bereavement counselors are here to help. Important members of your hospice care team, bereavement counselors are available during hospice care and beyond, providing individual and group grief support to your entire family.
Focusing on the Beauty of the Journey–The goal of hospice care is to make the transition through the final stages of a life-limiting or serious health condition more comfortable and peaceful for your loved one — and the whole family. This can be a very challenging and difficult journey for everyone involved. Working as a team with hospice can help comfort your family and allow your loved one to have the peace and dignity they deserve during their most difficult days.
Hospice Care You Can Count On–While your family member or loved one is in hospice, we want you to be able to focus on your loved one and know that you can rely on your Pemi-Baker Community Health hospice team to help with the rest.
Become a Trained Hospice Volunteer—Pemi-Baker Community Health is starting their next 5 week, volunteer training on July 7th from 4-6pm. Become a trained hospice volunteer from the comfort of your own home. This FREE training will be virtual, by computer. Contact Lauren Bell, SW at: lbell@pbhha.org or call 536-2232 for more details.
~Anna Swanson
One of the side effects of social distancing unfortunately, has been a slowing down or stopping of our normal exercise routines. With that comes less flexibility, balance and strength. Physical therapy is often thought of as something we do after an orthopedic injury or surgery, but in reality, physical therapy can help us remain independent and agile as we age. For seniors PT plays a significant preventative role and the physical therapists at Pemi-Baker Community Health know just how to help.
According to the Centers for Disease Control and Prevention (CDC) a third of all people over the age of 65 fall each year, making it the leading cause of injury in seniors. Every year, tens of thousands of older people are hospitalized with hip fractures. As many as 20 percent of them die within a year of the injury, while the rest never return to their prior level of function.
As we age, our bodies undergo a natural decline in flexibility, strength and balance, making it harder to maintain desired activity levels, and making us prone to falls. The National Institutes of Health cites physical therapy as a means to mitigate those losses, as well as to increase overall fitness. Fitness equates to independence.
Pemi-Baker Community Health’s Outpatient Physical Therapy Director, Matt Scagliarini, PT, DPT says, “We want the community to know that as an essential service, Pemi-Baker is continuing to provide rehab therapy regardless of what challenges come our way. We are following CDC guidelines to prioritize our patients and keep them safe during the COVID-19 (coronavirus) pandemic by staggering schedules, reducing traffic flow and proper cleaning between patients. We have been and will continue to provide physical therapy care to our clients while maintaining a safe environment throughout the coronavirus pandemic.”
Rehab services at Pemi-Baker include physical therapy, occupational therapy and speech therapy. Together, these services treat a span of ailments that commonly affect people in their senior years: orthopedic, pre and post-surgical care, cardio-pulmonary rehab; speech and movement disorders associated with Parkinson’s disease, stroke or other neurological conditions.
“A lot of clients experience chronic pain,” adds Scagliarini. “Having lived a full, active life tends to leave you with aches and pains from repeated use. Our heated therapy pool can help reduce the strain on your joints, allowing you to work on your balance and improve your strength safely and comfortably.”
Physical therapy can also help control the pain of many age-related problems, like arthritis and fatigue. “Physical therapy along with medication management by your PCP, provides a way to manage pain and maintain current levels of function, without falling into the trap of medication dependency,” says Scagliarini.
Among the 11 Pemi-Baker home health therapists and 9 outpatient therapists, their specialties include: Geriatrics, Myofascial & Cranio Sacral Therapy, Visceral & Neural Manipulations, Active Release Techniques (ART), IASTM (instrument assisted soft tissue mobilization), PelviDry Needling, Vertigo & TMJ, and the LSVT BIG program for their Parkinson’s clients.
Therapy at Pemi-Baker is actually a way of life. As Scagliarini sums it up: “We want to be involved in client’s lives at their homes as well as at our location on Boulder Point in Plymouth. We will work with you to keep you as active and healthy as possible.” Call your PCP today to ask for a referral for physical therapy at Pemi-Baker Community Health. Appointments are available.
~Anna Swanson
Mid-State Health and Pemi-Baker Community Health have collaborated to create an innovative joint position to best serve patients in the Plymouth community. “We are excited to welcome back Barbara Greenwell, APRN, ACHPN, to our practice. Barbara was a member of our team back in 2013-2014 when she practiced as an Adult/Geriatric Nurse Practitioner. She has returned to us with a wealth of knowledge and experience as Palliative Care Nurse Practitioner. Barbara’s primary role will be to work closely with the Pemi-Baker Community Health team to build their Palliative Care Program,” reports Bob MacLeod, the CEO of Mid-State Health.
Palliative care is a medical specialty designed to improve the health and quality of life for people with progressive illnesses. As an Advanced Certified Hospice and Palliative Nurse, Barbara will be working with the PBCH team to prevent and treat patient’s symptoms and side effects, as early as possible. Her twenty years of nursing experience in acute care and psychiatric nursing will benefit the patient’s psychological, social, and spiritual concerns as well. By offering face to face patient assessments in the office and in their homes, the hope is to prevent suffering and crisis that often result in hospitalizations. 
“Palliative care is about improving the quality of someone’s life even when the disease cannot be cured. We may not be able to cure the disease but we can improve the journey by improving the symptoms so people can truly live,” said Barbara Greenwell.
Pemi-Baker Community Health has seen the need for a larger palliative care program in Grafton County for some time. Barbara Greenwell will be joining Dr. Diane Arsenault, MD, Board-certified Palliative Care Physician along with the nurses and social workers on their team. “As we work collaboratively with Mid-State Health Center, Speare Memorial Hospital, and Newfound Area Nursing Association; having an APRN who is passionate and who is certified in both Palliative Care and Hospice, will greatly benefit our communities,” said Chandra Engelbert, CEO of Pemi-Baker Community Health.
With 52 years of experience, serving over 1000 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. PBCH is located at 101 Boulder Point Drive, Suite 3, Plymouth, NH. To contact us please call: 603-536-2232 or email: info@pbhha.org Visit our website: www.pbhha.org and like our Facebook Page: @PBCH4
Mid-State Health, ‘Where your care comes together.’ A health center on the leading edge of innovative, high-quality, patient-centered primary care. Two convenient locations: Plymouth Office 101 Boulder Point Drive, Suite 1, Plymouth, NH 03264 (603-536-4000) and Bristol Office 100 Robie Road, Bristol, NH 03222 (603-744-6200), Visit our website: www.midstatehealth.org.
~Anna Swanson
Pemi-Baker Community Health Raises Critical Funds for Home care and Hospice Patients-
The COVID-19 pandemic put a damper on Pemi-Baker Community Health’s plans for their Annual Auction and Brunch fundraiser but thanks to the generosity of community sponsors, donors and bidders, their ‘No-Show Auction’, an on line only event, was a success! 
With over 85 items to bid on, raffles to invest in and specialty services to donate towards, they hit their fundraising goal and raised the critical funds needed to continue their important work in supporting the members of this community who need medical aid at home. Now, more than ever, PBCH patients need nursing and social work support for their sudden illnesses and hospice needs. Many of their patients are experiencing increased feelings of depression and isolation, as well as heightened anxiety, particularly because many are at high-risk for COVID-19.
As a non-profit for over 52 years, Pemi-Baker Community Health has served family, friends and neighbors in 18+ towns and they couldn’t have done it without the generosity of individuals and businesses alike. Pemi-Baker would like to thank the following businesses for sponsoring the auction: Dumont Construction Inc., Mid-State Health Center, Northway Bank, Speare Memorial Hospital, NEEBCO, MatrixCare, Noyes Insurance, Service Credit Union, Insurance 24, Steve and Carole Osmer, Brian Weeks Electric, Highline Acoustics, Deb Hills Cleaning Services, Peabody & Smith Realty and Meredith Village Savings Bank.
Would you like to support Pemi-Baker Community Health? Visit their website, www.pbhha.org, to make a donation or join their ‘Circle of Friends’. This special group of good as gold supporters, make small, monthly donations to provide ongoing funding so PBCH can mobilize care, irregardless of the patient’s ability to pay. Just $10 a month will help ensure that every family can find the compassion, education and assistance necessary to help their loved one. You can make a difference to a friend or family member today with less than the amount you spend on lunch.
~Anna Swanson, Outreach and Communications
In an effort to keep all their home care and hospice clients safe, Pemi-Baker Community Health is taking preventative measures by testing their field staff for Covid-19. A team from the National Guard completed the tests last week for staff coming in contact with clients in their homes as well as therapists and administrative assistants working in their physical therapy office on Boulder Point.
“Our field staff are continuing to provide the much needed skilled services to our hospice and homecare patients during the Covid-19 pandemic. The patients we serve are able to remain at home due to our home visits that are being made by our dedicated team that consists of RN’s LPN’s, LNA’s, PT’s, OT’s, social workers and Chaplin. It’s very important to keep our clients safe and that we do not have any staff that are asymptomatic spreaders,” said Ernest Roy, PT, DPT, Clinical Supervisor PBCH-Home Health.
For over 52 years, Pemi-Baker Community Health has served family, friends and neighbors in eighteen towns and they are the home care and hospice provider of choice for Grafton County. PBCH partners with patients, their doctor, family and caregivers, helping home bound individuals in need of skilled medical services during recovery from illness, injury, surgery. Their Palliative and Hospice teams provide comfort and support for those who are facing life-limiting illnesses.
If you or your loved one have questions about receiving home health or hospice services, please visit their website at www.pbhha.org or call 603-536-2232 for more information.
~by Anna Swanson
Home health care is becoming a new front in the national fight against COVID-19 as hospitals discharge patients home and others strive to stay out of them. The World Health Organization just named 2020 the year of the Nurse and Midwife and with National Nurses week right upon us, Pemi-Baker would like to say thank you to all of our Nurses and Licensed Nurse Assistants who go above and beyond, day in and day out.
Home care nurses, therapists, and aides — who normally help an estimated 12 million Americans with everything from bathing to IV medications — are now taking on the difficult and potentially dangerous task of caring for coronavirus patients. While Americans are being told to keep to themselves, home health providers and their clients still largely have to engage in person, often in close proximity. Many agencies are ramping up phone or video visits but these are typically not covered by insurance and even the smartest phone can’t listen to someone’s lungs or get them to the bathroom.
The crisis is testing the industry, but it’s also a moment of pride for workers who have often felt under-recognized. “We have taken the Covid 19 pandemic as an opportunity,” said Danielle Paquette-Horne, PBCH Home Health, Palliative and Hospice Care Director. “We’re getting a chance to establish what can be done different by modifying our daily operations and to show the community that they can continue to count on us to serve them and their family during this pandemic,” Paquette-Horne said.
Coronavirus care at home has expanded rapidly in the last few weeks. Some agencies in most states are now taking COVID-19 patients referred after hospitalization or nursing home care or as an alternative to them, and Pemi-Baker Community Health is rising to the challenge.
Pemi-Baker Community Health’s COVID-19 taskforce meets three times a week to assure Pemi-Baker is up to date with CDC guidelines and like their colleagues in hospitals and nursing homes, PBCH’s home care workers have faced a scarcity of protective equipment.
“We are very grateful to the EVERSOURCE Foundation for their recent grant to help us buy more protective supplies for our nurses, LNAs and patients,” said Chandra Engelbert, Pemi-Baker Community Health, CEO. “To have a community partner we can rely on when our non-profit faces these challenges, is crucial and priceless,” said Engelbert, “Countless Pemi-Baker friends have also sewn cloth face masks for our staff and patients, (double prevention), and we want to thank them as well.”
To help raise funds, Pemi-Baker Community Health is holding a ‘NO-SHOW AUCTION’ throughout the month of May. With over 70 items to bid on, Raffles to invest in and Specialty Services to donate towards, they are hoping to make up for the fact that they had to cancel their largest fundraiser of the year. Please visit www.32auctions.com/PBCHMay2020 to participate.
For over 52 years, Pemi-Baker Community Health has served family, friends and neighbors in 18+ towns and they couldn’t have done it without the generosity of individuals and businesses alike. Pemi-Baker would like to thank the following businesses for sponsoring the NO-SHOW AUCTION: Dumont Construction Inc., Mid-State Health Center, Northway Bank, Speare Memorial Hospital, NEEBCO, MatrixCare by ResMed, Noyes Insurance, Service Credit Union, Insurance 24, Steve and Carole Osmer, Brian Weeks Electric, Highline Acoustics, Deb Hills Cleaning Services, Peabody & Smith Realty.
~By Anna Swanson
With the upmost concern about the health and safety of our community, we have decided to hold a “No-Show Auction” in lieu of our regular large fundraising event in late spring.
In these days of social distancing and an unknown future, it is important for us to continue our important work in supporting the members of our community who need medical aid at home. Now, more than ever, our Pemi-Baker patients need nursing and social work support for their sudden illnesses and hospice needs. Many of our patients are experiencing increased feelings of depression and isolation, as well as heightened anxiety, particularly because many are at high-risk for COVID19.
We are asking our loyal donors and supporters like YOU to help us raise critical funds. Our ‘No-Show Auction offers 5 RAFFLE items, 5 DONATION-Help a Neighbor items and 70 items and services to bid on.
We are very appreciative of the businesses who helped us by being sponsors or by donating services to make this auction possible.
We are incredibly grateful for everyone’s understanding, generosity and support during these uncertain times.
COVID-19 crisis puts thoughts of health care decisions in different light.
Pemi-Baker Community Health can help!
National Healthcare Decisions Day has been held on April 16 for twelve years. Yet, April 16, 2020 is a very different time than any of those previous years. The COVID-19 pandemic has altered the way Americans are living – and the focus on advance care planning has taken on a profound meaning for many people.
Pemi-Baker Community Health and the National Hospice and Palliative Care Organization want to acknowledge NHDD by stressing the importance of talking with your loved ones about your health care wishes and documenting those wishes by completing an advance directive. In fact, given the impact of Coronavirus (COVID-19) across the country, completing your advance directive – or reviewing and updating your care preferences if you have an advance directive – could be timely.
“Given the uncertainty that we find ourselves coping with during the COVID-19 public health crisis, taking time to talk about the care you would or would not want with your loved ones is a worthwhile activity for all of us to undertake,” said NHPCO President and CEO Edo Banach. “Far too many Americans put off talking about their health care wishes and then they find themselves in a medical crisis and it may be too late to ensure that you get the care you want.”
Advance care planning includes completing an advance directive (also known as a living will) and appointing a healthcare power of attorney (someone to make healthcare decisions for you if you are unable to speak for yourself). Then, most importantly, sharing your decisions with your family and loved ones.
Visit the Pemi-Baker Community Health website www.pbhha.org to download these free resources. Lisa Fortson, MSW, Pemi-Baker’s Hospice and Palliative Care Supervisor, stated that, “Pemi-Baker’s Social Work department is available for questions about the forms by calling 603-536-2232. It’s also important to remember that having these thoughtful discussions with your family and documenting your wishes can be a gift to your loved ones should you become critically ill and unable to speak for yourself. Your priorities will be clear to them.”
~ by Anna Swanson
As we are enduring this COVID-19 pandemic, a memory from my youth appeared in my mind a few days ago. In 1964, I got my first real job- one that I actually got a paycheck for. I was a sophomore in high school. Minimum wage was $1.00 an hour at that time! I was hired as the “library page” for our village library. Every weekday, after school, I worked for an hour, putting the returned books back on the shelves and relocating the ones that browsers (not yet a computer term) had misplaced. One of the titles that piqued my interest was RATS, LICE AND HISTORY: A Chronicle of Disease, Plagues and Pestilence by Hans Zinsser. 
It was first published in 1935, so it was probably already thought of as “an old title” by 1964. It was written intelligently and with scientific detail, but its author purposely wrote in a style that could easily be understood by the general public. The book was the eighth best-selling title in non-fiction noted by THE NEW YORK TIMES for 1935. A Wikipedia search will also inform you that several medical professionals credited the work to inspiring them to enter upon their chosen profession. The book focuses on the history of the disease of typhus and its deadly effects. It has been regarded as a biography of an illness. Besides Dr. Zinsser’s work, I was also reminded on Edgar Allen Poe’s THE MASQUE OF THE RED DEATH and Thomas Mann’s DEATH IN VENICE, fictional works that deal with similar phenomena.
We are already feeling the loss our normal routine and activity due to the precautions necessitated by the appearance of this virus. Staying at home is quite the discipline. In my current profession as Hospice Chaplain and Bereavement Counselor, I cannot help but be moved deeply, even to the point of tears, as I watch the nightly news. A nurse in an urban hospital companions a man who is dying and becomes the messenger to his family, assuring them that he died peacefully. They were unable to be with him because of preventative precautions. A prohibition on closeness when closeness is most needed. Bodies are transferred to refrigerated trucks, and I wonder how long it will be before their families can claim them- if that is even a possibility.
Other persons continue to die of other things in this time, but this virus impacts on everyone. Two Sundays ago, the forty-nine year-old middle son of acquaintances of mine died of a cardiac aneurysm. Speaking with his mother, I learned they were permitted only a brief prayer service at an outside shrine on the grounds of their church. Only his parents, his spouse and children, and his two siblings with their spouses and children were present. This very popular, well-loved, and gregarious family are bereft of the very social supports that could help to assuage their sudden and shocking loss. We are all touched by this experience and may very well carry the heaviness of it within ourselves for a long while.
In times when we are deprived of the comfort of social interaction in the face of loss and grief, small things become important. If you have lost someone during this time (whether or not from COVID-19), perhaps these suggestions might help. Create a small sacred space in your home to honor your loved one.
If it helps to place a photo of your loved one there, do that. If there are other mementos, use those as well. Use candles safely. Hannaford is still selling flowers- and we can still access food markets. If you have a spiritual practice or a religious tradition, make use of its words and rituals. If your loved one enjoyed music, listen to it. If they delighted in favorite foods, cook a meal to honor their memory. See if you can stream a movie they enjoyed.
If you are staying at home with family members, cherish the intimacy this time can offer you. Reach out to others who knew your loved one- email, texting, phone calls, or FaceTime. If you need comfort and help, ask for it. Make use of what can be available to you now, even in these extraordinary circumstances. Above all, allow yourself your feelings and your expression of them. Tears and groans are perfectly acceptable. I highly recommend (what I call) “therapeutic screams”- inside the car is the best place. Hopefully, we will find a time in our future when what we have not been able to do now will be able to be done later. So many people are assuring us that we will come through this- and we will! By the way, Dr. Zinsser’s book is still available! 
~By Guy Tillson, MDiv, MA-Pemi-Baker Community Health Hospice Chaplain & Bereavement Counselor
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