Lorna Piche is a nurse practitioner for Laconia Clinic in Laconia where she specializes in gerontology. Elizabeth Chang of Franklin VNA and Hospice is excited to be able to interview her and grateful for the chance to hear her thoughts.
Q: You specialize in gerontology. What does that specialty entail, and what spurred your interest in it?
A: I have been a nurse since 1991. I have always enjoyed dealing with elderly patients. I find that they hold a wealth of knowledge that we can all learn from every day. I very much enjoyed the experience of listening to their stories and how their lives were so different then from ours today. Gerontology is the study of older adults. I only see patients 18 and up. I specialize in the types of changes that the human body takes on as you develop in age. For example, certain medications must be significantly lower than if you were 25. As you age, your ability to metabolize, or clear medications from your body, changes, and if the provider is unaware of that, you may be getting an overdose of a medication that could potentially be unsafe.
Q: If people are looking for a new primary care provider, what considerations should weigh into that decision?
A: Family practice primary care providers can treat patients of all ages, including children. Internal medicine physicians only practice on people 18 years and older, and specialize in adult-gerontology typically. As you age, you may have more illnesses and co-morbidities than you did when you were, say, 25. So it is important that you recognize that as you age, your needs in a primary care provider will change.
Q: What drew you to this area to practice in?
A: As I said, I have been a registered nurse since 1991 when I graduated from New Hampshire Technical Institute, the first time with my associate’s degree in nursing. One of my nurse instructors was a nurse practitioner, and she had her own practice. I found that career path quite interesting, and I always dreamed that eventually, I would be able to have my own patients and to be able to care for them throughout their lifetime and to help keep them healthy and strong and then to help them transition into the next stages of their life.
Q: What partnership do you see between home hospice or home health care and primary care medicine?
A: At this point, the federal government does not allow me, as an APRN, to write prescriptions for home health care or home hospice patients without the co-sign of the physician. I do anticipate that this will change over the next year as that has become a very cumbersome way to practice medicine. Especially if the APRN is your primary care provider and can do all of their care for you, there is absolutely no reason that I am not qualified to write your medications for you while you are at home. Home hospice and home health care are essential to our community and how we will progress in the future. As older patients, it is often our desire to stay home at the end of our lives and not go to a nursing home. Often, in this new day and age of people being able to live anywhere in the world, our family is not close to us. Because people no longer have children at home to take care of them when they get older, their options are usually home health care, home hospice, or nursing home. Most people do prefer to stay home and in the comfort of their belongings where they feel safest.
Q: Any last thoughts that you would like to leave us with?
A: I have truly enjoyed working with the Franklin VNA & Hospice. Our patients in this area genuinely appreciate all of the help and care that is given to the patients. I have very much enjoyed working in the community of Laconia, and I find the patients here very kind and generous and loving. It is my hope to continue here in the future.
Franklin VNA and Hospice