HISTORY OF THE GOOD CHEER SOCIETY The Roots of Home Health & Hospice Care

HISTORY OF THE GOOD CHEER SOCIETY:The Roots of Home Health & Hospice Care In the latter part of the 19th century, the growth of social consciousness stimulated theinterest of well-to-do

HISTORY OF THE GOOD CHEER SOCIETY:

The Roots of Home Health & Hospice Care

In the latter part of the 19th century, the growth of social consciousness stimulated theinterest of well-to-do and civic minded citizens in the health and welfare of the poor Groupswere organized in various cities throughout the country, often under religious denominationalauspices, for the purpose of engaging in charitable works The earliest of these organizedactivities were carried out by the so-called "fruit and flower" missions Groups of prominentyoung society women visited the sick poor in their homes, bringing them, at first, fruit andflowers, but later, essential food staples Many of these early philanthropic organizations werethe forerunners of the present day visiting nurse organizations which are active in hundreds ofcities throughout the United States It was the deplorable conditions of neglect and squalorencountered by these early fruit and flower mission visitors, that pointed out the need for trainedassistance to provide home care to the sick, and to teach the essentials of hygienic living So, thefruit and flower missions soon began to employ nurses who would visit homes for the purposes

of rendering care and teaching health promotion and disease prevention Today, the majority ofthe existing visiting nurse agencies continue to be sponsored by voluntary groups

In the city of Nashua the story was much the same as in other cities The one exception wasthat Nashua was among the first of the smaller cities to develop the idea It all began in the fall

of 1883 when four friends, May Wallace, Elizabeth Spaulding, Elizabeth Flather, and Linna BelleFlagg gathered for their weekly painting lessons at Miss Flagg's art studio They expressed acommon concern for the poor and the sick members of the community, and conceived the idea of

a fruit and flower mission in Nashua The following week these four young Unitarian womengathered together seven other women of the same denomination, and this group formed thenucleus of an organization which they called the Good Cheer Society The name was suggested

by Mr George H Pierce

Elizabeth Spalding was the first president of the Society Membership was limited to five unmarried women at least twenty-one years old The stated purpose was "to give help andcheer to the sick and poor in any form except money" This was accomplished at first by visitingthe sick and needy and bringing them flowers, jellies, and other delicacies Later, the membersdistributed food, clothing, and fuel In 1893 the Society furnished two parlors at the EmergencyHospital which later became Nashua Memorial Hospital In 1897 it received its first legacy of

twenty-$100.00 from the estate of a Mrs Vose

At the turn of the century the visiting nurse idea was gaining impetus Between 1890 and

1905 the number of visiting nurse associations increased markedly throughout the country.Among the earliest of the important cities to establish these organizations were: Chicago 1890,Kansas City 1891, Buffalo and Denver 1892, and St Louis 1895

The Good Cheer Society appointed their first nurse in 1902 to provide home care to thesick on a visiting basis The Society was thus among the pioneers in the early establishment ofvisiting nursing

What was the status of Nashua at this time which stimulated the need for a visiting nurseservice? Because Nashua was located at the confluence of the Merrimack and Nashua Rivers, itwas an ideal site for the development of industries which could utilize the available water forpower Consequently, mills were established and textiles became the leading industry.Immigrants, in increasingly large numbers began to populate the city to work in the mills In

1880 the city had a population of 13,397 which swelled to 23,898 by 1900 Major consequencesattending industrialization and the accompanying population growth were overcrowding, poorhousing, unemployment, and poverty; all of which are factors contributing to ill health anddisease It may be assumed that it was these conditions which motivated the Good CheerSociety to expand its services to provide home care of the sick

In 1969 the staff consisted of eight nurses and a social worker Most of the nurses hadhad some special preparation in the field of public health nursing, and three had degrees.Financial support came from the interest from investments, endowments and bequests, patientfees (either directly from the patient or through insurance benefits; private, Medicare orMedicaid), and United Fund allocations

HISTORY OF VISITING NURSE ASSOCIATION OF NASHUA, INC.

At the October, 1973 meeting of the Good Cheer Society, Inc it was voted that "to meet thegrowing health needs of the community (it was felt that) the community would be betterserved by the formation of a Visiting Nurse Association of Nashua"

The new Visiting Nurse Association of Nashua was to be administered by a Board ofDirectors made up of business and professional men and women and interested citizens of the

community The Good Cheer Society, Inc was to become an auxiliary to the Association with

members of the Nursing (Agency) Committee The Good Cheer Society, Inc agreed to give theuse of the Good Cheer House at 6 Kinsley Street and its furnishings to the new Association and

to continue its financial support

Several organizational meetings were then held and incorporation

of the new Association was completed on December 27, 1973 The following were present at themeeting on that date:

Florence E Caron, Chester Lopez, Paul Marsolais, Patricia

A Sullivan, Conrad E Thibault and Charlotte Drury, Nancy

Wilbur, Lorna Winey representing the Good Cheer Society, Inc

At the second meeting of the incorporation, January 30, 1974, the following officers wereelected:

President: Conrad E Thibault

Vice President: David Hogan

Secretary Patricia A Sullivan

Treasurer: Paul Marsolais

Following this meeting the Good Cheer Society, Inc sent a letter to various people in thecommunity explaining the change in organization and inviting them to membership of the newAssociation As of July 1, 1974 there were 85 members.

The original Board consisted of Conrad Thibault, David Hogan, Patricia Sullivan, PaulMarsolais, Chester Lopez, Florence Caron, Ernest McCoy, Charlotte Drury, Nancy Wilbur, LornaWiney, Dolores Raby, Janet Shepard, Lorana Tally, Dr Herman Guiterman, Dr Robert O'Neil, Dr.Eric Romanowsky, Ann Tuttle, A A Haettenschwiller, T Harrison Whalen and Col WilliamClegg

Services were available to anyone in the Nashua-Hudson area, and ability to pay is not aqualification for receiving services Nursing visits average about 400 a month

IMPORTANT MILESTONES IN THE HISTORY

OF THE GOOD CHEER SOCIETY

1883 - Society founded with eleven active members wishing to do something for the

community They banded together to give help and cheer to the sick and needy

1893 - Society furnished two parlors at the Emergency Hospital, now Nashua

Memorial Hospital

1897 - First legacy of $100.00 received from the estate of a Mrs Vose

1902 - District nurse engaged

1912 - Society incorporated as a charitable organization

1916 - Need for baby welfare work realized and nurse appointed to organize the Baby

Welfare Station The Nashua Manufacturing Company donated the use of roomsfor this purpose at 3 Chestnut Street The space was used for this purpose and for

an office for the next twenty years

Hudson included in the territory to be covered by the nursing service

1918 - Contract signed with the Metropolitan Life Insurance Company to receive fees for

nursing services to their policy holders

Staff nurse salary $797.60 Baby welfare nurse salary $800.00 Assistant BabyWelfare nurse (part-time) $343.00

1923 - Two public health nurses and one Baby Welfare nurse employed

1926 - First caramels made as a fund raising endeavor Recipe given by the "Paint and

Powerder Club" of Lowell with the stipulation that the ingredients and proportions

be kept secret These delicious caramels have since been associated with theSociety and "Good Cheer Caramels" have become a favorite, not only in Nashua,but throughout the area.

Contract signed with the John Hancock Life Insurance Company to receive feesfor services to policy holders

1933 - Visit charge was raised to $0.75

1934 - Nurse appointed to the staff by the Relief Administration of Concord to care for

families receiving aid The position was canceled four months later

Six nurses on staff Mrs Sylvia Ganer, Supervisor

1935 - Supervisor appointed to the Nursing Committee of the Society

Nutrition Clinic conducted in conjunction with the Red Cross

1936 - Society purchased employment office of the Nashua Manufacturing Company on

Walnut Street for $3,400.00 Offices and Baby Welfare Station moved there andlocation became 86 Factory Street

1941 - To raise funds the "Nashaway Trading Post" was opened This was a profit

sharing enterprise in which donors of merchandise received 50 percent of theprofit and the Society 50 percent

Staff of five nurses

Mrs Sylvia Ganer resigned and Miss M Grace Ross, appointed Supervisor

Good Cheer Society joined the Nashua Federation of Social Agencies

1944 - Miss M Grace Ross resigned and Miss Ellen Record appointed Acting Supervisor

1945 - Mrs Louise Massie Levesque appointed Supervisor

1948 - Mrs L M Levesque resigned and Miss Ellen Record named Acting Supervisor

1950 - Mrs Beatrice F Allen appointed Supervisor

1951 - John Hancock and Metropolitan Life Insurance Company benefits dis- continued

1952 - Mrs B F Allen resigned and Miss Ellen Record appointed Acting Supervisor

1958 - 75th Anniversary of the founding of the Good Cheer Society

1965 - Staff composed of four full-time and two part-time nurses

1966 - Visiting Nurse Service certified for participation in the Medicare program.

Occupational therapy offered as a second service

Visit fee $4.50

1967 - Miss Ellen Record, Acting Supervisor, retired after 29 years of service with the

Agency Replaced by Miss Shirley A Egan

1968 - Visit fee raised to $5.50

Position of Hospital Coordinator created

Monthly Well Child Clinics begun in cooperation with the Nashua Board ofHealth

1969 - Occupational therapy discontinued as a second service and replaced with social

service

Program begun with University of New Hampshire, Department of Nursing, toprovide field practice for nursing students

A Professional Advisory Committee was established

Occupational therapy discontinued as a second service and replaced with socialservice

Program begun with University, Department of Nursing to provide field practicefor nursing students continued until April 1971

1970 - Miss Shirley Egan retired to accept a similar position in Lowell Miss Lydia

Beane took her place as director

A second part-time social worker was added to the staff to assist the coordinator

August 1970 - moved to Good Cheer House on Kinsley Street.

1971 - The year started with five full-time and one part-time registered nurse and two

part-time social workers At the end of the year there were three full-time andtwo part-time registered nurses, one full-time licensed practical nurse and twopart-time social workers A physical therapist was also available part -time bycontract

Prenatal classes for "Parents to be" were started with the sponsorship of theVisiting Nurse Service and four other local agencies

1972 - The Physical Therapy Program was certified by Medicare and became the third

service of the agency

The Homemaker/Home Health Aide Service began with a part-timesupervisor/coordinator and four part-time aides

Students from the Sacred Heart Hospital in Manchester established an affiliationwith the agency

1973 - Eight aides were trained by the New Hampshire Association of Home Care

Services and that program was certified by Medicare to make a fourth service ofthe agency acceptable to that program

Due to the increase in office detail, one full time bookkeeper was replaced by afull-time business officer manager and the part-time clerk typist was replaced by afull time clerk

1974 - The Homemaker/Home Health Aide Supervisor/Coordinator started full-time

work

The Good Cheer Society was instrumental in establishing the Visiting NurseAssociation of Nashua separating the agency business from the Good CheerSociety

At this time the average number of visits per month were:

Homemaker/Home Health Aides 73

HISTORY OF THE VNA

1975 - Agency director, Lydia Beane, announces retirement

Occupational therapy became available through VNA contract with Easter Seals.Homemaker program started and discontinued.

1976 - Ann Agran assumes the Executive Director position

Financial concerns prompted an evaluation of agency goals and delivery ofservices The social work staff and case work services were discontinued andwere replaced by a referral service as well as a MSW consultant Hospitalcoordinator was discontinued

1977 - Terminal care program - HOSPICE has expanded with additional support services

and staff training

The Nashua Public Health Department assumes responsibility of high risk familiesthus decreasing VNA efforts in this area

Homemaker Program reinstituted

1978 - Title XX The Homemaker Program has proven to be successful in providing

service to the elderly and disabled Five homemakers have been recruited to theprogram

VNA applies to federal government for inclusion in Hospice Demonstrationproject

A full-time enterostomal therapist was added to the VNA staff The ET spends 2/3

of her time working with patients at Memorial and St Joseph's hospitals and theremainder with the VNA

The State Council on Aging provides funding for pilot project Senior HealthOutreach and Treatment Program (SHOT) to reach the elderly who are notreceiving health care

1979 - The VNA increased its nursing supervisory staff to two with the recruitment of

The terminal care program was augmented by volunteers providing a wide range

of services from nursing, counseling, to homemaker and family support AHOSPICE care brochure was designed and distributed in the community

1980 - The VNA expanded to include the entire third floor of the Good Cheer House

1981 - VNA contracts with Nashua Memorial Hospital to provide IV therapy.

1982 - New VNA brochure was designed and printed

Homemaker staff was increased to 7 part-time positions

Case consultations initiated between DOW, ADC, NHA and Homemaker/ HomeHealth Aide Program Coordinator to discuss mutual clients

Executive Director, Ann Agran, left, and was replaced by Barbara Salvatore.Nursing services were expanded to include 24 hour coverage

Services expanded to include Tyngsborough, MA

1983 - Physical Therapy Assistant position created

VNA helped found Community Hospice of Greater Nashua

Reinitiated the provision of Medical Social Services

Initiated "Contracted Services Program", provided personnel to local social serviceagencies Five agencies serviced in first year for physical therapy and nursingconsultation

Updated agency mission and goals

Expanded Hudson Immunization Clinic to include school age children

Initiated Residential Health Screening and Education Program at GatewoodManor

Initiated inventory system for supplies

Explored feasibility of Adult Medical Day Care Services with the Nashua HousingAuthority

1984 - Accepted as provider in Blue Cross/Blue Shield Hospice Pilot program

Initiated Companion Care Program, to provide respite on a fee-for-service basis.Twelve companions hired to start

Formalized its linkages with the Manchester, Merrimack and Derry VNAs throughthe organization of the Visiting Nurse Association Consortium

Initiated contracted Aide Services at the Adult Day Care Program of the NashuaHousing Authority Contracted services to other human service agencies were

expanded; and on-call coverage/backup.

Agency revenues over $500,000

1985 - VNA now employs 47 staff

Initiated staff policy for Hepatitis B Titus & Vaccine

Adopt Organization Goals to fulfill Agency Mission

Residential Health Programs expanded to Buttercup Hill Project in Hudson

Initiated "The Visitor", a newsletter for patients and the community

Helped produce "Your Health" a monthly magazine for Waiting Room distribution,through the Visiting Nurse Consortium

1986 - Provided over 20,000 home care visits

Agency Revenue over 3/4 million; over 60 employees

Initiates joint venture with Souhegan Nursing Association for the provision ofMedicare certified Homecare services in Milford, Amherst and Mont Vernon.VNA Nanny Program started to provide In-Home Child Care on a fee-for-servicebasis Staff training provided by St Joseph's School of Nursing

Companion Care Respite Services now available on a sliding fee scale foremergency cases

Worked with Community Health Department to jointly market children services toBoston Hospitals

Developed local resources for IV Products and supplies through Nashua MemorialHospital and area pharmacies

Initiated IV Therapy, Respiratory Therapy and Extrastomal Therapy contractswith St Joseph's Hospital

Board establishes Replacement and Renewal account to fund future equipmentacquisition

Board adopts Long Range Plan

1987 - In-Home Day Care Companion Program initiated through contract with New

Hampshire Division of Elderly and Adult Services

Joint program for a Hospice Nurse initiated with Community Hospice

Agency Revenue over $1,100,000; 90 employees providing nearly 30,000 visits.

VNA develops Private Duty business and insurance revenues increase 480percent

Residential Health Programs expanded to Sullivan Terrace

Good Cheer Society sells property at 22 Prospect Street to VNA

VNA enters into Consolidation/Reorganization talks with Merrimack Valley VNAand Community Hospice of Greater Nashua

Board establishes Staff Training account

Employee Handbook published; credit union services started

VNA develops expertise in Alzheimer services

Agency assists in creation of National Long-Term Care Video, featuring localpatient

1988 - VNA accepts State grant to provide respite services to Alzheimers patients

Initiates training programs for community providers dealing with Alzheimers.Vagge Village and Arel Manor added to Residential Health program sites

VNA nurse, Ann Pierce, and patient featured in US News and WorldReport article on "Choosing a Home Health Agency"

Discharge Planning consultation is initiated with Nashua MemorialHospital, and St Joseph Hospital

VNA accepts State's request to expand its contract for In-Home Care services tocommunities served by the Salem District office

As part of a community-wide initiative, the VNA develops the HealthyHomebound Project, a volunteer program bringing health education videos toseniors confined to their home

VNA plays active role on the Presidential Forums Long-Term Care, a part of theNew Hampshire Presidential Primary process

Board of Directors votes to adopt the Articles of Merger which result in theJanuary 1, 1989 consolidation of the VNA with Community Hospice of GreaterNashua and Merrimack Valley Home Health/VNA The resulting organization isnamed Home Health and Hospice Care

1989 - Joan Stygles Hull was appointed President/CEO of the newly merged

organization

Progress towards Hospice certification continues

Medical Director and MSW hired

Study completed, indicating need for Well Child Clinics in Hudson; Good CheerSociety grants $4,000 for start-up money

Private Duty Program expands to include RN's, LPN's and HHA's Adult In-homeDay Care Program expands to include area served by Salem district office

Part-time Quality Assurance position approved

Central intake Program initiated

VFW gives agency its outstanding Achievement Award

Agency received United Way Gold Award and Award of Special Merit forincreasing donations by 30%

Special grant received to assist in Long Range Planning

1990 - Hospice becomes Medicare certified

IV Team initiated

Hudson Well Child Program begun

Childrens' Dental Clinic dropped by State and continued through HHHC HospitalLiaison Program begun at St Joseph's Hospital

Peggy Billings retires after 20 years with the agency

Initial plan to renovate and build addition to 22 Prospect Street site approved bythe Board of Directors

Home visits grew by 36%

Bereavement Counselor position approved

VFW gives agency outstanding Achievement Award

First annual "Theatre Night" with the American Stage Festival held as fund raiser.Staff grows to 130

Underserved population study illustrates need for Hispanic services