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Silverthorne Adult Medical Day Program

23 Geremonty Drive

Salem, NH 03079  (603) 893-4799




  • Below signature of practitioner certifies that the attached medication list is prescribed by this practitioner and is accurate &valid

Standard Silverthorne Orders:


Acetaminophen 500 mg. 2 tabs q 6 hrs. prn               yes                   no        (please circle)


Mylanta 30 cc q 4 hrs. prn                                          yes                   no


Milk of Magnesia 30ccq 6 hrs.prn                                yes                   no

(followed by 8oz of H2O)


May participant self medicate?                                   yes                   no


Basic First Aid can be given                                       yes                   no


Rehab Screen                                                              yes                   no


DNR on file                                                                yes                   no

                                                                        (if  yes a DNR PINK needs to be provided)                                                                                                                                           


Diet:    Regular            No added salt             low cholesterol            diabetic______calorie


            Low salt          low fat             ground             pureed      other________________


Can participant deviate from diet?



Is participant currently receiving:       Physical therapy  Yes____No___;Occupational therapy  Yes_____No___; Speech therapy Yes___No_____


Patient needs Adult Day to monitor mental__________ physical ______________status.


Activity restrictions________________________________________________________



MD Signature_______________________________________Date_________________


 In The Spotlight




Please join us on February 22 from 5:30-7:30 PM for a complementary spaghetti dinner with entertainment by Karen.  Seating is limited, please call 603-893-4799 to reserve your spot! More

February 1, 2018



Laughter, Smiles and Friendships... More