From the Presque Isle Star-Herald
By Scott Mitchell Johnson
PRESQUE ISLE — Plans to construct a 6-bed freestanding hospice house in Aroostook County are on track, and officials are in the process of selecting a location.
“We’re narrowing it down,” said Rick Duncan, chair of the Aroostook Hospice House Foundation board. “We’re talking with some folks who want to donate land to us; we’re just making sure it’s the right spot, if the building fits the land that’s being donated, etc. We should know by April where the facility will be constructed.”
The 8-10 acres of land is located between Presque Isle and Caribou.
“We felt that was quite essential … we wanted to serve the largest population and make it accessible for the greatest number of people,” he said. “We want it accessible for people from Fort Kent down to Houlton and beyond.”
Hospice is quality, compassionate care for patients dealing with a life-limiting illness. The principal goals of hospice are enhancing the value of life by controlling pain and any other physical symptoms, maintaining patients’ dignity and respecting their wishes, and providing emotional and spiritual support. Hospitals, on the other hand, are more primarily focused on diagnosing, curing and healing. End-of-life care requires something more.
Duncan’s late mother, Maxine, was the impetus for the Aroostook House of Comfort.
“Hospice has the philosophy of comfort care … keeping someone in their home or in an environment that they’re comfortable in, while hospitals are more focused on healing. Hospitals and nursing homes are wonderful institutions for care. Palliative care, end-of-life care requires some extra elements,” said Duncan.
“We tried to keep my mother at home, but her pain levels got to the point where we couldn’t manage her pain so we had to go to the hospital setting. She was there for 28 days. The management of her pain still continued to be a difficult process. Dealing with large doses of medications for symptom control and relief of suffering during some end-of-life journeys continues to be a topic of discussion and development in the medical setting,” he said. “The hospice program, under the guidance of the hospice medical teams and Hospice Pharmacia, are familiar with the different levels of needed medications and types to help control the pain. The hospitalist situation most hospitals use today means working with a new hospitalist every few days. With each new doctor one might run the need to re-educate the doctor concerning the loved one, and deal with the different biases in terms of end-of-life philosophies and levels of pain management. It is only natural that would happen. It was a learning experience for all of us involved, and I hope someone benefits from it.”
After his mother passed away in May 2009, Duncan and his family thought, “We need another option for families to choose from.”
“We started looking within the state. We visited the Gosnell Memorial Hospice House which is located in Scarborough and the Androscoggin Hospice House in Auburn. They are the only two hospice facilities serving all Maine families at this time. There are northern Maine families who have used these facilities in the past, but the distance is difficult for most families,” he said. “They are freestanding hospice care centers that are geared for the comfort of not only the patient, but the comfort of the family, too. It’s an atmosphere where families can come in, stay long periods of time, they can cook meals, and get the medical comfort care and whatever spiritual or family interaction care they need, as well. Dr. Donald Sawyer of The Aroostook Medical Center has been helpful with information as he was instrumental in helping to open the Omega Hospice House in Michigan.”
Another drawback, Duncan said, to having his mother in the hospital was that the setting was “not conducive for a family to be there.”
“When you have 3-4 family members trying to stay in the room … especially at nighttime … it’s hard. I slept in a chair quite a few nights,” he said. “It’s just not a comfortable atmosphere where hospice houses are designed as suites and people can stay there very comfortably.
“A year after my mother’s passing, I had the privilege of spending time with my grandmother, Velma MacDonald, in a hospice house in Ocala, Fla.,” said Duncan. “The family setting experience for my grandmother and me helped to reassure me of the importance of giving families traveling this journey with loved ones another option.”
Duncan said he saw another need for a hospice facility last April when his father-in-law, Robert Whited, opted to receive end-of-life care at home.
“My mother-in-law, my wife and a couple of her sisters became the in-house caregivers. Of course Hospice of Aroostook were a great support and came in, but the day-to-day care falls on the family members, and now all of a sudden the family members become the caregiver and that’s a whole different role … a tougher role, especially when handling medications,” he said. “They’re not able to be the daughters anymore; they’re the nurses. With an environment like a hospice house, they’re able to be the daughters again. Support and comfort is of utmost importance for the family, as well.”
Though the details are still being worked on, to date the Aroostook House of Comfort will be operated by Visiting Nurses of Aroostook.
“The Foundation is going to own the building,” Duncan said, “and contract the health care aspect out to Visiting Nurses of Aroostook/Hospice of Aroostook. There will be 24-hour medical care provided to patients onsite with a registered nurse and two CNAs on staff 24 hours a day who will work under a hospice doctor. However, the plan is still evolving.”
The 8,600-square-foot hospice house project is expected to cost about $1.8 million.
“The building cost looks to be about $1 million, we’d need $300,000 for equipment, furniture and fixtures, and we hope to raise another $500,000 for an endowment fund,” said Duncan. “We’ve talked with other people that are in the process of trying to build hospice houses in the state — one of them even shared their business plan with us — and it looks to be that the endowment fund may not be as an important part as we thought it was. The facility should sustain itself through revenue that’s brought in, so the total project cost might be a little lower. When we first talked about this project, we looked at a 4-bed facility, but that really wouldn’t generate the income that you’d need to sustain a hospice house, so it became a 6-unit.”
Each unit, or suite, includes the patient’s bed, loveseats that fold out into a double bed, and a single bed in an adjacent alcove. Patients would have their own private bathroom, and a kitchenette. Outside the suite — in a niche area located off of the hallway — is a small meeting space where families can consult with a doctor.
Down the hallway would be the nurses’ station, administration offices, a kitchen, a central dining area, a living room setting with a fireplace, a chapel, public restrooms, a private family meeting room, a children’s playroom, a garden and walking paths.
“Each suite has big, folding doors and there will be a patio off of each suite,” said Duncan. “People will be able to look out into the central area and we’ll have some walking paths that will be wheelchair accessible.
“There’s a lot of different hospice houses out there and we’ve tried to take what we thought were the most important aspects of a lot of different sites and incorporated those into the plans,” he said.
Architectural plans created by Mark Carter of North Peak Architecture were also designed for future expansion.
“At some point we could add an additional three suites,” said Duncan.
The Aroostook Hospice House Foundation board will be starting a capital fund-raising campaign later this year.
“We’re discussing the feasibility of hiring a professional fund-raising company to work alongside Steve Richard, who has raised a great deal of money for many worthy causes in the area. We have to look at this option as we are not doing this for the Presque Isle/Caribou area alone. This needs to be a joint effort with all communities and families in Aroostook County,” said Duncan. “Depending on how well that goes, we’d really like to at least start construction by late 2013, or more practically 2014. It all depends on how successful the capital campaign is.”
Duncan said there was a group in Fort Kent that explored the idea of building a smaller hospice home in the St. John Valley, but decided — due to regulations and other factors — to abandon the plan.
“They had fund-raised about $5,000, and they just gave us the money and swung their support over to us,” he said, noting that the corporation has over $50,000 in its fund right now. “Most of the monies have been left in memory of a loved one who has walked this journey. Family and friends support seeing another option for future families in Aroostook County. We have had people donate $1,000 just because they believe in this project. The month of December brought in more than $5,000 in gifts. We had a booth at the fair in July. It was amazing to hear the encouraging words of not to give up from County people, as well as people who were from away. Former County people were amazed we did not have a facility such as this yet as most states have numerous facilities.”
Anyone wishing to donate can make checks payable to Aroostook House of Comfort and mail to P.O. Box 766, Presque Isle, Maine 04769.
For more information, log onto www.aroostookhospicehouse.com or e-mail
“I also encourage people to take a look at hospice houses websites around New England to get the feel for what they provide,” said Duncan. “We are happy to talk about this project one-on-one, mail our information or come to your organization and speak. Contact us at 768-0201.”