After Eben Marsh’s wife, Polly, was diagnosed with cancer, they decided they could no longer stay in their two-story home in South Portland. They were lucky enough to have a friend that allowed them to stay in an Old Orchard Beach condominium, where Polly Marsh could use a wheelchair and bring in a hospital bed.

However, Eben Marsh knows many people are not so lucky and are forced to decide whether to put someone they love in a hospital or a nusing home. That’s why he believes Southern Maine needs a hospice house as an alternative.

Hospice of Southern Maine has been waiting since 2003 to build the first hospice house. Now with land secured and plans completed, the organization is only waiting for town approval, something that’s far from guaranteed.

The plan is facing opposition from those who would have to live next to the hospice house, who feel that a 15,700-square-foot, 18-bed Hospice house is too large and incompatible with the Hunnewell Road neighborhood.

After receiving a presentation from some concerned neighbors last month, the Zoning Board of Appeals, which must approve the project before it moves through the normal planning process, agreed to table the request until its March 8 meeting.

Jody Deegan, the CEO of Hospice of Southern Maine, plans to request that the board make a decision at its meeting so her organization can begin construction this spring.

“The community needs this, and that’s what’s discouraging for me. This just delays this project even longer,” Deegan said.

Dying alone, in pain

Hospice of Southern Maine was formed in 2003 through the merger and integration of several of home hospice organizations that shared the goal of providing hospice services and building a residential Hospice house.

Leaders of the non-profit group felt the consolidation would allow for better quality services delivered more efficiently in Cumberland and York counties.

According to statistics, there is a need for Hospice care in Maine. The National Hospice and Palliative Care Organization had found that hospice care is appropriate and would benefit 40 percent of all dying patients.

Nationally, only 25 percent of these people receive Hospice care, and in Maine that number drops to 9 percent. That is not surprising considering that Maine ranks 49th in the country in providing Hospice care, beating only Alaska, according to Medicare.

One of the major hurdles facing Hospice of Southern Maine is educating the public about their mission and the services they provide, Deegan said.

Hospice assists people who are no longer seeking cures and are entering the last six months of their life. Hospice staff includes physicians, nurses, home health aides, therapists, social workers, pharmacists and bereavement specialists.

The staff provides emotional, spiritual and physical services to patients and their families. One area where hospice provides a great deal of help is in pain management, which will ensure that a patient’s pain and symptoms do not get in the way of their life, Deegan said. There are other aspects of the program that are just as important, including family counseling during and after their loved one’s death.

“My experience with hospice was incredibly positive – mine and certainly my wife Polly’s,” said Marsh. “It made our last few weeks together as wonderful as they could be.”

“None of us want to die alone and die in pain, and most of us want to die at home,” Deegan said.

Quality not quantity

Hospice of Southern Maine is allowing Ervin Whitney to spend the end of his life at home. Whitney has been diagnosed with cancer.

His only options, without hospice care, were to go to the hospital or a nursing home.

“My sister and I wanted him at home, and without Hospice we couldn’t have done it,” said Kathy Potter, Whitney’s sister-in-law who stays at home with him while his wife, Julie, is working.

Prior to returning to his Windham home before Christmas, he was at Togus, where he said he had given up hope. “There’s nothing they can do for me up there,” he said.

Since he’s moved home, he feels better. His appetite is returning. He said much of that recovery is due to the Hospice staff.

“These people are making me feel great,” he said. “They are probably the best people I ever had anything to do with.”

Julie Whitney said she was familiar with Hospice through her work at a local nursing home. She did not want to send her husband to a nursing home, as some doctors had recommended. Today he is considered stable, she said.

“He now has quality of life, before he only had quantity,” she said.

Too big for the neighborhood

Deegan feels her organization could better provide services if it had a hospice house where terminally ill patients who cannot stay at their home will have the chance to utilize hospice care.

“We want to offer them the ability to go to a place that is as much like home as possible and offers acute care,” Deegan said.

So far the proposed one-story building has received a number of community complaints, and during last month’s appeal’s board hearing, Hunnewell Road resident David Hughes gave a PowerPoint presentation for 23 area residents.

Hughes does not believe the project meets the ordinances. He thinks the proposal is too large and would bring too much traffic to the neighborhood. He also believes the building would bad “visual impacts” on the neighborhood.

“We specifically made it clear we are not opposed to a hospice facility. We just feel this facility is much too large for a residential neighborhood,” Hughes said.

Hughes also felt the Hospice home would be much more densely populated than the zoning intends the neighborhood to be. He noted that eight homes could fit on the lot. Based on the latest Census figures, each home would contain an average of 2.35 people, bringing the total number of people living on that site to fewer than 19, if a developer were to build houses there.

By his calculations, Hospice’s request for an 18-bed home, with patients, their families and staff, would be tantamount to building five homes on each acre of the five acre property. That would far exceed the two homes per acre allowed on the property in the town’s zoning ordinance.

Hughes said a smaller Hospice home might fit nicely in a residential area. However, a building the size of the one being proposed would require a better road system. That’s why he believes it belongs in a commercial zone.

He suggested that Hospice of Southern Maine should build smaller facilities in several location, which he believes would better serve the region.

Like home

In addition to the 18 rooms at the hospice house, there will be some common areas: a cafeteria, a kitchen, a quiet room/chapel and a spa/tub room.

Deegan said Hospice’s assessment of the region found that the population could support a 30-bed building, but after further review the organization settled on 18 beds.

The building would be set back from Hunnewell Road and people passing by would be able to see only a small portion of the building. There also will be a significant amount of foliage planted to shield the building from view.

“Our goal is to make it feel as much like a residence as possible,” Deegan said, adding that placing the building in a neighborhood is an important component.

Hospice would allow people to visit 24-hours-a-day, but Deegan does not envision a family member speeding down the street to see their loved one. Instead, she said the staff is usually well aware when someone is close to dying. The staff usually notifies the family and suggests the family might want to stay overnight.

There will be medication on site, which will be locked. Staff members will be at the home 24-hours-a-day, with most of the staff working during the day.

There won’t be any ambulance sirens going down the street, although at times an ambulance might drop-off a patient. There will be laundry services on site, but some will be sent out too. A food delivery truck will stop at the home.

The additional traffic that is projected to be generated by the Hospice home will equal 34 additional trips between 4 p.m. and 6 p.m., according to Deegan.

Deegan said the Hospice home has met all of the criteria set forth in the zoning ordinance and adds that the building will take up only 7 percent of the lot compared to neighboring properties, which take up about 9 percent of their lots.

“What a great resource having a Hospice house would be,” said Marsh.