WATERVILLE – Susan Giguere built her business from scratch with persistence, passion and a determination to help people stay in their homes as long as possible.

She started Care & Comfort in 1991 with $2,000 and two employees. Twenty years later, the business has $10 million-plus in annual sales and 475 employees working from five locations around the state.

How did Giguere turn it into one of the largest home health and mental health agencies in Maine ?

“You just keep going at it,” she says. “You don’t give up if you run into problems.”

It helps if you have experienced the struggles associated with caring for aging parents in your home.

Years ago, Giguere was running an investment business in Massachusetts, raising children and taking care of her mother, who was blind and had Alzheimer’s disease, and her father, who was deaf.

What she really needed was someone to come into her home to help, but in those days, one could not get an agency to do that. Toward the end of her parents’ lives, a visiting nurses’ association did come to help.

When her parents died and she moved to Maine with her family, she started an agency that staffed nurses in temporary jobs at various doctor’s offices, hospitals and other institutional settings.

The venture ultimately turned into her current business, which serves about 3,000 clients out of the main office in downtown Waterville and from offices in Dover-Foxcroft, Bangor, Presque Isle and Wilton.

With a commitment to help families — and moral support from her husband, Leo — Susan Giguere built the business.

“I kept looking for opportunities,” she said. “I really believed in home health and Medicare. I knew it from a client’s perspective; I knew about people coming in and how important they were in our household.”

Leo Giguere says his wife is brainy, kind, caring and determined — qualities he thinks got her to where she is today.

“She has more tenacity, I think, than anybody that I know of,” he said. “Like a junkyard dog, when she gets a hold of something, she does not give up, no matter what.”

Toby Wood, a regional manager for Care & Comfort who has worked for Giguere for many years, says that she is an excellent role model, a good planner and tremendously involved in the company.

When it first started, she and Wood would meet with hospital officials, physicians and other businesses to try to get a foot in the door, he said. At first, those officials appeared not to be interested or have the time for them, but Giguere persisted in persuading them she could provide quality services. Ultimately, she won them over, according to Wood.

“I would say that one of her biggest qualities is persistence,” he said.

Care & Comfort’s home health division provides skilled nursing services, personal care, adult and pediatric long-term care and companions; the mental health division offers outpatient therapy, behavioral health services, child case management services, and home and community support for both children and adults.

Care & Comfort’s newest division, “Home Modification Specialists of Maine,” does everything from building ramps, repairing windows and painting, to remodeling rooms and building entire houses.

Giguere, 66, grew up in Milton, Mass., the youngest of 10 children. Her mother, Kathryn Dempsey, had a third-grade education, a beautiful singing voice, and very poor eyesight, according to Giguere.

“She loved to read Braille,” Giguere said. “I used to tell people I was the only kid in the neighborhood who had a mother who could read in the dark.”

Giguere recalled being about 2 years old, going with her mother to a quarry to wash sheets when the well went dry. Her mother tied a rope around her and tied it to herself, so Susan would not fall.

“She was sitting on the edge of the quarry, scrubbing sheets. My brothers would pull them through the water to rinse them off.”

That work ethic apparently rubbed off on Giguere, who carries admiration and fond memories of her parents.

“Running a company like this is nothing compared to the courage and bravery my mother had,” she said.

Giguere’s father, Thomas Dempsey, was a printer. A black-and-white photo of him in his Boston shop hangs near Giguere’s desk in her very large and colorful office at Dempsey Place, the name she gave to the Care & Comfort office at 180 Main St.

Care & Comfort has a good partnership with the state, she said. About 85 percent of the business is MaineCare.

The business offers about 40 services at various rates depending on the service, Giguere said. For instance, for $30, an employee will go to someone’s home, give him a bath and prepare a meal.

Giguere attributes much of the business’ success to her employees. She says it’s important to take care of employees, who take care of clients.

“I’m proud of all the things employees do for the clients they serve. It’s pretty cool that we’re all enabling families to stay at home.”