When a person becomes invalided by old age, stroke or dementia, family, spouse or significant other usually take over. But islanders have problems that mainlanders often don’t: family may not live on the island in question. Then, said Deer Isle’s Susan Oliver, “everybody … is like family: you take care of them whether you like them or not.”

On Swan’s Island recently, the community rallied round a well-liked widow in the early stages of Alzheimer’s, “People pitched in and helped,” said the Rev. Kenneth Dutille, minister of the Swan’s Island’s Baptist Church. Between visits from the Maine Seacoast Mission’s Sunbeam nurse Sharon Daily and Hancock County Home Health Care, church members from the island’s four churches and others provided help until she needed more advanced care.

Sometimes island residents are forced to move off-island when they can’t find the help they need. In the case of an elderly islander who wanted to stay on Swan’s, Dutille said, an off-island son employed a dozen island women care for his mother. “The son tried his darnedest to keep her here,” Dutille said, noting that with caregivers who are untrained, “there’s a lot of burnout.”

Avoiding burnout is tremendously important to the patient and the patient’s family and friends. Caregivers need breaks for necessary business, physical rest and peace of mind. But finding respite care for islanders becomes a problem in itself. Some islands use their health centers to offer day care. When they have a bed available, they can offer short-term live-in care. Just having a place to take the patient for a day can be a source of enormous relief to the caregiver.

Swan’s, with a winter population of 350 and with the help of summer residents, bought a building that had originally been built as a restaurant and turned it into the Mill Pond Health Center. Donna Wiegle works for the Seacoast Mission and part time at the Health Center.

Maura Michael administers Islesboro’s Boardman Cottage, a six-bed elderly/assisted living facility that offers 24-hour care with meals and medications, transportation to appointments and activities, and companionship. “If we have six or seven residents, we would take a patient for a week or two,” Michael said, adding that patients coming out of rehab can also come for a week or two. If the beds are full, she said, “We can take day patients from 7 a.m. until after the last boat comes back to the island.”

Vinalhaven’s eight-bed Ivan Calderwood Home offers assisted living and the same services as Boardman Cottage as well as resident activities, Administrator Linda Lynch said, adding that it also takes patients for respite care, “if we have an empty room.” She mentioned that Kno-Wal-Lin, a regional care agency based on the mainland, sends out nurses, speech therapists, and occupational and physical therapists to Calderwood. “We also do hospice care if we have an extra bed or if one of our residents goes on hospice,” she said. “We hospice them right here with Kno-Wal-Lin’s assistance.”

Chebeague Island has Island Commons, a seven-bed residential care facility administered by Kelley Rich. Leanne Krudner, who directs community relations and is also activities coordinator for Island Commons, said that Chebeague is just starting a community outreach project to keep islanders in their houses longer. The program, she said, ” is in an embryonic state.”

Lewis Holman, an Island Commons board member, said “precious little” was available in the way of respite care for caregivers at present, though three focus groups were working on “what kind of outreach we should be doing — day care is used occasionally at Island Commons and could be used for respite care.” For the most part, respite care on Chebeague is a matter of “islanders pitching in.”

Rich added: “We are excited to be involving the community to gain their input and feedback on services we can offer that would enable them to stay in their homes. Island Commons currently offers respite care when, as now, we have a bed available. Our respite care services mirror the care and services offered to our regular residents: from meal preparation and medication administration to helping with the activities of daily living.”

Deer Isle’s full-service Island Nursing Home has an adult daycare program. Cindy Gawley, director of nurses, said the Island Nursing Home offers longer respite care when a bed is available.

When Blue Hill’s Friendship Cottage daycare facility opens — it is scheduled to open in May — residents of Deer Isle, Isle au Haut and other islands off the East Penobscot Bay peninsula coming to the mainland will be able to bring family members and friends with them to leave at Friendship Cottage for the day. In the meantime, Blue Hill Memorial Hospital has offered space to Friendship Cottage’s Caregiver Resource Center. Program manager Anne Ossanna said the center is being staffed by the Eastern Agency on Aging: Janet Lewis on Tuesday mornings and Dorothy Van Horn on Thursday mornings. The Caregiver Resource Center offers the caregiver help in many ways, and when Friendship Cottage opens, that facility will offer respite care for caregivers.

For more information, call Seacoast Mission: 288-5097; Donna Wiegle for Mill Pond: 526-4101; Boardman Cottage: 734-2100; Ivan Calderwood Home: 863-9980; Island Commons: 846-4456; Island Nursing Home: 348-2351; Friendship Cottage’s Caregiver Resource Center: 374-5852.