People are getting better at talking about death, but many still struggle with the issue, according to two Wagga nurses who have chosen to specialise in palliative care.
After Dying to Know Day was acknowledged this month in Wagga, Di Savage and Eliza-Jane McGinn have spoken about the importance of people making plans for their care at the end of their lives.
Both women are passionate about their work.
"It's a very specialised field, so you've really got to want to work in it because if you don't, it would be hard work," Ms Savage said.
"It's very emotionally draining and you've got to really know your stuff because you're dealing with people who've got a lot of chronic conditions, as well as a terminal illness, and you're talking with doctors about medications and symptom management and all that type of thing. And you've got to know your patient because you can have two people with the same illness who present in two totally different ways.
"I look at it as a bit of a calling, just as some people are exceptional ICU nurses or paediatric nurses. I love what I do."
Ms McGinn specialises in both palliative care and orthopaedics and says she feels passionate about both types of nursing.
But when it comes to palliative care, "you really need to know your stuff and be a certain type of person because it's not just the patient, it's their families, the social situation. It's holistic care".
"It's always been a passion to care for people at the end of life and give them the dignity that they deserve, to be treated the way they deserve to be treated, and to be able to do it in their homes is even that little bit more special," she said.
"I've always said it an honour and a privilege to look after these people, to go into their homes. You need to be a certain type of person to do it.
"If somebody came in who didn't really want to do it, you'd be able to pick it.
"As we know from Dying to Know, some people don't like to talk about it."
Dying to Know Day is a relatively recent, but growing event designed to encourage people to talk about death and dying.
It was held earlier this month and there were at least three separate events in Wagga to mark it the day.
The day also aims to provide support and information for people who are going through the palliative care process or caring for someone who is dying.
The palliative care team, which works within the Wagga local government area, generally has between 65 and 70 clients at any one time, with about three new admissions each week.
One of the first conversations the palliative care nurses often have with new clients is about preparing advanced care plans.
"We do need to talk about it. It makes it much easier if there is an advanced care directive talked about and set up so that we know what someone's wishes are when we go in," Ms McGinn said.
"It makes the process much smoother."
"Of course, you don't have to be dying to have one," Ms Savage added.
"We both have them to explain our wishes."
Ms Savage chose to pursue a career in palliative care as a registered nurse after working in aged care.
"I worked in aged care for a long time as an enrolled nurse and when I was 40, I made the decision that I didn't feel we were doing palliative care particularly well where I was working and that was what I would specialise in, because it was a bit of a passion that we should be able to treat people who were dying a lot better than we were and give them a lot more control than what they had," she said.
As we know from Dying to Know, some people don't like to talk about it.Palliative care nurse, Eliza-Jane McGinn
According to Ms Savage, Wagga has one of the highest rates In the state for people who, by choice, are able to remain in their own homes during their end of life.
"But if people don't want to die at home, we do everything in our power to make sure they're in an appropriate place to do that," she said,
"We're very fortunate in Wagga. We not only have the community palliative care service, we also have the outreach program as well, which covers the towns around Wagga in the Murrumbidgee Local Health District.
"Having a hospice has helped, having the palliative care unit has been a big bonus and, of course, you've got the acute hospital setting if that's the only option available, but that's not the ideal situation if you are dying because it's geared for acute care, not people who've got a terminal illness.
"People still access nursing homes too, if that's an appropriate place for them to be. If they're not dying in the short term and they can't be looked after at home, the more appropriate place may be a nursing home."
The hospice referred to by Ms Savage is a 10-bed unit that was opened at The Forrest Centre in September 2018.
The $4 million unit took a year to complete, according to chairman of the centre's board of directors Peter Fitzpatrick.
"I believe that we all understand the growing challenge presented to carers by a family member suffering from dementia or those who are needing palliative care as they approach the end of life, and the centre is preparing for this future need," he said when the centre opened.
A permanent eight-bed palliative care unit has been open at Wagga's Calvary Hospital complex since 2015 as part of a $9.7 million upgrade.
The expanded unit was designed to encourage family support, with private gardens for each room providing a link with the outside environment.