The hours before death are generally peaceful, but medical care can be vital in the final period of a person's life, palliative care experts say.
The Calvary Mater Newcastle runs the Hunter's largest palliative care service, which works to ease people's pain and suffering.
With a compassionate approach, the service helps people and their families to foster acceptance during the end stages of life.
About 700 people are presently benefiting from the service, along with those in a 17-bed hospice at the Mater's Waratah site.
The Newcastle Herald spoke to people who work in the field to mark Palliative Care Week and help break the taboo of discussing death.
They hope that people live as well as they can, but also die as well as they can.
Common deathbed regrets are that people wish they had lived a life true to themselves, hadn't worked so hard and took more time to appreciate life and be with loved ones.
Dr Mark Mather, a palliative care senior specialist at Calvary Mater at Waratah, says death "isn't front and centre of most people's conversations".
"But we all have to acknowledge that at some point of our lives, we'll face a life-limiting illness or situation in which palliative care may play an important part."
Dr Mather said palliative care "isn't all about death and dying".
"It's certainly about looking after patients, but these people may still have months and occasionally years of survival.
"There's no question that end-of-life care has a very significant role in what we do."
Sheree Martin, a Calvary Mater nurse unit manager in palliative care, said the staff work with "people at very different stages of acceptance" of their diagnoses.
End-of-life conversations can depend on the patients, carers and families being ready for such discussions.
"It's very important that we have clear, open communication and be guided to some extent by the needs of the patient and their family," she said.
This can involve planning to make the experience as comforting as possible.
"It's more of a process than just a conversation. It happens on an almost daily or weekly basis, depending on the actual people you're seeing," she said.
"It's a regular part of what we do. It's not an awkward one-off type of conversation."
With sensitive discussions that address people's questions and concerns, Dr Mather said "you can help people get their heads around what is awful news".
"No one ever wants to hear that a disease is going to lead to dying, or that death is approaching much sooner than anyone would want."
But this doesn't change the reality of the situation.
"And so, we do have to help people through the burdens of the illness in the ways that we can," he said.
Ms Martin says there is "a huge need for palliative care".
"If there was anything we could wish for, it would be ongoing resources to provide that care to the growing number of people referred to our service," she said.
A Palliative Care Australia report forecast that the need for palliative care would rise by 35 per cent from 2020 to 2030 and more than double by 2050.
"It's already increasing now by about 11 per cent a year," a spokesperson said.
Palliative Care NSW chief executive Linda Hansen said the awareness week was a chance to discuss how to "expand access" to meet patient needs "now and into the future".
Palliative Care Australia chief executive Camilla Rowland said "death and dying is a difficult subject to talk about and engage with".
But she said "powerful voices" campaigning on the issue "inspire and start important conversations".
Juliane Samarra, a palliative care nurse practitioner, was among those to join the campaign and break the taboo of discussing death.
"Generations ago people died at home, cared for by their family," she said.
"We have now hidden death and dying behind closed doors, either in nursing homes or hospitals. We need to embrace death and dying as part of living."
Palliative care workers have witnessed patients in their dying days experience spiritual epiphanies and visions of loved ones that have passed on, which raise questions about an afterlife for some people.
Palliative Care Australia says spiritual care is an "integral part of palliative care".
For those who work in palliative care, good support helps them do their jobs well.
"It can be very challenging at times. There's no question," Dr Mather said.
"You deal with a lot of hardship and sadness on a daily basis."
His job is to provide care and advice, but he knows he can't carry the weight of other people's sadness and what they're going through.
"If I did that, I simply wouldn't be able to work. It would burn me out in no time," he said.
"We all have things that keep us well, like families and external interests.
"For me, my family is a wonderful support. They provide an anchor from which to work from."
Support from colleagues and work satisfaction helps.
"We're lucky that our entire team within the hospital and community system is very supportive," Dr Mather said.
"And there's the sense that we're contributing. We see that as important. You get that lift from seeing the good work and outcomes that the team provides for people in very vulnerable situations."
Ms Martin says it is "a very privileged space to work in".
"Providing care and support to patients and families at a very vulnerable time in their lives means a lot to us as people and clinicians," she said.
The Calvary Mater's palliative care department provides numerous services across the Hunter.
The 17-bed hospice at Waratah is a small part of what Ms Martin says is "a very large service".
The department provides clinical support and outreach services to other hospitals, aged-care homes and community nurses.
It also provides advice and help to people who choose to die at home, along with bereavement services.
About 700 patients outside the hospice are registered with the Newcastle outreach service, which covers a 20-kilometre radius from the Mater.
The department also supports services in Port Stephens, Maitland, Cessnock, Hunter Valley and Mid North Coast.
"It's a network of clinicians trying to provide care to people as best they can," Ms Martin said.
Dr Mather said the Calvary Mater was "one of a number of palliative care services in the Hunter.
"But we are the biggest and most resourced, given we're associated with the tertiary hospital at the Mater."
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