Julie Maihi-Taniora knows all too well the value of palliative care nurses.
"When I first heard that they wanted to put me in palliative care, I thought 'that's just end of life'," she said.
"But it actually isn't. It's helping you enjoy life 'til the end of life, which is absolutely amazing."
For those who are able to access regular palliative care, it can make the final weeks and months more positive and comfortable. For the community, it eases the pressure on overstretched hospitals.
Palliative carers have not just helped Ms Maihi-Taniora deal with the physical pain of pancreatic cancer, but also the mental toll terminal illness can take.
They've also helped her plan for her death. Ms Maihi-Taniora hopes she can die at home.
"It's actually quite funny because when you've got mortality staring you in the face, it's like OK, now I've got a choice of what I want to happen whereas if I was in a car accident, there is no choice,'' she said.
Her experience has been a meaningful one, but others are missing out on having the same support.
Expanding palliative care would ease pressure on hospitals
Providers say there simply aren't enough trained staff for the patients who need them. According to a KPMG report for Palliative Care Australia, demand will increase by 50 per cent by 2035 and double by 2050.
As the election gears up, palliative care advocates are urging the major parties to commit to more funding for the sector, and they say it can be cost neutral.
Palliative Care Australia's budget submission says a $240 million yearly increase to home and community care would allow an extra 35,000 Australians to die in their homes. Last year, a total of 150,000 people died in Australia.
An increase in deaths at home would help hospitals.
KPMG analysis for the sector predicts it would result in 28,500 fewer emergency department visits and 200,000 fewer hospital bed days. And while this is a drop in the ocean, it would likely be a cost-neutral policy.
In one part of outer Melbourne alone, more than 140 hospital admissions this year were avoided after a $300,000 state government grant to deal with COVID-19.
Palliative Care South-East chief executive Kelly Rogerson said the boost prevented 141 admissions to hospital, saving the health system $880,000.
"We know that our hospital diversion, keeping people at home and being able to see them throughout the evening and into times when they're in crisis, actually reduces the burden on both the ambulance system and the hospital system,' Ms Rogerson said.
Every year 36 per cent of Australian deaths occur in aged care.
The royal commission into that sector called for palliative care to be a core service.
Advocates want $137.5 million to help improve services in aged care, in particular to boost the number of palliative care nurses in residential aged care homes.
'We need to talk about death more'
For too long, palliative care has been the "poor cousin" of the health system, according to the Australian Medical Association's vice president Chris Moy.
He has backed the calls for greater investment in palliative care and said in some ways it was the most important part of medicine.
"You can only do that by funding palliative care to make sure that doctors and nurses are there for patients as they die, and to protect their families as well."
Politically, palliative care has not been a headline issue for state or federal governments.
Advocates said there had been a lack of political leadership.
"It's much easier to cut a ribbon at a hospital than to actually have a proper discussion with the community about this, which is, in fact just as important, because it is reality that we will all die it is something we have to face,'' Dr Moy said.
In her outer suburban Melbourne home, Ms Maihi-Taniora said she hoped more people could access services — and talk about dying.
"Everybody's scared of death," she said.
"When your mortality is there and you're looking at it, it's like, I have to come to terms with how I want things to happen and be at peace with myself."
Ms Maihi-Taniora said talking about death had normalised it, and eased her fears.
"Definitely we need as a society to talk about death more," she said.
Health Minister Greg Hunt, who is retiring at the election, defended the Morrison Government's record on palliative care.
He said it provided subsidies for palliative care medicines under the Pharmaceutical Benefits Scheme and palliative care consultations under Medicare, including through telehealth.
It has also poured tens of millions into palliative care programs.
"Our government also supports national activities that strengthen the palliative care system through workforce education, carer support, community awareness, quality improvement, advance care planning, national communications, and research activities,'' he said.
The Labor Opposition is yet to make an announcement on palliative care.
