"Hospice is a community effort," says Hospice Whanganui chief executive Davene Vroon.
Less than 50 per cent of the local organisation's funding is provided through the Whanganui DHB, the rest has to come from the community through donations, bequests and fundraising.
This week is Hospice Appeal Week and funding is a real, important, urgent matter.
"We are going through some transition, and change is always challenging," says Davene. "We have to be so nimble now, as organisations. We have to constantly swerve because we don't know what the next external challenge is that is coming at us. There is so little we can control in that now."
She says challenges have to be met and circumstances allowed for while still being true to the ethos and purpose of Hospice.
"It is still about providing an excellent service to the patient and their whanau: that is the thing that always drives us, that's always at the centre. Despite all the stuff we need to figure out, what is it that we need to do and become in order to provide the kind of service to that patient that I would want for my mum or my dad.
"How do we adjust ourselves in a changing world to be the best for them?"
Davene says the challenges for all hospices nationwide are similar.
"In a local context, on average we see about 350 patients a year, but every one of those 350 touch the lives of so many others. This is one of the great privileges of working in Hospice: this is an organisation that truly touches the lives of thousands in the community every year.
"Sometimes I feel there is a perception that Hospice is about this building and the five beds up here in St Johns Hill, when, in fact, most of our patients are in the community. When you talk to a patient and their whanau and you ask them, 'What do you want from your care? What are your wishes?' More often than not, it is to stay at home in a familiar environment, with friends and whanau around us, and retain a level of independence."
It then becomes the job of Hospice to supply the resources and care to make that possible.
"On any given day, we would see about 70 patients ... and by far the majority of them are being cared for by our doctors, nurses, social workers and whanau support staff in their homes.
"From a funding perspective, the reality is that it is probably costing us 20 to 25 per cent more in expenses, to do what we do, than it did a few years ago ... but our funding base hasn't risen to match that. Covid has had a huge and devastating impact on our service ..."