There has been a sea change in the way Otago Community Hospice operates since chief executive Ginny Green joined 11 years ago.
``When I started the focus was on the in-patient unit and everything else around the in-patient unit supported the work of that unit,'' she said.
``What was happening was a very small group of patients were getting amazing care - and they still do if they are in here - but at the detriment of the other 200 people out there who our community team were dealing with.
``We have kind of done a massive flip between the in-patient unit and the community and our education programme.''
Most of those who give to the annual street appeal or take part in OCH's fundraising activities during next week's Hospice Week activities probably imagine they are helping to keep the organisation's North Rd building going.
They are, but the vast majority of OCH's work is done out in the community - three-quarters of the people being helped by hospice remain at home and never set foot in the building.
Hospice full-time care co-ordinators have about 25 patients on their books at any time, as well as working with GPs and on hospice's education programmes.
Ironically, given the perception of hospice being a place where people go to die, very few people actually breathe their last there: the nine resourced beds in the unit are rarely full, and only a third of admitted patients actually die in the hospice.
``It's a measure of success, of how well people are being cared for out in the community,'' Ms Green said.
``In the old days, there were patients in here who were well enough to be sitting up at the dining table: now the patients who are in here are very poorly indeed ... it's more of an acute admitting facility where we put measures in place to help them, and then they go back out again.
``It's a misconception that people come into this building to die, because they don't.''
The hospice worked because its staff were not just managing a person's physical symptoms, Ms Green said.
Staff were also paying attention to psychological and social pressures, on both the patient and their family, and offered support across all issues.
Ms Green called current hospice methods a return to earlier days when most people died at home with community and family help - but with hospice services available when things got more complicated.
``There is some sadness, but I see a lot of joy and happiness: it sounds odd, but it's lovely,'' Ms Green said.
About a third of New Zealanders who die each year do so with hospice support.
That level of demand brings with it plenty of pressures for administrators, who each year have to parlay the general goodwill which exists for hospice into fundraising activities to support an ever-increasing budget - last year a 10% rise in patient numbers at Otago Community Hospice was met with a 6.5% increase in community-raised funds.
The hospice had to raise $2.4million this year, ``in a community this size'', Ms Green said.
``We have to constantly look for unique ways of raising money and not fatiguing our regular supporters, which is why our shops are so important: they are our stars.''
The seven hospice shops across Otago contribute a third of the hospice's annual revenue, and that money is put to work on the front line - 81% of the operating spend of hospice goes on clinical costs.
``People who donate to not-for-profit organisations like to know that their donated dollar is going to the cause, and in Otago people can be reassured that that is the case,'' Ms Green said.
Hospice Week runs from May 14-20.
