Karlynne Earp was lying on the bathroom floor, struggling to breathe.
It was the toughest point of her battle with Covid-19 earlier this year and she thought her life was coming to an end.
Earp was staying at her recently deceased father-in-law's retirement villa in South Africa's Western Cape Province.
Struggling to breathe, the bathroom floor was the coolest place to be.
Singapore-based Karlynne and partner Spencer Carr had gone to Plettenberg Bay three weeks earlier to nurse Spencer's father before he died.
"Then we got Covid," she says.
"Five of Spencer's friends died of Covid around the same time."
She and Spencer were ill with Covid for two weeks and then it took a month to get their strength up.
"The biggest thing was the lethargy, we were sleeping for 20 hours a day. Then there was the terrible headaches and sweats that come with the high temperatures."
They found they couldn't return to Singapore due to Covid-19 restrictions implemented in their absence. Spencer had to hand in his notice at James Cook University and Karlynne never got to start a new job at Singapore General Hospital, working on end-of-life care planning.
"Seven cancelled flights later we were back in New Zealand, to Taupō, my turangawaewae, the place where I was born, and where my father David Mayne lives," Karlynne says.
Karlynne is a trained nurse and spent 35 years nursing at the Counties Manukau and Waikato District Health Boards (DHBs). From 2010 she was involved in end-of-life care until the move to Singapore in 2018.
She is now Lake Taupō Hospice's chief executive officer.
Implementing a Covid-19 resilience plan was one of her first tasks upon arriving at Lake Taupō Hospice in June.
She says hospice will be there to provide end-of-life care for the 80-110 hospice patients currently in hospice care.
"With the pandemic, we are planning for the worst and hoping for the best.
"We have scenarios for what the hospice service will look like if our staff numbers are down 20 per cent, 50 per cent, 75 per cent."
The requirement to wear PPE protective clothing effectively doubles the number of staff required, due to the need to dress each other.
Some volunteers are trained in the use of PPE gear but Karlynne says more volunteers are needed to do the heavy lifting for equipment delivered to patients' homes such as beds, compression mattresses, wheelchairs, Lazyboy chairs, and bathroom and toileting equipment.
"Throughout all alert levels we have always been there for our patients, but we have to keep our staff safe."
Community relations and fundraising manager Ross Mortimer says the past 18 months have been financially and logistically challenging for Lake Taupō Hospice.
"We have been a powerhouse."
Hospice can't operate without funding from the community. It receives 30 per cent of its funding from the Lakes DHB and the rest is from donations and proceeds from the hospice shop and events.
This year people are being asked to buy donations to hospice as Christmas presents for their loved ones.
"We are probably one of the lowest funded hospices in New Zealand. But we are also one of the mightiest."
Ross says the hospice fundraiser Fabulous cabaret was a huge success and wants to thank the community for its support.
"People have been contacting me from all over New Zealand asking about the 2022 event and wanting to buy tickets. They're not on sale yet.
"The community got behind Fabulous, and the atmosphere among the 450-strong audience was that of a group of friends, everyone seemed to know everyone."
The End of Life Choice Act 2019 came into effect at the beginning of November and Karlynne says they are prepared for the eventuality of patients applying to the Support and Consultation for End of Life in New Zealand registrar.
Nationally, hospices have taken the position of conscientious objector because assisted dying is the flip side of a hospice's service to provide a philosophy of care.
"We would never bring it up [assisted dying] and we will not withdraw our services if a patient makes that choice," Karlynne says.
"There has been a lot of change in the end-of-life space. Twenty years ago people were not having conversations about death."
To buy your loved ones a Lake Taupō Hospice donation for Christmas go to the hospice shop at Totara Point Shopping Centre or online to www.laketaupohospice.co.nz/donations/