Jeremy Adlam enjoys tending to the horses at his mother Kerrie Winfield's property at Lower Norton, south-west of Horsham in regional Victoria, but it is remarkable that he is able to at all.

Ms Winfield was told that her son had 24 hours to live on Father's Day in September last year.

Mr Adlam, 39, has advanced cancer and when he developed chronic kidney failure doctors said he needed palliative care.

He also lives with an intellectual disability, which Ms Winfield says means he is not fully aware of his health status.

Last year Mr Adlam was being treated at the Peter MacCallum Cancer Centre and Ms Winfield considered selling her farm and moving to Melbourne to care for him, but he chose to go home.

"I hate hospitals and I've been in too many," he said.

But establishing support locally proved challenging, which Ms Winfield said was down to a complicated co-ordination process between palliative care services in Melbourne and nurses in Horsham.

During that time, Jeremy was "extraordinarily sick", but as he got better, the family decided to spend his final days at home, which required a lot more work.

"After Father's Day, every week and weekend, palliative care here in Horsham were either phoning me or having meetings with me here to see what they could do to help me and Jeremy," Ms Winfield said. 

This process was daunting for Mr Adlam.

"Through occupational therapists, physiotherapists, the nursing staff, it took six months for palliative care in Horsham to realise what they were supposed to be doing," he said.

'Quite a gap already'

An independent report from KPMG showed that by 2050, patients requiring palliative care in Australia will have doubled. 

Palliative Care Australia chief executive Camilla Rowland said that showed the need for more workers, especially outside metropolitan centres.

"In rural areas … people are dying younger overall, and so their need for palliative care is going to need to come at a younger age, and that comes with a whole lot of complexity and issues," she said.

"We know probably that only about 80 per cent that have life-limiting illnesses could benefit from palliative care, yet we know probably about 60 per cent of people who need it are getting it.

"[That] is quite a gap already, but if we need to plan for the future, we need to start planning now to say, 'This is what [palliative care] needs to look like.'"

There has been a community push for expanded palliative care services in the Latrobe Valley, in the state's south-east.

The cause has been championed by local health advocate Jane Anderson, who has called for a dedicated palliative care unit to be set up at the Latrobe Regional Hospital in Traralgon.

The hospital has a palliative care team and four dedicated beds, but no in-patient facility suited for comfortable end-of-life care.

Ms Anderson says the community wants an "environment that is more like a home, so people have got the experience they're looking for at that time, so their family can be there, their needs are met and pets can be there as well, if possible".

A Victorian government spokesperson said the government was "making sure Victorians with a life-limiting illness can access high-quality services so they can live out their final days as comfortably as possible".

Training local nurses

The Australia New Zealand Society of Palliative Medicine is calling for effective long-term strategies, including training workforces in the local area, to address the gaps.

"We believe there is a workforce out there that could be activated if they could do palliative training in their local area," president Michelle Gold said.

Grampians Health palliative care nurse Maire Coffey, who has provided care to Mr Adlam, said nurses servicing smaller Wimmera towns needed to "be a bit smart" in their work.

"[I've] focused quite a lot of my time trying to build up the capacities of nurses… in aged care facilities," she said.

"We're trying to put in a lot of planning and a lot of education into training up those nurses to have them feel confident."

In the meantime, Ms Winfield is pleased to have her son on the farm.

"Jeremy is not treated as a sick person, he's not treated as a disabled person," she said.

"He does his day-to-day chores, he loves to ride his motorbikes, and helps us to clean up and garden.