FOND DU LAC, Wis. — An extension ladder off Andy Land's back deck near his gas grill is a training ground for the Khumbua Icefall.

A few blocks away, Buttermilk Creek Park substitutes for the Hillary Step. The city park is where Land, 52, uses a harness to drag an old Firestone tire up, down and around the city sledding hill. And at the Fond du Lac Family YMCA, Land straps a 40-pound pack to his back as he works the treadmills and stair stepper machines.

When you live in Wisconsin, it takes a bit of creativity when training to climb Mount Everest, the world's highest peak. But for Land, an experienced mountaineer who has stood atop some of the world's most challenging peaks, reaching the summit of the 29,029-foot Himalayan mountain isn't the most important part of this spring's more than two-month excursion to central Asia.

Land is headed to the death zone to bring attention to death itself, but not those that occur on the treacherous mountain.

Instead, Land, a hospice nurse for nearly 15 years, wants more people to talk about end-of-life decisions regardless of elevation, the Wisconsin State Journal (http://bit.ly/1tFuq6S ) reported.

"Almost all of the money that's ever going to be spent on your health care in your entire life is going to be the last couple years of your life, and I can tell you that a lot of that is wasted," Land said. "We absolutely have to have conversations about how do we recognize when people are dying and shift our focus from making their bodies live as long as possible to helping them die well."

Land has raised $75,000 but would like to hit $1 million in his Climbing for Hospice campaign for the Hospice Organization & Palliative Experts (HOPE) of Wisconsin, a membership organization for all hospice and palliative care programs in the state.

None of the money raised for HOPE is being used for his trip. Instead, most of the $60,000 in expenses is being paid for by his brother, who at 54 years old is dying of heart and respiratory disease. Ironically, his brother, who adjusted his life insurance policy to fund Land's climb, is not in a hospice program.

The costs for the climb include a $41,000 guide fee, $5,000 in airfare and $3,000 for climber's insurance in case he has to be rescued from the mountain. He also needs specialized gear such as a $700 goose down climbing suit, a $1,000 pair of hiking boots and $250 crampons. This will also be the first climb in which Land will use bottled oxygen.

Dying on the mountain is a real possibility, although his guide service, International Mountain Guides based in Ashford, Washington, has never lost a client on Everest. If Land makes the summit, he would join an elite group of about 5,000 people in the world and 500 from the U.S. to make it to the top and survive. Land knows of only four others from Wisconsin to have accomplished the feat.

"You're going to die of something, not that I want to die on that mountain, but I want to live my life," Land said.

"Tomorrow is promised to no one," he said. "If anything, you learn in hospice that you need to go and live as well as you can every single day. I've never had anyone (in hospice) tell me they wished they had made more money in their life."

Land trains twice a day, seven days a week. Jeff Barnes, an athletic trainer and certified strength and conditioning specialist, has Land doing cardio, weights and lots of stretching and balancing exercises. Barnes said a big part of his job is teaching Land, who he calls an elite athlete, how to avoid injury. He compares what Land is doing to that of someone training for a triathlon.

"He's been setting personal bests every week," said Barnes, 47, a Prairie du Chien native who runs the rehabilitation department at Quad Graphics in Hartford. "He has that mental drive and work ethic to succeed."

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Mountains scaled by Land over the past 20 years include McKinley in Alaska, Rainier in Washington, and a more than 19,000-foot climb to the summit of Huayna Potosi in Bolvia. In 2011, he traveled to Argentina, where he scaled Mount Aconcagua. At 22,841 feet, it's the highest mountain in the Western and Southern Hemispheres.

"Will I be scared? No question about it," Land said of his Everest climb. "I'll turn around if I need to. Getting down is more important than getting to the top."

Land was born in Battle Creek, Michigan, grew up in Indiana and earned a bachelor's degree in clinical psychology at Purdue University. That led to a job on a psychiatric ward in Chicago where he met his wife, Mary Sue, who also worked at the hospital. He later earned a nursing degree from North Park University in Chicago before moving in 1995 to Fond du Lac to be in a smaller community for their now three boys and closer to Mary Sue's hometown of Wrightstown.

In 2000, Land began working in the hospice care program at Agnesian HealthCare. He was named its director in 2002 and in 2010 helped launch Agnesian's palliative care program that offers both in-patient and outpatient services.

One of Land's patients was Susan Ahern, who was diagnosed with cancer in December 2012. She spent three weeks in the Agnesian hospice program before dying in August 2013 at the age of 76. She spent the whole time at her home of 48 years on Lake Winnebago, and it was Land who attended to her in her last two days of life.

"He is an extremely capable person in his field of work. He's a great ambassador for his program," said John Ahern, Susan's husband of 51 years. "People who do what he does, they have to have some special traits. They lead a family through the experience and you come out the other side feeling stronger and feeling better. It's quite amazing."

But Land will have to be at his physical and mental best to complete his Everest climb. It takes 10 days just to hike to base camp. Weeks are then spent acclimatizing and climbing back and forth between four camps at different elevations before an attempt at the summit.

He likens mountaineering to what a patient and their family may experience at the end of life. It can include long periods of boredom and malaise, lethargy, continual work just to get keep moving, interspersed with fear, times of elation and a closeness with God.

"The opportunity to go to Mount Everest is obviously a once-in-a-lifetime thing," Land said. "I've definitely had second thoughts, and third thoughts and fourth thoughts. But I'm totally committed now, and I really do feel like there's something bigger at work in this."

This is an AP Member Exchange shared by the Wisconsin State Journal