Kayla Bonkowski

People who work in hospice describe a changed relationship with what matters. That knowledge does not come from training. It comes from the rooms. Ask someone who has worked in hospice for ten years what the work has taught them and the answer is almost never clinical. They do not talk about assessment tools or intervention models. They talk about what they have observed when people are dying. The observations are consistent across practitioners. Dying people regret specific things. The patterns in those regrets are not what most people expect before they encounter them. Kayla Bonkowski is training to work in hospice and palliative care in Sterling Heights, Michigan. She holds a Cum Laude psychology degree from Rochester College and is completing her MSW. She is candid that she does not yet have the accumulated bedside knowledge that comes from years in the field. What she has is the academic preparation to receive it. People who work consistently near death describe a changed relatio...

The emotional work of end-of-life care gets discussed. The operational layer underneath it does not. Without that layer, the emotional work cannot happen. Every conversation about hospice focuses on the grief support. The difficult conversations. The sustained presence with dying patients and fractured families. Those things are real and they require specific clinical skill. They are also not the first thing the social worker does when she walks in. The first thing is usually logistics. Kayla Bonkowski is completing her MSW in Sterling Heights, Michigan, with a focus on hospice and palliative care. She holds a Cum Laude psychology degree from Rochester College. What she calls the infrastructure of hospice -- the operational layer nobody discusses -- is the part she has thought about most carefully. A family in a hospice setting is not only grieving. It is simultaneously managing an administrative situation of significant complexity. The Medicare hospice benefit covers a defined set of...