Kayla Bonkowski | What Dying Teaches the Living

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 relationship with time. Not the sentimental version -- not the "live in the moment" framing that attaches to illness narratives. In a more practical sense: a more accurate sense of proportion. Of what is worth the time it takes and what is not.

This knowledge reshapes attention. Hospice workers describe a specific attentiveness -- to the things being left unsaid in a family, to the conversations the patient wants to have but has not yet started, to the relationships that could still shift. They have seen how quickly the window for those things closes. The attention follows the knowledge.

Kayla Bonkowski's psychology background from Rochester College includes the study of how awareness of mortality shapes human behavior, values, and relationships. That theoretical grounding does not substitute for what bedside work teaches. It gives her a conceptual structure for receiving what the work will teach, and for understanding what she observes.

She lives in Sterling Heights with her son and two dogs. She fosters rescue animals, trains consistently, has organized her daily life around specific commitments that reflect what she actually values. The discipline she has built -- in the gym, in the foster placements, in graduate school -- reflects someone who has already started practicing the kind of attention she is building toward professionally.

What hospice work conveys is personal. It is shaped by what a specific person notices when consistently present near death, and by what those observations do to their sense of what matters. For Kayla Bonkowski, the expectation is that the work will confirm and deepen things she already holds: that presence matters, that relationships are the central human project, and that the quality of someone's death is worth caring about with the same intention as the quality of their life.

The field is organized around that premise. The practitioners who stay in it longest tend to be the ones who entered with that premise already in place.

What Kayla Bonkowski will learn in those rooms will not come from her degree, though the degree prepares her to be in them. It will come from specific patients, specific families, specific conversations that closed before they should have and ones that opened just in time.

There is something specific to note about what hospice work does not do to the people who do it well. The popular assumption is that sustained proximity to death erodes practitioners -- that the weight of it compounds over time into burnout or cynicism or detachment. The testimony of people who have stayed in the field for a long time tells a different story. Many describe the work as grounding. The proximity to death clarifies rather than distorts. It reduces the noise in how you think about your own life. For Kayla Bonkowski, who is building toward this work deliberately and with a considered sense of what it requires, the expectation is not that the work will diminish her. The expectation is that it will sharpen her sense of what matters -- which is, in the end, the resource that makes sustained presence with dying people possible.

She is also attentive to what the field does not offer in terms of formal preparation for what working in hospice teaches. The MSW program covers the clinical skills, the intervention models, the assessment tools, the ethical frameworks. It does not cover -- cannot cover -- the specific knowledge that accumulates from sustained presence in rooms where people are dying. That knowledge is earned. It changes the practitioner slowly, through specific encounters, through accumulated moments. Kayla Bonkowski is preparing for the clinical training. She understands that another kind of preparation will begin the day she walks into the first room.