I was a professional dancer. When I was in my late twenties, my husband passed away. He received hospice care for his final two months.The hospice nurse arrived to assist us. As we were all crying and holding hands, I looked up at the nurse and saw her smiling. It wasn't a big smile but, a peaceful smile. I remember thinking, how can she do this? Since then, I became interested in how people process and cope with death.

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This is the second installment in my series on hospice care. See the first installment here.

Before my mother was in hospice, I thought it was basically about keeping the patient comfortable. Period. I've learned it's a whole lot more.

My guest today is Heather Kroski, social worker at Midwest Palliative & Hospice CareCenter.

JB: Welcome to OpEdNews, Heather. Tell us a bit about your job, please.

HK: As a social worker, I provide educational and emotional support to patients, family, caregivers, and often staff at facilities. I provide anticipatory grief around end of life issues and assist families at time of death. As social workers, we are there to advocate for patients and family members. These are my primary responsibilities. But we often wear many hats and find ourselves doing unexpected little things in the moment. I have found myself helping someone carry boxes as they pack up their loved one's belongings or helping someone make stew for their loved one because, in that moment, they needed someone next to them. When I walk into a patient's room or walk in to meet a family, whether for the first time or not, I am there to meet them where they are at, in whatever coping stage that may be. More often than not, I sit with people and listen. Sometimes, that's what people need the most--someone to listen.

JB: How do you do it? I remember your coming to my mother's within moments of her death. I had never met you before and yet you were such a strong, low-key presence at an awful time. Isn't it incredibly emotionally taxing for you?

HK: I remember coming to your mother's house. Walking in did not seem awful to me. Your mother seemed so peaceful and the room was calm and still. While there was much sorrow, I could also feel all the love you, your daughter, and your mom's caregiver had for each other and the life your mom had led. It was an emotional moment that I had the honor of being present at. I am happy to hear that my presence was strong yet low key. I never want to be intrusive in these moments in families' lives.

It can be taxing at times. While present at a death, my job is to be calm and provide comfort while allowing families to grieve in their own way. Self care is also important as a social worker. Being able to share and process my reactions with a trusted colleague after a visit or death can make a difference. It also does not hurt to allow myself time to do something for myself, like dance, which is something I love to do. In addition, it helps me to spend time with my own family, playing with my two young boys and husband. Like everybody, I need to give myself permission to accept what I just did and just experienced with each family as a moment in their lives. It's just a moment. I hope it's a moment during which I am helpful. But it is their moment. It's not about me. It's about them. When I go into a house, it's not about what my goals or needs are in any way. It's about what they want and need and hope for.

JB: I'm glad you know how to take care of yourself. How long have you been doing hospice care, Heather? And how did you get into it in the first place?

HK: Well. most of the time I take care of myself. As most of us know, a good work-life balance can be hard to manage successfully.

Before getting a masters in social work, I was a professional dancer. I have been dancing since I was a young girl and still do. It is a passion that runs deep within me. I do not think I will ever be able to stop dancing. However, there was something missing for me in my life. I was starting a family and no longer wanted to feel that I had to compete for a career as a performer. So, I went back to school to become a social worker to work in the field of hospice care. Yes, I went into social work knowing that I wanted to work in death and dying. It was a career change, a big career change.

I am often asked the question: why do you this? Or how can you do this? When I was in my late twenties, my husband passed away. He received hospice care for his final two months. I remember clearly after he passed, myself and many other family members were gathered around his bed. The hospice nurse arrived to assist us. As we were all crying and holding hands, I looked up at the nurse and saw her smiling. It wasn't a big smile but, a peaceful smile. I remember thinking, how can she do this? Since then, I became interested in how people process and cope with death. I am not sure if having gone through such a personal loss has given me a certain strength to be present with others that are going through the process of losing someone, but I do try to be present with others during their experiences.

JB: You certainly were there for us at a pretty difficult time. I remember watching you and thinking you moved like a dancer. At the time, it seemed like a stretch to go from one radically different career to another. After talking with you, it makes more sense to me.

HK: You are right, it does seems like a stretch. However, being a dancer has given me an ability to understand how a lot of what's important that we say, we say without words. The transition at end of life is much like a dance. There is the body, the music of life around you, and the unknown that is left for each person's interpretation.

JB: That's a lovely way to put it. I didn't know much about hospice then and, while I know a bit more now, I'm sure there are many readers out there who know even less than I did. Can you give us an idea of what hospice looks like? It's not a one-size-fits-all, is it?

HK: You are right, again. Hospice is not a one-size-fits-all. I think most everyone understands that hospice is end of life care. There needs to be a medical diagnosis of a life expectancy of six months or less to live. There is not a crystal ball and often people live more or less than six months. Hospice should provide a family with comfort, peace, and a sense of living at this time. Hospice services are provided wherever a person is at. It can be a house, a nursing home, or at a hospice unit. The idea is to treat body, mind, and spirit.

While there is a large focus on ensuring comfort, how that is achieved is guided by a patient and their family. One family may want minimal visits from hospice staff and another may want frequent visits. In my experience, there are families that can openly share their needs and goals and others that desire to keep things more private. You said hospice is not a one-size- fits-all. That is true. Much like how someone lived their life is the same way they continue through the end of their life. Some patients seem to like a lot of family around them and others may not. Some patients seem to ask many questions and others barely talk. The hospice staff is there to help guide patients and families through this time.

JB: You spoke about how the very end of life is a dance of sorts, Heather. That's more than a metaphor: through hospice, music [in our case, specifically, a harp] is involved. That was a new but wonderful concept for me. I'm pretty sure that many of our readers are likewise unfamiliar with it. Can you fill us in?

HK: Midwest has a program called Music Care Services. This program is made up of music therapy and music thanatology. They use a wide range of music techniques to provide a space for patients to express feelings, relax, and often allow for patients to remember meaningful moments in their lives. Both therapies can often be a benefit to not only patients but to family members as well. Family members often see the effects of music on their loved ones and it can provided a sense of comfort. Family members can often see a smile that has not been seen in a very long time or their loved one take a deep sigh and relax.

Music therapy is different from music thanatology. I recall that your mother was provided with a visit from one of Midwest's music thanatologists towards her final days. Our thanatologists use science-based techniques to provide patients, and families, with comfort in their final hours. They arrive at a patient's house with their harp and voice in hand. Once they sit down, they respond to breathing and pulse. I think of it as the therapist responding to the room, the tone, and the now. As I said before, I feel that this transition, at end of life, is a dance between the body, the music around you, and what is to come. The presence of music at this time can make this dance lined up and balanced. I have had family members tell me that the presence of music next to the patient at this time not only eased their loved one but, provided them with a place to open their hearts to feel joy of life.

JB: Tony, the harpist, came just a few hours before my mother died. Although I wasn't present, my daughter and our caregiver were both very enthused about how peaceful it was and how my mother, pretty vegetative at that point, nevertheless visibly reacted to the music. I truly believe it eased her on her way and that gives me comfort.

I now know that there's a wealth of services provided for families after the patient has already died. That was a big surprise to me and I'd like to share this information with readers.

HK: Some of my colleagues are better equipped to answer, Joan, so I'm turning your question over to them.

Grief Services Manager, Fran Nathanson: Because the grieving process can include feelings of sadness, pain, isolation, depression, confusion, anger and resentment, our organization seeks to create a safe environment for people to connect with bereavement professionals, as well as others who have had similar experiences. We offer grief support programs to adults, teens and children at no cost, including support groups, family workshops and individual counseling. We also stay in contact with families through periodic mailings. In addition, we offer bereavement camps for children and teens. Our Glenview office organizes CampCare, which includes an overnight camp in Wisconsin for school-age children who have experienced loss, and an Adventure Camp for teens that takes them canoeing and camping along the Wisconsin River. Our Barrington location offers Camp Courage, a weeklong day camp in Ingleside for ages 6 to 13. Finally, our Chicago location runs school-based outreach services that connects students who have lost loved ones with bereavement services. Camps and children's services are also free and open to everyone our communities, regardless of whether their loved ones died in our care.

JB: Those services sound wonderful and much needed, especially for younger family members. Is hospice a growing trend? Is it recognized by doctors and insurance companies as a viable option?

Kelly Fischer, Chief Operating Officer: Yes, according to the National Hospice and Palliative Care Organization's Fact and Figures on Hospice Care, the number of patients and families served by hospice has steadily increased over the past several years. With this new generation of seniors, we are on the cusp of a sea change in how people see themselves age--quality of life is increasingly becoming a part of the discussion, not just length of life. The desire for quality of life, and demands from their Gen X caregivers, will influence and reshape tomorrow's care systems. I believe that baby boomers will demand more palliative care and holistic end-of-life care for themselves and their loved ones.

Our program is growing. We continue to work with healthcare providers to assist them and help them refer patients sooner so that they can benefit from the holistic care and full range of service offered by hospice and palliative care.

JB: Is hospice recognized by doctors and insurance companies as a viable option, Kelly?

Kelly Fischer: We do see greater understanding and utilization by healthcare professionals, as they have come to trust quality providers like us to assist them in supporting the needs of their patients.

Medicare, Medicaid, and most private insurance companies now cover hospice care.

JB: Good. Do most people who use hospice at home or in a facility?

KF: According to the National Hospice and Palliative Care Organization's Hospice Facts and Figures, the majority of patient care is provided in the place the patient calls "home." In addition to private residences, this includes nursing homes and residential facilities. In 2013, two thirds of patients received care at home. We are pleased to be able to offer patients care wherever they desire, and if or when more intensive care is needed we have facilities throughout our service are that patients can utilize for care or symptom management.

JB: It was wonderful to talk with you, ladies. My mother had the benefit of your services and it's nice to learn that there are many other offerings as well. Having the opportunity to have Tony Pederson play his harp at her bedside, and having Heather come over late that night, just minutes after my mother died, gave my family a good taste of how much hospice can enhance a sad but inevitable and natural part of the life cycle. Thanks so much for what you do.

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my interview with Heather's colleague, Tony Pederson: Hospice Harpist Treats Patients With Music 7.16.15

The Music-Thanatology Association International professional association website.

From Elisabeth Mistretta, Senior Brand Communications Specialist: "Because Midwest CareCenter has merged with JourneyCare and Horizon Hospice & Palliative Care as of June 1, we are now one organization. Our new name is slated to be announced in October, and we now serve 1,200 patients daily across 10 Illinois counties."

Midwest CareCenter's main website

Their website's page on Music Care Services

YouTube video about Midwest CareCenter

Authors Website: http://www.opednews.com/author/author79.html

Authors Bio:

Joan Brunwasser is a co-founder of Citizens for Election Reform (CER) which since 2005 existed for the sole purpose of raising the public awareness of the critical need for election reform. Our goal: to restore fair, accurate, transparent, secure elections where votes are cast in private and counted in public. Because the problems with electronic (computerized) voting systems include a lack of transparency and the ability to accurately check and authenticate the vote cast, these systems can alter election results and therefore are simply antithetical to democratic principles and functioning.



Since the pivotal 2004 Presidential election, Joan has come to see the connection between a broken election system, a dysfunctional, corporate media and a total lack of campaign finance reform. This has led her to enlarge the parameters of her writing to include interviews with whistle-blowers and articulate others who give a view quite different from that presented by the mainstream media. She also turns the spotlight on activists and ordinary folks who are striving to make a difference, to clean up and improve their corner of the world. By focusing on these intrepid individuals, she gives hope and inspiration to those who might otherwise be turned off and alienated. She also interviews people in the arts in all their variations - authors, journalists, filmmakers, actors, playwrights, and artists. Why? The bottom line: without art and inspiration, we lose one of the best parts of ourselves. And we're all in this together. If Joan can keep even one of her fellow citizens going another day, she considers her job well done.


When Joan hit one million page views, OEN Managing Editor, Meryl Ann Butler interviewed her, turning interviewer briefly into interviewee. Read the interview here.

While the news is often quite depressing, Joan nevertheless strives to maintain her mantra: "Grab life now in an exuberant embrace!"


Joan has been Election Integrity Editor for OpEdNews since December, 2005. Her articles also appear at Huffington Post, RepublicMedia.TV and Scoop.co.nz.