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Death From an Overdose: Managing the Grief

March 26, 2015

heroin overdose


According to the Centers for Disease Control and Prevention, death rates from drug poisoning have tripled since 2012. The researchers found an average increase in heroin-related drug poisoning deaths of 6% per year from 2000 through 2010. The increase from 2010 through 2013 was an astonishing 37%. Deaths have shifted from middle and older-aged men to younger white men from Middle America.

It’s tragic and impacts the bereaved on many levels.

Grief reactions are often intricate and complex. When you add that the person died from an overdose, accidental or not, it complicates matters. There is a myriad of emotions that occur when someone dies and when someone dies from an overdose, the most difficult ones rise to the surface.

Shame, blame, guilt, stigma, isolation, loneliness, fear and anxiety are prevalent.

Sometimes the bereaved feel guilty. They relive over and over the “should haves, could haves” and “if onlys.”  The bereaved often blame themselves and they blame others. Shame is a common reaction. Some feel judged for loving someone with an addiction or for having an addiction themselves. Unfortunately, the shame makes people hesitant to share. Consequently, they don’t reach out but rather become isolated and lonely. It is a sad, downward spiral.

Fear and anxiety are also prevalent grief reactions with a substance abuse death. There is the fear that other family members or friends will overdose or that people who are currently using might die. And, there is the fear of relapse for people in recovery.

The stigma society imposes for substance abuse loss is overwhelming and there is an overlap between intentional overdose and unintentional overdose. Unfortunately, people deeply misunderstand addiction and mental illness. suggests the following to help manage grief after a substance abuse death:

  1. Accept the role substances played in the death.
  2. Find a way to work through and express emotions. This could be through talking, writing, making art or music, hiking, etc. Do whatever works for you.
  3. Educate yourself and understand addiction. Understanding addiction can help put to rest feelings of guilt and blame. One thing to learn is that we are powerless and we don’t have control over someone else’s addiction.
  4. Surround yourself with the right support system. Avoid those who disenfranchise your grief. You might find comfort with a counselor or a support group with others who are also experiencing grief of an overdose death.

Grief includes all kinds of feelings. If you feel overwhelmed with emotion, trust the grief process and give yourself permission to be with all your feelings. Know that there are others out there who feel the same. And, there are counselors and support groups that will welcome and support you. You do not have to grieve alone.

Diane Snyder Cowan, Hospice of the Western Reserve ©2015

Locate Hidden Treasures at the Warehouse Sale

March 12, 2015

warehouse sale photoCleveland, Ohio (March 10, 2015) –It’s time for another Hospice of the Western Reserve Warehouse Sale. No matter what you’re looking for you’ll find it here: furniture, artwork, china sets, lamps, linens, glassware, holiday decorations, collectibles and much more.

Proceeds from the sale support seriously ill patients and their families, veterans in need of specialized care, grief and trauma counseling in schools, and other community-based programs provided by this nonprofit agency.

The sale will be held Friday, May 15 from 8 a.m. to 4 p.m. and Saturday, May 16 from 9 a.m. to 3 p.m., at Hospice of the Western Reserve Headquarters, 17876 St. Clair Ave., Cleveland.  Cash and major credit cards (VISA, MasterCard and Discover) are accepted for payment (no checks).

Hospice of the Western Reserve is also actively seeking donations of furniture, and household goods for the Warehouse Sale. All furniture items will be previewed prior to acceptance for donation; tax receipts will be provided. Arrangements can be made to pick up large furniture or fragile donations from anywhere in Northeast Ohio at no cost to the donor. Those interested in contributing items for the sale should contact the Warehouse Sale Team at 800.707.8922 ext. 6881. NOTE: The agency is unable to accept bedding, books, clothing, cribs and car seats, small electronics, small and major appliances, medical supplies, sporting goods, children’s toys and games, computers and related hardware, mattresses and box springs, televisions and stuffed animals.

Hospice of the Western Reserve Warehouse Sales are held periodically throughout the year. To receive notice of upcoming sales, send an email to:  For a list of upcoming sales, visit

Hospice of the Western Reserve is a nationally acclaimed non-profit agency providing comfort and emotional support to patients and their families. The agency provides palliative end-of-life care, caregiver support and bereavement services throughout the region, and cares for people in a variety of settings, including private residences, assisted living and retirement communities, nursing homes, at Ames Family Hospice House in Westlake and David Simpson Hospice House in Euclid. For more information, visit, or call 800.707.8922.


LGBTQ, Art Therapy and Grief

February 25, 2015

Grieving the loss of a loved one is difficult enough, but when the relationship is non-traditional it can become even more complicated. When an LGBTQ person cannot openly mourn the death of a loved one or when society at large disenfranchises this grief, heartache is turned inward and the healing process suffers. Sadly, sometimes folks disenfranchise their own grief. Secrecy, shame and guilt are a few of the grief reactions commonly expressed in the LGBTQ community. Turning grief inward can result in isolation, use of unhealthy coping strategies and feelings of depression.

Members of the LGBTQ community who have experienced the death of a loved one, especially of their significant other, may not have the support from family and friends that heterosexuals come to expect when a loved one dies. Family and friends may not understand the relationship or may be angry at their loved one and partner. Some family and friends may not have known about these relationships as couples could have kept them hidden for years. This all complicates the mourning process and impacts mourning rituals.

LGBTQ art therapy workshops offer this community the opportunity to come together in a safe environment to creatively work through their grief as well as to create art in honor of their loved one.

Michael created this beautiful rose Suncatcher (dyes on silk) to honor his late partner. His partner loved roses and had a beautiful rose garden. Unable to get support from his family and friends, Michael relied on his deceased partner’s family to comfort him on his grief journey.


Maggie’s grief was also disenfranchised by her partner’s family. In fact, shortly after the death, her partner’s children arrived at her home to take out their mother’s bedroom set. Maggie was assertive and didn’t allow this to happen. Sadly though, Maggie’s loss was complicated because her partner was the breadwinner. In addition to her death, Maggie lost her home and had to move to a smaller community away from her supports. The art therapy workshops allowed her to work through her feelings of grief and come to some acceptance. The groups provided a safe place for her to come, create and meet other members of her community who were grieving. Her piece, Door to Tomorrow, shows her feeling alone but hopeful.



Members of the LGBTQ community need to know that they have the right to grieve and that support is available.  Please consider attending one of our LGBTQ art therapy events. For more information, contact the bereavement center at 216.486.6838.



Click here to see our Spring Support Groups 2015.


Diane Snyder Cowan, Director, The Elisabeth Severance Prentiss Bereavement Center ©2015

Food and the Grief Connection

February 2, 2015

95168617After the death of a loved one, many newly bereaved lose their appetite and interest in food. However food can play an important role in grief work. Food is a harbinger of memories.  Aromas often transport us to the past, providing comfort and joy in treasured remembrances.

Think about the food that connects you with your deceased loved one. Was it a special meal? Was it the meal where he or she proposed? Was it associated with a holiday? Was it a late-night snack at the kitchen table or a picnic on a beach? Take a minute and you will most likely come up with many dishes. One or two will stand out.

Of all the special dishes my mother-in-law prepared, my husband’s childhood favorite was apple pancakes. With his eyes lit and mouth-watering, he is able to describe how his mother and grandmother would carefully core an apple, thinly peel the outer layer and slice it into circles. After the batter was on the griddle his mom would place one apple slice on it and then flip it over.

A master baker recently described a simple cheesy potato recipe that her mother used to make. With tears in her eyes she recalled how this dish, more than any fancy meal or celebration, connected her with her mother.

After my dad died, I could not look at a lemon bar without tearing up. Now I smile and take a bite on his behalf.

Many bereaved share stories about duplicating their deceased loved one’s recipes. One routinely makes her aunt’s cranberry relish for Thanksgiving despite the fact that no one eats it. For her, this ritual connects her with her aunt.

In grief work, continuing bonds are the objects or events that connect us to the deceased.  Continuing bonds are dynamic. They shift and change over time. Preparing your deceased loved one’s recipe can be one way to make and find meaning in your relationship. If you’re not into cooking, simply having that tasty treat or going to a restaurant that you both frequented will provide that bond.

Appetizers, entrées and desserts that transport us to special memories can provide meaning and comfort during the grief journey.

Please visit our on-line grief discussion groups.

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Choosing A Hospice: Bill Finn Offers Tips on NPR

January 20, 2015

The number opodcast picturef for-profit hospice firms has tripled in the last 15 years, and an analysis by The Washington Post  indicated that for-profit hospice firms often provide less nursing and crisis care.

That was the topic of discussion on NPR’s Diane Rehm Show Jan. 15, as guest host Frank Sesno moderated a forum on hospice care in the United States. The forum included Norman McRae CEO, Caris HealthCare LP; Dr. Joanne Lynn geriatrician, hospice physician and director of the Altarum Institute Center on Elder Care and Advanced Illness; Peter Whoriskey reporter, The Washington Post; and Tim Cox CEO, The Washington Home and Community Hospices.

Listen to the Jan. 15 podcast.

Hospice of the Western Reserve CEO Bill Finn, who heads the sixth largest non-profit hospice organization in the country, called into the show to offer his opinion on what potential clients should be looking for when choosing a hospice, especially in a crowded field.

“It’s more than profit vs. non-profit; we need to look at best practices, quality and service and it’s confusing for people trying to make decisions,” he said. “The next level should be, ‘Is this a hospice that employs full-time physicians? Is this a hospice that has certified staff? Is this a hospice that is JHACO certified? Or in our case, do they have a research institute? Do they have a full-blown pediatric program? Are they using other therapies that aren’t required under Medicare…music, massage, art therapy to enrich the experience? Do they have more than the minimum requirement of volunteers? Do they have their own in-patient units?’

“These are the things that strategically differentiate not just profit and non-profit but best practice hospice care in America. That’s what a consumer really needs when faced with a choice of 50 hospices and trying to figure out what the right thing to do is.”

In October of 2014, Consumer Reports issued its criteria on how to find a good hospice program. Key factors included: selecting a non-for profit hospice program with 20 or more years of experience, and having hospice-certified nurses and doctors on staff — and available– 24 hours per day. Read the entire Consumer Reports article here. 





When the unthinkable happens: Homicide and Grief

January 9, 2015

It seems as if the news is filled with senseless murders and of inexplicable interactions between the police and the community. The inconceivable happens – a special person dies in a sudden and unexpected way. When a loved one is murdered, family and friends often experience traumatic symptoms along with grief reactions.

Homicide is so sudden and unanticipated. It falls outside the usual experience of what one expects life to be like.  Abruptly losing a person in this manner can shatter one’s sense of well-being. Strong reactions are common, including fear, helplessness, shock, anger and even horror. These trauma reactions are normal responses to an extremely difficult time in our lives. But when you mix these reactions with grief, the results can be overwhelming.

Grieving parents of murdered children and grandchildren often mention that they feel like they are in “another world,” but the world around them doesn’t stop. It’s common to feel a sense of numbness, of “being in a fog.”

You may also feel:

  • Disbelief at what happened
  • Intense rage at the guilty party
  • Guilty as if somehow you could have prevented this tragedy
  • Preoccupied with visual images or sounds
  • Fear, distrust, helplessness, and hypervigilance
  • Blame, isolation, exploitation
  • Anger

The signs and symptoms of a stress reaction may last a few days, a few weeks, a few months, or longer, depending on the severity of the traumatic death.  The understanding and support of family and friends can help the stress reactions pass more quickly.  Here are a number of tips that can help during this very difficult time:

  • Maintain as normal a schedule as possible (as impossible as it seems); structure your time
  • Follow the basics for good health (even when you don’t feel like it) – rest, eat well, exercise
  • Reduce other stressors as much as possible – make to do lists, be patient with yourself when you can’t find your keys, limit distractions that might interfere with concentration
  • Be aware of numbing the pain with overuse of drugs or alcohol; go easy on caffeine
  • Talk to people – reach out, spend time with others
  • Do things that feel good to you – take a walk, listen to music, keep a feelings journal, etc.
  • Set boundaries with law enforcement officials, news media and friends and family
  • Give yourself permission to feel the pain and share these feelings with others
  • Don’t feel the need to fight reoccurring thoughts, dreams or flashbacks; they are normal and will decrease overtime and become less painful

Above all, know that you’re not going crazy. Your reactions are normal. However, there are times when a traumatic death is so painful that professional assistance may be helpful. Seek professional help if anger, anxiety and depression persist, worsen or begin to interfere with your life, job or relationships. Be kind and gentle with yourself and remember that there is no right or wrong way to grieve.

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Job Opening: Group Practice Manager

January 5, 2015


Location: Cleveland, OH

Responsible for the overall management of physician and palliative care services. Directs and coordinates the day-to-day business practice and scheduling of physician activities and patient visits, as well as overseeing the billing and coding for such services. The Manager demonstrates behavior consistent with the mission and vision of Hospice of the Western Reserve.


Bachelor’s degree in health or business administration; Minimum two years management experience in physician practice office setting; Demonstrated experience with medical practice contract negotiations and Part B billing.

Email resume and/or application to or fax to 216.298.0388.

Volunteer Opportunities

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About Hospice of the Western Reserve

Hospice of the Western Reserve provides palliative end-of-life care, caregiver support, and bereavement services throughout Northern Ohio.  In celebration of the individual worth of each life, we strive to relieve suffering, enhance comfort, promote quality of life, foster choice in end-of-life care and support effective grieving.

*Please do not submit resumes or any personal information in the comments section*

Botanical Gardens, Patient’s Beauty Inspire Hospice Nursing Assistant

January 5, 2015


Not everyone has the  opportunity to experience “life being lived to its fullest” at work, but one Hospice of the Western Reserve employee was so touched after taking accompanying a patient on a “day to remember,” she wrote a poem capturing the occasion, and created a digital picture to emphasize one of her patient’s more memorable days.

Hospice of the Western Reserve Nursing Assistant Christine Cross spent a “day to remember” with patient Arveda Helmick at the Cleveland Botanical Gardens in early November. With nature cooperating, Arveda was able to spend a beautiful day with the last of the year’s blooms outdoors and with the continuously blooming flowers in the Glasshouse.

Cross, a member of the Alt-home East team in Mentor, said the day was special for Arveda.

“She said she will never forget this moment, ever,” Cross said. “She was so touched and blessed to be a part of something special.  She said, ‘God must be looking down at me because it’s a beautiful day! The most precious gifts, is receiving things you cannot buy. I will forever hold this special day close to my heart.

The day was also special for the nursing assistant.arveda4

“It was so precious to see her eyes light up,” Cross said.

Cross, a talented photo editing artist, used an editing program to create a series of composites featuring Arveda.

“(Hospice of the Western Reserve social worker) Dawn Nickels gave her a beautiful scrap book that she did for her with my photos,” Cross said. “I downloaded a new app I was using for different pics of my own. I tried a few of hers just to see how they would turn out.  And they turned out awesome. She looks at her scrapbook daily and is just in awe and great memories she had.

“Having this experience with her is just the greatest gift ever. This is one of many reasons why I love my job.”

Nickels a social worker on the Mentor Alt East team made a scrapbook capturing the day’s events.  Nickels, who has been scrapbooking for more than 18 years created the book from photos taken during the day. She often makes books to commemorate patients’ “days to remember.”

Other team members chipped in to make the day memorable. Hospice of the Western Reserve home care nurse Kathy Rinehart, LPN preceptor Dawn Pechatsko and a volunteer also attended with Arveda.

In the days following IMG_9406the trip to the botanical gardens, Cross wrote the following to commemorate the day with her patient:

God’s beautiful picture

It surely was a beautiful this early November day.
Your face was beaming with great joy.
You melted my heart, as I saw the beauty within your eyes.
So many precious moments was captured throughout the day.
The beauty of nature, took your breath away. Then you said, “God Is Smiling Down On Me.”
No one could wipe that precious smile away. There were so many butterflies, but you could see the twinkle in your eye.
You stood there in awe, and admired the beauty within the butterfly. We walked through many gardens and picked up some leaves along the way. God painted a beautiful picture.
And we all shared it together on this beautiful, wonderful, blessed day.

What Do You Resolve to be More of in 2015?

December 31, 2014

It’s time to welcome a brand new year.
What are your New Year’s Resolutions for 2015?
What moments do you resolve to have more of? Be more of? See more of?

Here are some of our favorite stories of people who did more of in 2014.



More love? 





1More patriotic?

 lubrizolgroupMore service?

Sue with Heather Englander, BVU and Dennis Lehman, Executive VP and General Manager   More volunteering?

more joyMore joyful sounds? 

carousel_solinksy1214  More resilient?

amara wagner  More generosity? 



More earth friendly?



Hospice Honors WWII Vet, Real-Life Rosie the Riveter

December 29, 2014

A couple married almost seven decades was honored for serving the country during World War II during a special recognition ceremony hosted in their home in Independence Village, a senior living community in Avon Lake, Ohio.

The ceremony was planned by Hospice of the Western Reserve as part of its We Honor Veterans commitment to honoring and celebrating the contributions of veterans in its care, and providing services geared to the unique end-of-life needs of veterans and their families.

Joe and Helen Wilkinson, as well as several of Joe’s family members, were honored at a veterans recognition “pinning ceremony.” The ceremony for the couple, who began dating 74 years ago, included friends, family, members of their couple’s hospice care team, and nine members of the Avon Lake Honor Guard.

Joe, 91, was drafted at 17, serving in the Army’s Air Corps in World War II as a private first class. He was appointed Company Clerk because he was the only newly drafted soldier in the company who knew how to type. He was also charged with ensuring B-26 Maurader bombers were properly loaded.

While Joe was serving overseas, his fiancée, Helen, remained in the United States, working in a “Rosie the Riveter” position in Indiana, securing airplane wings with bolts.

Joe frequently wrote to Helen, eventually telling her he was coming home and to “get the wedding dress ready.” The couple married on Sept. 23, 1945, soon after Joe returned.

The pinning ceremony, which honors veterans, regardless of age or affiliation, included commemorative pins for Joe, as well as for his son Randy Wilkinson (Vietnam Marine Corps), grandson Michael Rowe (Air Force), brothers Paul  Wilkinson (World War II Army Corps of Engineers) and Jack Wilkinson (World War II Tanks Corps) and his daughter Nancy’s father-in-law Russell Rowe (World War II). Jack and Helen were both honored with certificates; Helen for her work stateside.

“I loved serving,” Joe said at the event. “I’d serve again.”

The multi-generational ceremony allowed Joe to remember not only his service to the country, but the courtship that began before he served and culminated in the long-term marriage. The couple, who were raised in CaIMG_0032-1rbon Hill, Ohio and have known each other since they were children.

“I knew I wanted to date Helen but her parents wouldn’t allow it until she was 16,” Joe said. “I’ve known her since she was a little kid. I was best friends with her brother. Our first date was at a party her family threw for her on her 16th birthday.”

The couple took several opportunities to exchange quick kisses after the ceremony which was led by Hospice of the Western Reserve volunteer and Navy veteran Greg Weiss.

Weiss said the ceremony is an important way to commemorate and honor veterans.

“These are some of the most humble people I can meet,” Weiss said. “It’s an honor and a privilege. Watching Joe’s face, I could see he was so proud. It meant so much to him. To have three generations of the same family serve and be honored together is so special.”

Nancy Rowe, Joe’s daughter, said hospice was a huge help.  “As my folks got older I realized the importance of hospice,” she said. “It’s been a relief taking a burden off my shoulders and my brother’s.”