Are you taking care of residents or conditions?

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John O'Connor
John O'Connor

Mr. Fogel quietly passed away last week at a Chicago-area nursing home. Most of the staff didn't know he was in the building. Among the few who did, he was a resident with heart problems.

That's hardly surprising, and this description is not meant to insult an operator with a solid reputation. But it does speak to a larger trend we're seeing: residents as conditions.

It's not too hard to see why this shift is happening. Staff turnover is a constant challenge, especially among frontline caregivers. Plus residents tend to come and go much more quickly these days. And in the increasingly frantic world of long-term care, identifying short-stay residents by an obvious condition can be a real time saver.

We should probably expect this trend to become even more pronounced as long-term care facilities keep looking and acting more like their kissing cousins, hospitals.

Given these drivers, it can be tempting to get sucked into the conditions vortex — and forget what put long-term care settings on the map.

Which brings me back to Mr. Fogel. Or Bob, as his friends called him. Prior to temporarily occupying a nursing home bed, he accomplished a few other things during his 86 years on the planet.

One was writing a book debunking the myth about slavery being an unprofitable and dying business prior to the Civil War.

He also wrote another controversial book: "Railroads and American Economic Growth: Essays in Econometric History." The publication gives trains far less credit for economic development than its advocates typically claim.

He also spent more than 25 years examining how Union Army veterans aged. He did this to gain a deeper understanding of how better nutrition, improved working condition and fewer diseases were contributing to longer lives. In all, Fogel researched and wrote more than 20 books, as well as countless research papers. He was considered a pioneer in the use of cliometrics. This discipline examines history by applying economic theory and statistical methods. These days, that approach would be called analytics.

His penchant for rigorous data analysis and persistent research was legendary. He once told a colleague, “If it's worth doing, it's worth spending 10 years to get it right.”

And oh, by the way, he was also awarded the 1993 Nobel Prize for Economics. All in all, a pretty good run.

Most residents are in pretty bad shape by the time they arrive at your facility. And it can be easy to see them as nothing more than “heads in beds.” While such cynical sentiment can creep into a field largely defined by census levels, it's ultimately damaging.

Every resident in your community has experienced the joys and sorrows that living brings. They are all important. Most are worth getting to know better. And some, like Dr. Fogel, are truly national treasures.

They are not conditions. They are not numbers. They are people. Never forget that.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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