The key business principle always applies, even with death

James M. Berklan
James M. Berklan

No matter how you slice whatever you do for a living, you are employed to provide one thing: good customer service. Knowing what your “customer” wants and needs, and then getting it to him or her, is the route to success.

That's why I was so intrigued with new study results this week pertaining to end-of-life care. The big takeaway: Families of patients who had cancer or dementia said end-of-life care was better than for those dealing with other conditions.

Cancer and dementia coming out on top for once? There was a whiff of “man-bites-dog” to this story.

The reasons behind the findings wind up pretty logical, if not so easy to guess. They have profound implications, especially for long-term care providers.

One of the main reasons family members scored cancer and dementia experiences higher was those conditions came with higher rates of palliative care consultations. There were also fewer do-not-resuscitate orders, and communication between patient and caregivers was viewed as far better than average.

(To get it right out in the open, researchers acknowledged that the National Palliative Care Research Center had a hand in funding the study, as did three governmental groups. Study authors also pointed out that their funding sources had no role in designing, conducting or interpreting the study.)

So where does that leave us? With people nearing the end of their life liking it when caregivers consulted them on their feelings and choices.

Some would call it customer preferences.

Relatively fewer cancer and dementia patients died in intensive care units, researchers also found. That might not indicate choice, but it is something worth tucking behind the ear for possible later use when you're on the floor with frail, vulnerable older individuals all around you. Setting of death is a strong marker of satisfaction, or dissatisfaction.

The other conditions considered in this “report card” of end-of-life experiences were: end-stage renal disease (ESRD), cardiopulmonary failure (congestive health failure or chronic obstructive pulmonary disease) and frailty.

Researchers indicated that more talking, planning and consulting with these patients could bring better end-of-life care. The question is, why stop with them? Why not apply these principles to every kind of health-compromised resident in your care?

An overwhelming number of your residents are closer to death than you are. Why not find out what would make their final days better — before those final days arrive. Before they are unavoidable.

In turn, it would make for more peaceful sleep and contented days before the true end stages come. Talk about reverse engineering a success story.

And it all comes down to good customer service.

Follow James M. Berklan @JimBerklan.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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