This was always a loaded HR category for me and it usually applied to sending people home early in anticipation of big snowstorms. Now it has new meaning as health care facilities and all industries and services redefine work roles.

Because of the Fields specialties in dementia particularly and complex geriatrics generally, essential depends on who you ask. As a private business, the challenge to have enough staff but not too many is a puzzle of micro and macroeconomics, supply and demand and, sometimes, it feels like an effort to ignore or marginalize universal principles like gravity and thermodynamics.

Some departments are easy to manage, relatively, as breakfast, lunch and dinner are pretty straightforward. Executive chef Bill has managed the dietary expenses very well and provided the food-based hospitality program as tastefully and cheerfully as any fine country club or resort.

Theologian John Wesley is credited with the cleanliness is next to godliness saying and our laundry and housekeeping people are assured of good seats in heaven. Geriatrics is a messy business but looking good, feeling good and providing a sanitary and appealing environment are intertwined. Endless laundry, relentless cleanliness and sanitizing and good hair, make-up and clean clothes for everyone all the time are what families identify as the traits that set us apart and above other providers in the region.

Considering our customers principle diagnoses of dementia and its subtypes and the carefree practice of hygiene and grooming in people with Alzheimer’s disease, these are indeed essential personnel.

The Fields’ health care hotels link nursing and activities almost as one in my public health geriatrics philosophy. Health management and maintenance of conditioning the bodies and the minds in the course of dementia are clearly the best practice. We can’t cure dementias but a unified program can decrease the medical and psychological problems along the way and provide excellent quality of life in the face of devastating and fatal diseases.

Non-clinical managers and administration are small teams with excellent individual and group skills. They manage a big small business with 200 employees, 100 guests and about 300 family members and outside staff coming and going.

Which leaves me my Buddhist management philosophy is to make my presence unnecessary. In other words, to become non-essential.