The Change in Nursing Home Residents' Preferences Over Time

Nursing home (NH) residents' preferences for everyday living are the foundation for delivering individualized person-centered care. Yet, work has not examined what the most and least important preferences of nursing home residents are and if those preferences change over time.

This study examined the change in nursing home residents' (n = 255) preferences for everyday living over a 3-month period. Participants were recruited from 28 NHs in the suburbs of a major metropolitan East Coast area of the United States.

Residents were interviewed face-to-face using the Preferences for Everyday Living Inventory-Nursing Home version at baseline (T1) and 3 months later (T2). Change was analyzed in 2 ways: (1) percentage exact agreement (eg, respondent stated "very important" at both time points) and (2) percentage of preferences that remained either important or not important between T1 and T2.

Sixteen preferences were rated as very or somewhat important by 90% or more of NH residents. With regard to the stability of preference ratings, findings demonstrate an average exact agreement of 59%, and an average important versus not important agreement of 82%. In addition, 68 of the 72 preferences had 70% or higher stability over time. In other words, the preference either remained "important" or "not important" to the NH resident 3 months later. Preferences in the domain of enlisting others in care had the least amount of change.

This study highlights the most important everyday living preferences of NH residents and provides assurance to care providers that the majority of preferences assessed via the PELI are both important to NH residents and stable over time. Preference-based care plans can be designed and used over a 3-month period with confidence by providers.