“It Depends”: Reasons Why Nursing Home Residents Change Their Minds About Care Preferences

Abstract

Findings indicate that nursing home residents' preferences may change in importance or fulfillment in relation to personal or environmental circumstances. In order to develop formal care that matches older adults' preferences, regular assessment of both elders' preferences and the contextual factors affecting preferences is needed. However, given the changing nature of preference importance, there is also a need to determine how to best balance older adults' changing preferences within care delivery environments.

Examining Clinical Predictors of Change in Recreational Preference Congruence Among Nursing Home Residents Over Time

“…Those residents that were functioning better were more likely to attend more activities that aligned with their important preferences. These findings are consistent with prior work that documents that residents' preferences can be restricted by or can change due to within person or personal factors (e.g., sensory ability, level of interest in preference fulfillment; Heid et al, 2014). As found by prior work, it may be that as individuals experienced increased disability (e.g., in vision, language, continence, range of motion, cognitive capacity), they also experienced a change in their ability to engage in the same way with their environment or achieve person by environment fit (Bartoli, Aguzzi, & Tarricone, 2010;Lawton & Nahemow, 1973;Marioni et al, 2014;Marsiske, Klumb, & Baltes, 1997;Rosso, Taylor, Tabb, & Michael, 2013).…”

“…In addition, more frequent assessments of preferences may facilitate a more nuanced understanding of how preferences relate to person-level characteristics. This study does not document change in importance ratings over the 52-weeks; it may be that some preferences remain stable while others change (Heid et al, 2014;. Further work should examine the impact of potentially shifting preferences over time.…”

“…Further work is needed to explore the environmental characteristics and characteristics of the caregivers that impact PC in care. As found in Heid et al (2014), the process of meeting a person's preferences is also affected by facility barriers of scheduling, the quality of relationship, or training staff have with the residents to whom they provide care. In addition, work documents the challenges of meeting individuals needs/wants due to the workings of the institution as a whole (Ulsperger & Knottneurs, 2011) and the environment in which one lives (Lawton & Nahemow, 1973).…”

“…Individual characteristics (i.e., functional, cognitive, sensory, language) may make it more challenging to meet the needs of residents or to create person by environment fit and require tailoring of services , while other characteristics may support the delivery of PCC (Heid et al, 2014).…”

Person‐directed care planning in nursing homes: A scoping review

“…PDCP also requires integrating knowledge of the person's priorities and preferences into care planning (Heid et al, 2016; Iris et al, 2012). Then, the care plans can guide daily practices.…”