The impact of nursing home residents’ characteristics on ratings of importance of autonomy preferences in daily care over time

Abstract

Objective: Nursing home (NH) residents’ preferences for everyday living are the foundation for delivering individualized care. Yet, work has not examined the impact of demographic and clinical characteristics of NH residents on the stability of their preferences over time.

Method: This study examined the rate of change in reports of importance of 27 autonomy-related everyday preferences from the Preferences for Everyday Living Inventory over 3-months and the demographic and clinical characteristics associated with change for nursing home residents (N = 255). Descriptive frequencies and tests of mean difference were utilized to examine differences between individuals reporting change in importance over time compared to those that did not report change.

Results: Autonomy preferences in daily care remained stable over 3-months for the majority of residents. For residents that did report change on autonomy preferences, no systematic associations of demographic or clinical characteristics were found to be associated with change. Rather, change was associated with differential characteristics based on the preference.

Conclusion: This study indicates that knowing a person’s demographic or clinical characteristics in care will not uniformly inform a caretaker’s understanding of the individual’s reports of importance for autonomy related preferences over time. Future work should explore the role of care environment on change in preference ratings over time.

Keywords:

• Person-centered care
• everyday preferences
• nursing home residents
• autonomy

Acknowledgments

We would like to thank Karen Eshraghi and Christina Duntzee, the research team members who worked diligently to collect these data, and the older adults who participated in the project.

Conflicts of interest

None

IRB approval

All procedures were approved by the Madlyn and Leonard Abramson Center for Jewish Life Institutional Review Board (Assessing preferences for everyday living in the nursing home: Reliability and concordance issues; IRB Protocol #: 120901).

Additional information

Funding

This work was made possible by generous funding from an NINR grant(R21NR011334: PI Van Haitsma) and The Patrick and Catherine WeldonDonaghue Medical Research Foundation. The content is solely theresponsibility of the authors and does not necessarily represent theofficial views of the National Institute of Nursing Research, theNational Institutes of Health, or the Donaghue Foundation. M. Rovinewas further supported by the National Center for Research Resourcesand the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1 TR000127.