Unmet Preferences More Common Among Residents With Functional Impairment

Nursing home residents with poorer physical and sensory function and living in underresourced facilities are more likely to report unmet preferences, according to a study published online in the Journal of the American Medical Directors Association.

“The Preferences Assessment Tool in the Minimum Data Set (MDS) 3.0 assesses 16 resident preferences for daily routines and activities,” researchers explained in the study introduction. “Although integrating important preferences into care planning is essential to provide person-centered care in nursing homes, preferences rated as important but unmet or unimportant may not receive much attention.”

To identify the prevalence of unmet preferences as well as unimportant preferences, researchers examined 51,859 MDS assessments from 2012 through 2017. The assessments spanned a total 25,668 long-stay residents age 65 or older at 295 Minnesota nursing homes.

The rate of residents reporting 1 or more unmet but important preferences for daily routines and activities was 3.3% to 5.1% across all years, according to the study. Meanwhile, 10% to 16.6% of residents deemed 4 or more daily routine and activity preferences as unimportant.

Residents with higher depressive symptoms and functional and sensory limitations were more likely to report preferences were unmet. Residents with functional and sensory limitations and living in rural nursing homes and facilities with fewer activity staff hours per resident were more likely to report unimportant preferences, the study found.

“It is important for staff to elicit preferences that truly matter for residents,” researchers advised, “and to enable residents to meet their preferences.”

—Jolynn Tumolo

Reference:

Duan Y, Shippee TP, Ng W, et al. Unmet and Unimportant Preferences Among Nursing Home Residents: What Are Key Resident and Facility Factors? [published online ahead of print, 2020 Jul 29]. J Am Med Dir Assoc. 2020;S1525-8610(20)30556-9. doi:10.1016/j.jamda.2020.06.033