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.

The no-cost PCC toolkit provides a new means to measure the quality of PCC delivery. As of February 2014, over 700 nursing homes have selected the Advancing Excellence in America's Nursing Homes PCC goal as a focus for quality improvement. The toolkit enables providers to incorporate quality improvement by moving beyond anecdote, and advancing more systematically toward honoring resident preferences.

Preferences are the expression of individuals’ basic psychosocial needs and are related to care outcomes. This study tested the consistency of people’s everyday preferences over one week, comparing responses of nursing home residents (n = 37; mean age 82) and university students (n = 50; average age 20). Participants completed the Preferences for Everyday Living Inventory at baseline and 5–7 days later. Preference consistency was calculated three ways. First, we calculated correlations (range = .11–.90), then the overall percent of exact agreement (e.g., response was “very important” at both time points), which was 66.1%. Lastly, we collapsed responses to “important” or “not important” and found an increase in percent agreement (86.6%). Personal care preferences were more stable, while leisure activities were less stable. The groups did not have significant differences in consistency. Some preferences are more consistent than others; age and frailty alone do not appear related to preference instability.