The Value of Resident Choice During Daily Care

Abstract

Allowing long-term care (LTC) residents to make choices about their daily life activities is a central tenet of resident-centered care. This study examined whether staff and family rated care episodes involving choice differently from care episodes not involving choice. Seventeen nurse aide and15 family participants were shown paired video vignettes of care interactions. Participants were asked to rate their preferred care vignette using a standardized forced-choice questionnaire. Focus groups were held separately for staff and family members following this rating task to determine reasons for their preferences. Both staff and family rated the vignettes depicting choice as “strongly” preferred to the vignettes without choice. Reasons provided for the preference ratings during the focus group discussions related to resident well-being, sense of control, and respondents’ own personal values. These findings have implications for LTC staff training related to resident-centered care to promote choice.

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

“…For example, federal nursing home regulations updated in 2016 add residents, their families and direct caregivers to the interdisciplinary teams responsible for determining care goals (CMS, 2016). Even prior to the 2016 reform, federal guidelines made resident choice over daily schedules a right and instructed nursing home inspectors to determine whether residents were offered daily life choices (Simmons, Durkin, Rahman, Schnelle, & Beuscher, 2014). Similarly, the Patient Self‐Determination Act of 1991 advanced individuals’ abilities to participate in their own care across healthcare settings, including nursing homes (Mallers, Claver, & Lares, 2014).…”

“…At organisational and interpersonal levels, staff and residents’ families must recognise the importance of PDCP to the well‐being of residents, as such recognition can support staff to engage in PDCP (Simmons et al, 2014). From the perspective of the adaptive leadership framework, such recognition is essential to the collaborative work among nursing home residents, their families, and staff (Corazzini & Anderson, 2014).…”

“…Although the many beneficial outcomes of PDCP reflect its wide‐ranging value and there is general agreement that perceived control is important for older adults’ well‐being (Simmons et al, 2014), inconsistency across studies in operationalising PDCP and examining its outcomes limits our knowledge. Furthermore, care planning interventions often are implemented in conjunction with other efforts, making it difficult to determine which changes are affecting outcomes (Stanhope et al, 2015).…”

A Controlled Trial of an Intervention to Increase Resident Choice in Long Term Care

“…Prior to training, the video vignettes were presented to groups of families and NAs who rated the scenarios in which active choice was offered as reflecting significantly higher quality care than the scenarios in which no or passive choice was offered. 23 These results suggest that the vignettes demonstrating active choice reflect care that caregivers regard as high quality. A sampling of these training videos can be viewed online at http://www.VanderbiltCQA.org/Choice.…”

“…To spur replication, the intervention tools needed for staff training and monitoring (i.e., the video vignettes and the observational tool) have been rigorously evaluated and found reliable. 8,9,23,28 These tools are now publicly available online at no charge (go to http://www.VanderbiltCQA.org/Choice). Nurse supervisors do not have to spend as much time observing care as research staff spent in this study; however, we do recommend weekly observations of care for a small sample of residents (3–6) identified by staff as requiring assistance with morning care.…”