Unmet and Unimportant Preferences Among Nursing Home Residents: What Are Key Resident and Facility Factors?
Yinfei Duan, Tetyana P Shippee, Weiwen Ng and 7 others
PMID 32739282WHAT IT FOUND
Few residents reported unmet preferences for daily routines or activities, but 13.5% to 16.6% said more than half of daily routine preferences were unimportant.
Poorer physical function and sensory loss were linked to both; depression was linked to unmet preferences.
Key findings
01In 2012, 5.1% reported at least one unmet daily routine preference and 4.6% reported at least one unmet activity preference; by 2017, 3.3% reported unmet preferences for daily routines or activities.
02Residents with poorer physical function, impaired sensory function or more depressive symptoms were more likely to report unmet preferences, while residents with dementia were less likely to report unmet preferences.
03Poorer physical function, sensory impairment, rural facilities and fewer activity staff hours were associated with more unimportant preferences.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only residents who answered the preference assessment themselves were included; 16.5% had family or staff report preferences, so residents who could not answer themselves are missing. Very few residents reported more than one unmet preference (1.45% for daily routines, 0.82% for activities), so the study mainly captures whether at least one preference was unmet. The study was limited to Minnesota nursing homes, so results may not apply to all US nursing homes. An unimportant rating may reflect expected barriers or social desirability rather than true lack of interest, so it may underestimate unmet preferences. Residents from atypical facilities were excluded, including facilities with high proportions of younger, short-stay, or mentally ill residents. Facility quality measures and PIPP rounds were included, but no significant associations with preferences were found.
Declared interests
The article text does not include a conflicts of interest or funding declaration. The publication type lists NIH extramural research support.
The easy way to misread this
Do not read low unmet preference reports as proof that nursing home preferences are being met. Residents may mark preferences unimportant because they expect the facility cannot fulfill them, so unimportant ratings may hide unmet needs.