Assessing Choices Made Available to Nursing Home Residents

By Richard Shank

Person-centered care is an important concept that has gained widespread acceptance in the long-term care community, and discussions about it revolve around providing care recipients with choices. Vanderbilt University researchers published an evaluation of a survey process designed to assess the availability of choices for nursing home residents.

The researchers’ hope was to provide nursing home operators and state survey administrators with a method to assess the provision of resident choice throughout the day. Their goal was to describe a standardized observation protocol that will determine whether nursing home staff members offer choices to residents during everyday activities.

In their evaluation of the protocol, they observed staff-resident interactions during activities and compared their data to the deficiency statements cited by state survey staff. In all 20 nursing homes they examined, staff failed to provide choices to residents in at least one of the three activities of daily living performed. Residents were most often not offered the choice of when to get out of bed, what to wear, and where they’d like to eat breakfast. These deficiencies of care were not detected by state survey staff. In fact, only two deficiencies were reported in any of the 20 nursing homes enrolled in the study.

The study results indicate that both nursing home operators and state survey staff can utilize a standardized observation protocol in their efforts to ensure that nursing home staff members honor residents’ choices.

Source: Schnelle, J. Bertrand, R., Hurd, D. et al. 2009. Resident choice and the survey process: The need for standardized observation and transparency. The Gerontologist 49(4): 517-524.

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