The effect of staff care practices on nursing home residents' preferences: Implications for individualizing care

Purpose: To examine the effect of staff care practices on nursing home residents' preferences for dining location. Methods: A cross-sectional study was conducted with 304 long-stay residents in six skilled nursing homes. Research staff conducted direct observations during meals for two days and interviewed residents on the same two days about their preferences for dining location for each scheduled meal (breakfast, lunch and dinner). Results: Staff care practices were significantly related to residents' preferences to eat in the dining room for all meals after adjusting for resident characteristics and nurse aide staffing level. For each unit increase in the proportion of residents taken to the dining room for meals by staff, residents' preferences to eat in the dining room also significantly increased by approximately three to four percent for each mealtime period. Discussion: Staff care practices may influence residents' reported preferences for dining location. Daily care practices may be inappropriately justified by residents' preferences, which are shaped by their nursing home care experience and reduced expectations. In efforts to individualize resident care, nursing home staff should consider the influence of established care practices on residents' reported preferences for daily care.