Adults who receive long-term services and support experience better health and well-being when their care reflects their values and preferences. To ensure that this level of care is available to all Americans, it is vital that state and national policy, regulations, and financing take an evidence-based approach that reflects and promotes preference-based, person-centered care.
This section of the website shares our research and its policy implications for advancing preference-based care in long-term services and support settings. We highlight studies focused on five areas:
- Preference assessment
- Measuring quality outcomes for nursing home residents
- Measuring quality outcomes at the organizational and statewide level
- Balancing resident preferences with health and safety risk
- Person-centered care implementation
Our studies show that nursing home communities achieve better outcomes when they use practical, scientifically tested tools to assess older adults’ preferences, integrate that information into care plans, and evaluate their success in aligning preferences with care. The outcomes include:
- Greater resident satisfaction with care
- Better star quality ratings
- Fewer deficiencies and complaints
These are key indicators for consumers, providers, regulators, and policymakers seeking to improve quality of care and quality of life in America’s nursing homes.
Preference Assessment
Preference assessment ensures that nursing home residents live according to their wishes and receive quality care. This set of articles highlights the importance and reliability of preference assessment tools and consistency of resident preferences over time. Policy implications include:
- Timing preference assessments at key intervals during nursing home stays
- Prioritizing preference integration into care practices
- Providing staff training
- Allocating adequate resources to support these components.
The stability of nursing home residents’ ratings of importance of recreation preferences over one year.
Heid, A., Abbott, K., Rovine, M., Eshraghi, K., Madrigal, C., Crumbie, V., & VanHaitsma, K. (2022). The stability of nursing home residents’ ratings of importance of recreation preferences over one year. Journal of Applied Gerontology, 41(8), 1942–1951. https://doi.org/10.1177/07334648221089239
The change in nursing home residents’ preferences over time.
Abbott, K. M., Heid, A. R., Kleban, M., Rovine, M. J., & VanHaitsma, K. (2018). The change in nursing home residents’ preferences over time. Journal of the American Medical Directors Association, 19(12), 1092-1098. doi:10.1016/j.jamda.2018.08.004
Delivering person-centered care: Important preferences for recipients of long-term services and supports.
Abbott, K. M., Klumpp, R., Leser, K. A., Straker, J. K., Gannod, G. C., & Van Haitsma, K. (2018). Delivering person-centered care: Important preferences for recipients of long-term services and supports. Journal of the American Medical Directors Association, 19(2), 169-173. doi: 10.1016/j.jamda.2017.10.005. https://www.ncbi.nlm.nih.gov/pubmed/29146223
The consistency of self-reported preferences for everyday living: Implications for person-centered care delivery.
VanHaitsma, K., Abbott, K. M., Heid, A. R., Carpenter, B., Curyto, K., Kleban, M., Eshraghi, K., Dunzee, C., & Spector, A. (2014). The consistency of self-reported preferences for everyday living: Implications for person-centered care delivery. Journal of Gerontological Nursing, 40(10), 34-46. doi:10.3928/00989134-20140820-01
Measuring Quality Outcomes for Nursing Home Residents
This group of articles focuses on methods to measure delivery of preference-based, person-centered care care. Our most recent studies find that:
- Residents with higher preference satisfaction ratings report significantly higher satisfaction with overall care.
- The Preference Match Tracker, a new pragmatic person-centered tool enables nursing home providers to systematically assess preferences, evaluate the congruence between resident preferences and actual care delivery, ask residents about their satisfaction, and chart organizational priorities for continuous quality improvement.
The association between preference satisfaction and satisfaction with overall care for nursing home residents.
Madrigal, C., Mogle, J., Abbott, K., Mills, W., Fick, D., Scanlon, D., Behrens, L., Eshraghi, K., & VanHaitsma, K. (2022). The association between preference satisfaction and satisfaction with overall care for nursing home residents. Journal of Aging & Social Policy, 34:5, 707-722, doi: 10.1080/08959420.2022.2029265
Honoring the everyday preferences of nursing home residents: Perceived choice and satisfaction with care.
Bangerter, L. R., Heid, A. R., Abbott, K., & VanHaitsma, K. (2017). Honoring the everyday preferences of nursing home residents: Perceived choice and satisfaction with care. The Gerontologist, 57(3), 479. doi: 10.1093/geront/gnv697. https://www.ncbi.nlm.nih.gov/pubmed/26874190
Honoring nursing home resident preferences for recreational activities to advance person-centered care.
Van Haitsma, V., Abbott, K.M., Heid, A., Spector, A., Eshraghi, K., Duntzee, C., Humes, S., Crumbie, V., Crespy, S., Van Valkenburgh-Schultz, M. (2016). Honoring nursing home resident preferences for recreational activities to advance person-centered care. Annals of Long-Term Care and Aging, 24(2): 25-33. https://www.hmpgloballearningnetwork.com/site/altc/articles/honoring-nursing-home-resident-preferences-recreational-activities-advance-person-centered]
New toolkit to measure quality of person-centered care: Development and pilot evaluation with nursing home communities.
VanHaitsma, K., Crespy, S., Humes, S., Elliot, A., Mihelic, A., Scott, C., Curyto, K., …Abbott, K. (2014). New toolkit to measure quality of person-centered care: Development and pilot evaluation with nursing home communities. Journal of the American Medical Directors Association, 15(9), 671-680. D https://www.ncbi.nlm.nih.gov/pubmed/24721341 doi:10.1016/j.jamda.2014.02.004.
Measuring Quality Outcomes at the Statewide and Organizational Level
Our large-scale study of an Ohio statewide care pay-for-performance initiative provides important insight into the design of person-centered care incentive programs. We report on :
- Specific elements of the Ohio initiative
- Organizational factors associated with the adoption of a comprehensive preference assessment too
- Positive outcomes for nursing homes.
Also, our publications discuss the value of implementation science and Agile methodologies for accelerating quality improvement in nursing homes.
These studies underscore the need for policies and financing that support:
- Provider training
- Adequate staffing levels
- Ongoing research to promote person-centered care practices.
Can implementing person-centered care tools reduce complaints? Evidence from the implementation of PELI in Ohio nursing homes?
Kunkel, M., Bowblis, J., Straker, J., VanHaitsma, K., & Abbott, K. (2024). Can implementing person-centered care tools reduce complaints? Evidence from the implementation of PELI in Ohio nursing homes. Journal of Aging & Social Policy, 1–15. doi: 10.1080/08959420.2023.2265775
Impact of implementing the Preferences for Everyday Living Inventory on nursing home survey deficiencies.
Kunkel, M., Bowblis, J., Straker, J., Van Haitsma, K., & Abbott, K. (2023). Impact of implementing the Preferences for Everyday Living Inventory on nursing home survey deficiencies. Journal of the American Medical Directors Association, 24, 1: 113-118, https://doi.org/10.1016/j.jamda.2022.10.021
Exploring the relationship between extent of person-centered care implementation and staffing levels in Ohio nursing homes.
Kunkel, M. C., Bowblis, J., Straker, J., Van Haitsma, K., & Abbott, K. M. (2023). Exploring the relationship between extent of person-centered care implementation and staffing levels in Ohio nursing homes. Journal of Applied Gerontology, 42(11), 2189-2197 . https://doi.org/10.1177/07334648231185274
Organizational and resident characteristics of nursing homes associated with partial and complete implementation of the Preferences for Everyday Living Inventory (PELI).
Madrigal, C., Moore, R., Kunkel, M., Bowblis, J., Straker, J., VanHaitsma, K., & Abbott, K. (2023). Organizational and resident characteristics of nursing homes associated with partial and complete implementation of the Preferences for Everyday Living Inventory (PELI). Innovation in Aging, 7(2). https://doi.org/10.1093/geroni/igad008
A Rising tide lifts all boats: Equitable nursing home policy through implementation science.
Abbott, K., Douglas, N., VanHaitsma, K. (2022). A Rising tide lifts all boats: Equitable nursing home policy through implementation science. Public Policy & Aging Report, 32(1), 6-12, https://doi.org/10.1093/ppar/prab030
Applying Agile methodology to reengineer the delivery of person-centered care in a nursing home: A case study.
Abbott, K., Hulshult, A., Eshraghi, K., Heppner, A., Crumbie, V., Heid, A. R., Madrigal, C., Spector, A., & Van Haitsma, K. (2022). Applying Agile methodology to reengineer the delivery of person-centered care in a nursing home: A case study. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2022.05.012
Exploring the criterion validity of pragmatic person-centered care/culture change measures.
Kunkel, M. C., Madrigal, C., Moore, R., Bowblis, J. R., Straker, J., Nelson, M., Van Haitsma, K., & Abbott, K. M. (2022). Exploring the criterion validity of pragmatic person-centered care/culture change measures. Journal of Applied Gerontology, 41(12), 2542–2548. DOI: 10.1177/07334648221117528
Lessons learned From Ohio’s statewide implementation of the Preferences for Everyday Living Inventory as a pay for performance initiative to enhance person-centered care.
Abbott, K., Elliot, A., VanHaitsma, K. (2021). Lessons learned From Ohio’s statewide implementation of the Preferences for Everyday Living Inventory as a pay for performance initiative to enhance person-centered care. Journal of the American Medical Directors Association, 22(10), 2074-2078, https://doi.org/10.1016/j.jamda.2021.06.011
Recommendations to deliver person-centered long-term care for persons living with dementia.
Wagner, L. M., Van Haitsma, K. , Kolanowski, A., & Spetz, J. (2021). Recommendations to deliver person-centered long-term care for persons living with dementia. Journal of the American Medical Directors Association, 22(7), 1366–1370. https://doi.org/10.1016/j.jamda.2021.05.003 . https://www.jamda.com/article/S1525-8610(21)00428-X/fulltext#relatedArticles
Resident preferences and CNA empowerment: An exploratory factor analysis of culture change.
Abbott, K.M., B.K., A., Straker, J., & Brown, J.S. (2020). Resident preferences and CNA empowerment: An exploratory factor analysis of culture change. Journal of Applied Gerontology, 39(12), 1284-1291. https://doi.org/10.1177/0733464819884862
Balancing Preferences and Managing Risk
This set of articles focuses on the organizational and caregiving dilemmas that arise when resident preferences may involve risk. Our research highlights the need to develop:
- Evidence-based training and protocols to improve staff competence in addressing risky preferences
- Organizational and regulatory policies that support care teams in balancing preference fulfillment with health and safety risks.
Assessment of nursing staff learning needs around person-centered risk management in nursing homes
Behrens L., Madrigal, C., Dellefield, M.E. (2023). Assessment of nursing staff learning needs around person-centered risk management in nursing homes. Journal of Gerontological Nursing, 49(2):7-12. doi: 10.3928/00989134-20230106-02.
Nursing staff perceptions of outcomes related to honoring residents’ “risky” preferences.
Behrens, L., Boltz, M,, Sciegaj, M., Kolanowski, A., Jones, J.R., Paudel, A., & VanHaitsma, K. (2022). Nursing staff perceptions of outcomes related to honoring residents’ “risky” preferences. Research in Gerontological Nursing, 15(6):271-281. https://doi: 10.3928/19404921-20220930-01.
Negotiating risky preferences in nursing homes: A case study of the Rothschild person-centered care planning approach.
Behrens, L., Van Haitsma, K. S., Brush, J., Boltz, M. P., Volpe, D. & Kolanowski, A. M. (2018). Negotiating risky preferences in nursing homes: A case study of the Rothschild person-centered care planning approach. Journal of Gerontological Nursing. 44(8), 11-17. doi: 10.3928/00989134-20171206-02. https://www.ncbi.nlm.nih.gov/pubmed/29355878
Person-Centered Care Implementation
This set of articles investigates person-centered care innovation in nursing homes and the impact of evidence-based practices on care quality:
- The Individualized Positive Psychosocial Intervention (IPPI) is an innovative program shown to reduce distress and improve wellbeing among residents living with dementia and is currently being tested in a multi-site implementation study.
- Incorporating evidence-based, foundational concepts into policy, programming, and training initiatives can re-center residents’ overall care experience and quality of life at each level of the care process.
Evaluating the implementation of the Individualized Positive Psychosocial Interaction (IPPI) as a quality improvement project in nursing homes.
Kasler, K., Heppner, A., Van Haitsma, K., Abbott, K. (2024). Evaluating the implementation of the Individualized Positive Psychosocial Interaction (IPPI) as a quality improvement project in nursing homes. The Gerontologist. Doi:10.1080/07317115.2024.2317403
Person and family centered care: Comprehensive care planning.
Boltz, M., Abbott, K., Berman, A., Fazio, S., Molony, S., Ratliff, K., VanHaitsma, K., & Zimmerman, S. (2024). Person and family centered care: Comprehensive care planning. In Practice and Leadership in Nursing homes: Building on Academic-Practice Partnerships. JoAnne Reifsnyder, Ann Kolanowski and Jacqueline Dunbar-Jacob. (Eds). Indianapolis, IN: Sigma Theta Tau International.
Project Impact Reports