This study examines stability of nursing home (NH) residents’ preferences (n = 255) related to autonomy over time, and demographic and clinical characteristics associated with change. For the majority of residents, preferences related to autonomy remained stable over 3-months. When analyzing group differences for residents reporting change versus others, no systematic associations with resident demographic or clinical attributes were found; however, differences by preference did emerge. For practitioners, the study suggests that knowing a resident’s characteristics may provide insight into how the person’s autonomy preferences may evolve over time.