This study examined 85 dyads of nursing home (NH) residents and relatives to understand how well family proxies understand residents’ preferences. Results demonstrate that proxies understand some preferences better than others and that the use of a dichotomous answer choice (important vs. not important) increases concordance within dyads. Notably, dyads differ on the recognizing the importance of growth activities for residents, with residents reporting greater importance than proxies. The study sheds light on how family members can inform care planning for residents.