6; most were men (61%), and almost all were Caucasian (95.7%). On the Mini-Mental State Examination, they had a mean score of 24.96 (3.56 standard deviation) and a range of scores from 12 to 29, indicating that some individuals had mild to moderate levels of cognitive impairment. 15 Research assistants (RA) at both sites interviewed residents using the Preferences for Everyday Living Inventory (PELI). Developed and tested with home health and NH populations, the PELI elicits seniors’ preferences related to 55 daily activities that fall into 5 preference domains: growth activities (eg, reading),

diversionary (eg, watching TV), self-dominion (eg, choosing what to eat), social contact (eg, keeping in contact with family), and caregivers and care (eg, giving instruction to formal caregiver).16 Several click here of the PELI items were subsequently selected for inclusion in the MDS 3.0, which is used in all Medicare and Medicaid certified NHs.17 RAs asked participants whether they liked each

activity “a lot,” “somewhat,” or “not at all” (scale: 2 to 0). If the response was “likes a lot,” researchers asked about preference satisfaction: “How satisfied were you with the fulfillment of this preference over the last 2 weeks?” Possible responses were “not at all satisfied,” “somewhat satisfied,” and “completely satisfied” (scale: 0 to 2). These response options were selected because cognitively impaired individuals are frequently overwhelmed by the cognitive Sorafenib ic50 load imposed by more options. Researchers constructed a measure of preference congruence by examining the relationship between strongly held preferences and a resident’s self-report of their satisfaction with care related to those preferences. Respondents had strong preferences (“likes a lot”) for a mean of 29 items (standard deviation = 10.32), with a range from 12 to 51 items for the sample. On average, respondents reported that three-fourths (75.6%) of their most strongly endorsed preferences either were “completely satisfied” (mean percent = 52.8) or “somewhat satisfied” (mean percent = 3-mercaptopyruvate sulfurtransferase 22.8). One-fourth were “not satisfied at all” (mean percent = 24.4). To account for acquiescence

bias,18 only the response, “completely satisfied,” was chosen to represent preference congruence. An Excel spreadsheet calculated a preference congruence indicator for each respondent on every item. A difference score was created by subtracting the respondent’s “likes a lot” score (2) from his or her satisfaction rating (0–2, where a higher number represents higher satisfaction). The team chose only to calculate a preference congruence score based on strongly endorsed preferences (“likes a lot”). The goal was to focus staff attention on important preferences as a first step toward individualizing care delivery. The resulting Excel report was color-coded for easy interpretation. Red indicated a strongly held preference that a resident felt was “not satisfied at all.