Providing Resident Directed Care

Offering choice and honoring preferences are key points of culture change, resident quality of life, and recent focus of nursing home state survey teams.


Research Questions

  • Will staff training increase the number of care episodes where choice is offered to residents?
  • Are there any resident related effects over time?

Baseline: Morning Care Observations (3-6 months)

  • Observation of CNA/Resident Interactions during morning care; 1-2 times per week. (Forms & Templates)
  • Resident Interviews for Care Preferences, Quality of Life, Pain, Depression, and Mental status 

Intervention: Staff Training (3 months)

  • Training of CNAs: 12 weekly 10-minute sessions on how to offer choice in four morning care ADL areas. Each session comprised of specific training video vignettes, active discussions, and feedback on prior week's observational data.  (Training Vignettes)
  • Training of Nursing Supervisors: Observations of morning care throughout the week. (Forms & Templates)

Quality Improvement Process: Post-Intervention Transition

  • Encourage nurse supervisors to maintain care improvements by continuing observations and tracking progress with a simple Quality Improvement template. (Forms & Templates)