Comparing Resident, Proxy, and Staff Respondents for Nursing Home Residents’ Preferences for Everyday Living

Zachary J. Kunicki, Caroline Madrigal, Lien T. Quach, Melissa R. Riester, Lan Jiang, Matthew S. Duprey, Melanie Bozzay, Andrew R. Zullo, Mriganka Singh, John McGeary, Wen Chih Wu, James L. Rudolph

Research output: Contribution to journalArticlepeer-review


To encourage person-centered care, the Centers for Medicare and Medicaid require nursing homes to measure resident preferences using the Preferences Assessment Tool (PAT). No known research has examined the implications of respondent type (i.e., resident, proxy, staff) on preference importance; therefore, the purpose of this study was to compare the importance of preferences depending on which respondent completed the PAT. Participants included 16,111 Veterans discharged to community-based skilled nursing facilities after hospitalization for heart failure. A majority (95%) of residents completed the PAT compared to proxy (3%) and staff (2%). Proxy responders were both more and less likely to indicate individual preferences as important compared to residents. Staff members were consistently less likely to indicate all preferences as important compared to residents. Findings from this study emphasize the need for proxy and staff to find methods to better understand residents’ preferences when residents are not able to participate in assessments.

Original languageEnglish
Pages (from-to)28-36
Number of pages9
JournalJournal of Applied Gerontology
Issue number1
StatePublished - Jan 2023

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the This work was supported by the VA Health Services Research and Development Center of Innovation in Long Term Services and Supports (CIN 13-419 and C19 20-213), the VA QUERI-Geriatrics and Extended Care Partnered Evaluation Center for Community Nursing Homes (PEC 15-465). The funders did not play a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors retained full independence in the conduct and communication of this research. The statements and opinions expressed are those of the authors and do not represent the official policy or procedures of the United States Government or the Department of Veterans Affairs.

Publisher Copyright:
© The Author(s) 2022.


  • proxy report
  • resident preferences
  • self-report
  • staff report

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology


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