F0400: Interview for Daily Preferences
F0400: Interview for Daily Preferences
Item Rationale
Health-related Quality of Life
Individuals who live in nursing homes continue to have distinct lifestyle preferences.
A lack of attention to lifestyle preferences can contribute to depressed mood and increased behavior symptoms.
Resident responses that something is important but that they can’t do it or have no choice can provide clues for understanding pain, perceived functional limitations, and perceived environmental barriers.
Planning for Care
Care planning should be individualized and based on the resident’s preferences.
Care planning and care practices that are based on resident preferences can lead to
improved mood,
enhanced dignity, and
increased involvement in daily routines and activities.
Incorporating resident preferences into care planning is a dynamic, collaborative process. Because residents may adjust their preferences in response to events and changes in status, the preference assessment tool is intended as a first step in an ongoing dialogue between care providers and the residents. Care plans should be updated as residents’ preferences change, paying special attention to preferences that residents state are important.
Steps for Assessment: Interview Instructions
Interview any resident not screened out by the Should Interview for Daily and Activity Preferences Be Conducted? item (F0300).
Conduct the interview in a private setting.
Sit so that the resident can see your face. Minimize glare by directing light sources away from the resident’s face.
Be sure the resident can hear you.
Residents with hearing impairment should be interviewed using their usual communication devices/techniques, as applicable.
Try an external assistive device (headphones or hearing amplifier) if you have any doubt about hearing ability.
Minimize background noise.
Explain the reason for the interview before beginning.
Suggested language: “I’d like to ask you a few questions about your daily routines. The reason I’m asking you these questions is that the staff here would like to know what’s important to you. This helps us plan your care around your preferences so that you can have a comfortable stay with us. Even if you’re only going to be here for a few days, we want to make your stay as personal as possible.”
Explain the interview response choices. While explaining, also show the resident a clearly written list of the response options, for example a cue card.
Suggested language: “I am going to ask you how important various activities and routines are to you while you are in this home. I will ask you to answer using the choices you see on this card [read the answers while pointing to cue card]: ‘Very Important,’ ‘Somewhat important,’ ‘Not very important,’ ‘Not important at all,’ or ‘Important, but can’t do or no choice.’”
Explain the “Important, but can’t do or no choice” response option.
Suggested language: “Let me explain the ‘Important, but can’t do or no choice’ answer. You can select this answer if something would be important to you, but because of your health or because of what’s available in this nursing home, you might not be able to do it. So, if I ask you about something that is important to you, but you don’t think you’re able to do it now, answer ‘Important, but can’t do or no choice.’ If you choose this option, it will help us to think about ways we might be able to help you do those things.”
Residents may respond to questions
verbally,
by pointing to their answers on the cue card, OR
by writing out their answers.
If resident cannot report preferences, then interview family or significant others.
Coding Instructions
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Code 1, very important: if resident, family, or significant other indicates that the topic is “very important.”
Code 2, somewhat important: if resident, family, or significant other indicates that the topic is “somewhat important.”
Code 3, not very important: if resident, family, or significant other indicates that the topic is “not very important.”
Code 4, not important at all: if resident, family, or significant other indicates that the topic is “not important at all.”
Code 5, important, but can’t do or no choice: if resident, family, or significant other indicates that the topic is “important,” but that they are physically unable to participate, or have no choice about participating while staying in nursing home because of nursing home resources or scheduling.
Code 9, no response or non-responsive:
If resident, family, or significant other refuses to answer or says they do not know.
If resident does not give an answer to the question for several seconds and does not appear to be formulating an answer.
If resident provides an incoherent or nonsensical answer that does not correspond to the question.
Coding Tips and Special Populations
The interview is considered incomplete if the resident gives nonsensical responses or fails to respond to 3 or more of the 16 items in F0400 and F0500. If the interview is stopped because it is considered incomplete, and there is no family member or significant other to assist in completing the interview, fill the remaining F0400 and F0500 items with a 9 and proceed to F0600, Daily Activity Preferences Primary Respondent.
The resident, family member or significant other is being asked about current preferences while in the nursing home but is not limited to a 7-day period to convey what these preferences are.
The facility is still obligated to complete the interview within the observation period.
Interviewing Tips and Techniques
Sometimes respondents give long or indirect answers to interview items. To narrow the answer to the response choices available, it can be useful to summarize their longer answer and then ask them which response option best applies. This is known as echoing.
For these questions, it is appropriate to explore resident, family and/or significant other’s
answers and try to understand the reason.
Examples for F0400A, How Important Is It to You to Choose What Clothes to Wear (including hospital gowns or other garments provided by the facility)?
Resident answers, “It’s very important. I’ve always paid attention to my appearance.”
Coding: F0400A would be coded 1, very important.
Resident replies, “I leave that up to the nurse. You have to wear what you can handle if you have a stiff leg.”
Interviewer echoes, “You leave it up to the nurses. Would you say that, while you are here, choosing what clothes to wear is [pointing to cue card] very important, somewhat important, not very important, not important at all, or that it’s important, but you can’t do it because of your leg?”
Resident responds, “Well, it would be important to me, but I just can’t do it.”
Coding: F0400A would be coded 5, important, but can’t do or no choice.
Examples for F0400B, How Important Is It to You to Take Care of Your Personal Belongings or Things?
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Resident answers, “It’s somewhat important. I’m not a perfectionist, but I don’t want to have to look for things.”
Coding: F0400B would be coded 2, somewhat important.
Resident answers, “All my important things are at home.”
Interviewer clarifies, “Your most important things are at home. Do you have any other things while you’re here that you think are important to take care of yourself?”
Resident responds, “Well, my son brought me this CD
player so that I can listen to music. It is very important to me to take care of that.”
Coding: F0400B would be coded 1, very important.
Examples for F0400C, How Important Is It to You to Choose between a Tub Bath, Shower, Bed Bath, or Sponge Bath?
Resident answers, “I like showers.”
Interviewer clarifies, “You like showers. Would you say that choosing a shower instead of other types of bathing is very important, somewhat important, not very important, not important at all, or that it’s important, but you can’t do it or have no choice?”
The resident responds, “It’s very important.”
Coding: F0400C would be coded 1, very important.
Resident answers, “I don’t have a choice. I like only sponge baths, but I have to take shower two times a week.”
The interviewer says, “So how important is it to you to be able to choose to have a sponge bath while you’re here?”
The resident responds, “Well, it is very important, but I don’t always have a choice because that’s the rule.”
Coding: F0400C would be coded 5, important, but can’t do or no choice.
Example for F0400D, How Important Is It to You to Have Snacks Available between Meals?
Resident answers, “I’m a diabetic, so it’s very important that I get snacks.”
Coding: F0400D would be coded 1, very important.
Example for F0400E, How Important Is It to You to Choose Your Own Bedtime?
Resident answers, “At home I used to stay up and watch TV. But here I’m usually in bed by
8. That’s because they get me up so early.”
Interviewer echoes and clarifies, “You used to stay up later, but now you go to bed before 8 because you get up so early. Would you say it’s [pointing to cue card] very important, somewhat important, not very important, not important at all, or that it’s important, but you don’t have a choice about your bedtime?”
Resident responds, “I guess it would be important, but I can’t do it because they wake me up so early in the morning for therapy and by 8 o’clock at night, I’m tired.”
Coding: F0400E would be coded 5, important, but can’t do or no choice.
Example for F0400F, How Important Is It to You to Have Your Family or a Close Friend Involved in Discussions about Your Care?
1. Resident responds, “They’re not involved. They live in the city. They’ve got to take care of their own families.”
Interviewer replies, “You said that your family and close friends aren’t involved right now. When you think about what you would prefer, would you say that it’s very important, somewhat important, not very important, not important at all, or that it is important but you have no choice or can’t have them involved in decisions about your care?”
Resident responds, “It’s somewhat important.”
Coding: F0400F would be coded 2, somewhat important.
Example for F0400G, How Important Is It to You to Be Able to Use the Phone in Private?
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1. Resident answers “That’s not a problem for me, because I have my own room. If I want to make a phone call, I just shut the door.”
Interviewer echoes and clarifies, “So, you can shut your door to make a phone call. If you had to rate how important it is to be able to use the phone in private, would you say it’s very important, somewhat important, not very important, or not important at all?”
Resident responds, “Oh, it’s very important.”
Coding: F0400G would be coded 1, very important.
Example for F0400H, How Important Is It to You to Have a Place to Lock Your Things to Keep Them Safe?
1. Resident answers, “I have a safe deposit box at my bank, and that’s where I keep family heirlooms and personal documents.”
Interviewer says, “That sounds like a good service. While you are staying here, how important is it to you to have a drawer or locker here?”
Resident responds, “It’s not very important. I’m fine with keeping all my valuables at the bank.”
Coding: F0400H would be coded 3, not very important.
@Difrodah Wawuda @Norah Ngaku-1 you have included F0500 and F0600 in this document [RI1]
hi. i have corrected this. [NN2]
