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PELI PAL Card Project 2020 by Scripps Gerontology Center
Image shows an older woman wearing a headscarf and smiling at the camera. The image includes the words 'Nursing Home Quality Improvement Project' in a purple rectangle on the left.


In recent years there has been a push in the field of long-term services and supports to focus on person-centered care (PCC), a philosophy that recognizes “knowing the person” and honoring individual preferences. However, systematically assessing and communicating information about nursing home residents’ important preferences across care team members is difficult. There are many barriers to communicating preferences such as not all care team members having access to electronic medical records and high staff turnover. The focus of the PAL Card Project is on facilitating the communication of nursing home residents’ important preference information across departments by implementing a person-centered quality improvement initiative called Preferences for Activity and Leisure (PAL) Cards.

What are PAL Cards?

PAL Cards are personalized 5x7 laminated cards that reflect a resident’s recreation and leisure preference information gathered using either the 8 activity items from the MDS 3.0 in Section F or 33 items from the Preferences for Everyday Living Inventory (PELI) (see Figure 1 below). The cards are then placed on a resident wheelchair/walker/door as a way to communicate important preferences to staff, volunteers, and other residents throughout a provider community. This revised Quality Improvement Project includes a new approach for sharing resident communication preferences.

Figure 1.  Example front and back side of a resident PAL Card.

Front side of a resident PAL card includes the resident's name, a logo and some textBack side of the resident PAL card lists the resident's interests.

Objectives/goals of the project

The goal of this project is to offer virtual coaching and on-demand support to Ohio nursing home providers interested in using the PAL Cards for a quality improvement initiative in their community.

Quality improvement outcomes

  • Communicate residents’ preferences regarding important recreation and leisure interests
  • Successfully initiate conversations between staff and residents or residents and volunteers
  • Assist “fill-in” or “floating” staff to be able to quickly learn about the residents they are providing care for
  • Provide opportunities for staff and residents to develop stronger relationships
  • Increase resident’s well-being knowing their voices are heard and preferences understood
  • Collect data to inform the scalability of the project with all residents in the community

Date(s) of project

Applicants will be accepted on a rolling basis between July 15 through December 31, 2020. Applications will not be accepted after December 31,2020. Support will be provided to participating communities through June 30, 2021.  Communities who participated in the 2018 PAL Card QIP are eligible to participate, but would be required to work with new residents (not the ones who had PAL Cards created in 2018). 

How to Join

Contact the project manager for more information:

Scripps Gerontology Center
Dr. Katy Abbott, PhD, MGS
Assistant Professor of Gerontology & Scripps Gerontology Center Research Fellow
Miami University
Tel: 513 529-0869
E-mail: abbottkm@miamioh.edu

Brief Description of Required Activities

  • Identify an onsite project coordinator or point person to lead the project initiative.
  • Selection of an outcome of interest that aligns with the community’s goals.  For example, the provider could select resident level outcomes, such as a decrease in antipsychotic medications, behavioral and psychological symptoms of dementia, or engagement in activities.    
  • Take part in one 60-minute virtual training session(s) and 3-6 monthly coaching calls scheduled at participant’s convenience.  The number of monthly coaching calls will vary depending upon the provider needs.  Monthly calls are approximately 20-30 minutes in length.
  • Create PAL Cards with 15-20 NH residents.  This includes allowing for staff or volunteer time to complete PELI interviews using either the 33 recreation and leisure items from the PELI or the 8 Activity items from the MDS 3.0 assessment. 
  • Incorporate stated important preferences into the PAL Card template to create an individualized card for each resident, print, laminate, and place the resident’s PAL card, with his/her permission, on his/her walker, wheelchair, or in room so it can be visible. (The Scripps Gerontology Center can assist with laminating cards if needed)
  • Discuss PAL Cards during staff meetings and new employee orientation to explain their purpose
  • Collection of tracking data that includes the type of interview used, who completed the interview, time to complete the interview and create the PAL card, reasons for refusals if applicable, if the card was reviewed for accuracy by the resident or family, where the PAL Card was placed, and if the card was still in the original location each month (log forms will be provided). 
  • Staff who come in daily contact with residents involved in the initiative, such as housekeeping, maintenance, and certified nurse’s assistants will also be asked to complete a short 10 question questionnaire about their experience with PAL Cards. 
  • After PAL Cards have been completed, the project coordinator will be asked to complete a telephone interview to report and discuss outcome data.
  • Data collected during the duration of the study will be treated as confidential information, stored in a secure location for the duration of the project, accessed only by project personnel at Miami University and destroyed after the data have been analyzed.

In exchange for participation, organizations will receive:

  • Virtual training for PAL Card implementation
  • Monthly coaching calls to assist with trouble shooting barriers to implementation
  • A certificate of completion

Evidence of Participation in the Project

  • Submission of the on-line Qualtrics form requesting to participate between July 15, 2020 and Dec. 31, 2020  
  • Submission of log forms tracking PAL Card data
  • Submission of feedback forms from staff interacting with residents
  • Photos of 15-20 completed and placed PAL cards
  • Exit interview via telephone with Scripps to report on and discuss outcome data.

Relevant links 

Preference Based Living


Dr. Katy Abbott, PhD, MGS
Assistant Professor of Gerontology & Scripps Gerontology Center Research Fellow
Miami University
Tel: 513 529-0869
E-mail: abbottkm@miamioh.edu