The refinement of a patient assessment tool for older patients, Lorensen's Self-Care Capability Scale, is described where a systematic elicitation of patient preferences is included in the assessment. This study tests a decision analytic approach as a strategy for formalizing subjective judgement, which makes it possible to include patients' own values and preferences in planning patient care. Applying this technique to patient assessment contributes to explicitly tailoring nursing care decisions to desired outcomes as preferred by individual patients. A shared approach to decision making between nurse and patient ensures a mutual understanding about goals, priorities and patient values through discussion and negotiation. This pilot study supported the merit of including patient preferences systematically in the assessment of older patients. The method provides an important decision aid for nurses in planning nursing care in accordance with patients' own values and preferences for care.