To remain in their homes, older adults may need help with daily activities (called activities of daily living or ADLs). Consumer direction means giving people more choices and more control over both the type of care they receive and the caregivers who provide it.
From 2001 to 2005, staff from the National Association of State Units on Aging and the National Council on Aging worked to build knowledge for, and support of, consumer direction through:
- Surveys, publications, workshops, presentations, briefings and a project website.
- Technical support and small grants to state units on aging and grassroots consumer groups in 13 states to increase consumer-direction options for elders.
Surveys and interviews with state administrators in 2004 established a baseline from which to assess growth in consumer-directed programs for older people. Survey findings included the following:
- Some 38 percent of the consumer-directed programs were established in the five years prior to the 2004 survey. This indicates a growing trend toward increased availability of consumer-directed service options for older persons.
- While state respondents clearly define consumer direction broadly, there is strong support for continued expansion of consumer direction as a viable service option for older people.
Project staff developed the Consumer Direction Tool to help citizens, policy-makers, providers and legislators determine whether long-term-care programs and policies help people to make their own choices about the services they need and the people who provide them. People can also use the tool to identify and surmount barriers to consumer direction.
The 13 states receiving technical assistance:
- Created partnerships with state agencies, consumer and provider organizations, and individual consumers and family caregivers to build support for consumer direction.
- Developed reform agendas calling for the expansion of existing consumer-direction programs.
Five states—Illinois, Iowa, Pennsylvania, Washington and West Virginia—used their reform agendas to develop successful proposals for RWJF's Cash and Counseling demonstration grants in 2004, according to the project director. Cash and Counseling provides Medicaid enrollees who are frail or have disabilities with a monthly cash allowance to purchase their own personal care and homemaker services. Participants also receive counseling to help plan their service purchases.