Independent Choices: Enhancing Consumer Direction for People with Disabilities was a $3.4 million program of the Robert Wood Johnson Foundation (RWJF) designed to foster the development of consumer-directed home and community-based services for people of all ages with chronic disabilities.

Authorized by the Board of Trustees in July 1995, the program ran until June 1999. Independent Choices, managed by the National Council on the Aging, Washington, supported four research and nine demonstration projects.

Key Results
The demonstration projects:

• Made tangible progress at the state level in planning for and designing options for older users of personal assistance services, such as personal care (help with activities of daily living such as eating, dressing and toileting) and homemaker or chore services.
• Designed and implemented an emergency back-up service, which offers emergency and short-notice personal assistance services (e.g., help with meal preparation, toileting, bathing and grooming, and light housekeeping).
• Developed training materials for staff and consumers of a consumer direction program in Minnesota.
• Designed and implemented an emergency back-up service, which offers emergency and short-notice personal assistance services (e.g., help with meal preparation, toileting, bathing and grooming, and light housekeeping).

The research projects:

• Studied consumer direction for older people with Alzheimer's disease and older people living in assisted living and nursing homes.
• Showed that it is possible to solicit consumer perspectives on care preferences for use in making professional judgments that are in line with consumer preferences. Research also showed that addressing consumer preferences may have important implications for the quality of care and satisfaction with care.
• Compared outcomes for physically and cognitively impaired people in a consumer-driven personal assistance program to those of people receiving agency-directed services.
  
  See Project List for links to reports on the demonstration and evaluation projects.

Key Assessment Findings
Overall, the assessment team led by A.E. Benjamin, Ph.D., at the University of California, Los Angeles found that:

• Independent Choices was generally successful in meeting its goals. The program stimulated some innovative activity in the field and attempted to tackle some important issues in a serious and focused way.
• Independent Choices partially contributed to the "mainstreaming" of consumer direction in the field of aging. The program broadened the number of actors and sites where consumer-directed projects are being planned and implemented.
• Independent Choices played a modest role in shifting attention from the ideology of consumer direction to the technical challenges of designing programs.