Researchers at the Institute for Health Policy at Brandeis University examined the extent to which older Boston adults wanted to participate in the management and supervision of community-based long-term care services, and whether their decisions varied by race/ethnicity.
The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Independent Choices: Enhancing Consumer Direction for People with Disabilities, which was designed to foster the development of consumer-directed home and community-based services for people of all ages with disabilities.
- The vast majority of African-American (73%), Latino (88%) and white Western European-American (76%) subjects, and the majority of Chinese subjects (50%) preferred a traditional case management model over a negotiated case management model (which featured client involvement in service planning and agency responsibility for organizing services) or a cash & counseling model (which featured a monthly cash allowance, selected advice and training and consumer management of resources).
- Older adults who were in good health and felt control over their workers were less likely to choose the traditional case management model than those who were in poor health and felt less control.
- Older adults' preferences for consumer direction span a continuum. Older adults who want more control in one area of their community-based long-term care services may not want more control over all areas.
- It is important to provide older adults with a range of options that might allow for greater control in some areas of community-based long-term care service delivery.