Consumer Directed Care

According to the definition developed by the National Institute on Consumer-Directed Long-Term Services, consumer direction of long-term care services, or consumer-directed care, is both a philosophy and a practice model for home care. As a philosophy, it emphasizes consumer choice and control, recognizing that service recipients themselves are the ones who best know their needs and preferences and, as such, should have primary authority and responsibility for making decisions about those services. In practice, consumer direction means that consumers make concrete choices about their care and ultimately manage the delivery of their services to the extent that they are willing and able to do so.

While people ordinarily associate consumer direction with hiring and firing workers, there is more to it than that. It also involves consumers: having good information about the service network in order to make informed decisions; being involved in the care planning process; selecting home care agencies and workers; training workers; and monitoring the quality of services by providing performance feedback to workers and provider agencies (Eustis and Fischer). However, with the additional information and authority over services also comes increased responsibility for consumers to understand their service needs and preferences and to manage the delivery of their care.

In addition to increased consumer control over service management, consumer-directed care also often allows for more flexibility in terms of who delivers the services. Many consumer-directed care programs offer consumers the opportunity to hire those who are most familiar to them—family members, friends, and neighbors—to serve as independent (nonagency) providers of home care services.