Consumer-Directed Care – Don’t Do It Alone 

By Mark Broughton, Certified Senior Advisor (CSA)® 

Consumer-directed care (CDC) provides families and older adults direction and control over the care received in the home. This includes the ability to choose a a caregiver, negotiate caregiver wages, define hours and services rendered, and have more control and knowledge of care plan outcomes. All of these are advantages certainly, but because the process can be complicated, here are things to consider:


1. Consider hiring a case manager or Certified Senior Advisor 

Central to the success of the CDC model is the presence of a trained professional who can help direct the overall care plan over the course of one’s journey. Families may not be equipped or trained to play this vital role, so strongly consider including such a professional on your team. If you don’t, you may likely find out too late you’re in over your head. In a very real sense, this professional needs to be the family’s quarterback in order for in-home CDC to be successful, even if their role over time decreases.


2. Have a back-up care plans 

When families use the CDC model they often forget about making contingency plans for care. What if the regular caregiver gets sick, needs to go on vacation, or has car trouble? Agencies automatically take care of this situation, the CDC model does not. Families using the CDC model should be instructed to plan ahead and have back-up caregivers identified before the need arises, or have made arrangements with a traditional agency in advance to provide them with back-up care if/when needed using their more expensive agency caregivers. Back-up care must be planned for right from the start.


3. Are you covered? 

The number one issue with the CDC model is often the lack of safety and protections for the family and the caregiver. Hiring privately in order to save money need not mean taking undue risks or skipping common sense precautions. There are third party companies in the industry, such as, that provide a solution to this problem, and families need to know they exist. Such companies allow families to choose their own caregiver and negotiate the wage from their online network of pre-vetted local caregivers, AND offer the added protections and security of background checks, bonding, liability insurance, payroll services and full tax management so the family can also have the peace-of-mind they deserve.


Families using the CDC model also need to know that if they choose to avoid using the protection services of such companies, they may well find themselves in an unexpected lawsuit, out valuable stolen property, or under the review or an audit by the IRS or Department of Labor. These are serious matters indeed, so it is imperative families understand the potential consequences of using the CDC model to simply save money, but choosing to have a blind eye towards potential legal or financial consequences.



Many would agree that consumer-directed care is emerging as the next big thing in the private duty care industry driven primarily by cost savings, but it is important to recognize that CDC requires additional ingredients in order to be successful. This article helps remind us that “there is no free lunch,” especially when it comes to effective in-home senior care. As you evaluate CDC for your own use, or perhaps on behalf of others, please keep these extra ingredients in mind to make sure the final result is all you intended it to be.

In-home senior care process can be difficult and complicated, so never underestimate the fact the benefits of having help during the journey.