Consumer Directed Care

I have an older friend, Fran, who needs assistance in order to continue living in her home. She broke her hip a few years ago and now has difficulty with bathing, housework, and grocery shopping, to name a few of the tasks that we all need to do on a daily basis. Fran’s situation was reviewed by SeniorCare and it was determined that she was eligible for assistive services. Due to the ongoing worker shortage, Fran was put on a waiting list for some of the services for which she was eligible.

Knowing that Fran needed assistance now, Fran’s Care Manager at SeniorCare suggested the “Consumer Directed Care” program. Using Consumer Directed Care, Fran chose and hired her own helper–a friend of the family, who was immediately able to start providing Fran with the assistance she needed. In addition, Fran immediately began receiving Meals on Wheels home-delivered meals, received a medical alert device and a virtual companion device, which helps in a myriad of ways, not the least of which is helping Fran feel less isolated from the world. (Learn more about at

Consumer Directed Care is available to people who have been assessed and found eligible for a state-funded home care service. The consumer becomes the employer, is allowed to choose their home care worker (or workers), set their schedule, and assign tasks that fit specific needs that may not be allowed with a traditional home care agency, such as assisting with pets, certain cleaning tasks, and assistance with unique medical care as they train the worker themselves in carrying out these tasks.  A “Fiscal Intermediary” (FI) agency takes care of the payroll, tax withholding, and other accounting tasks that are required of a legal employer.  The FI agency is contracted and paid by SeniorCare. The rate of pay for the worker, who submits a weekly timesheet, is determined by state mandates. The consumer is responsible for the hiring, training, scheduling, and—if needed—the termination of the home care worker. Consumer Directed Care can be used to cover a portion of or all of the services for which a person is eligible.

The consumer chooses their own worker, but must follow some basic rules. The worker may be a family member, but may not be the consumer’s spouse. The worker must be

  1. Legally authorized to work in the United States and have a social security number
  2. Able to pass a CORI screening
  3. Able to understand and carry out directions from the consumer
  4. Willing to receive training and supervision for all designated tasks

Consumer Directed Care is an excellent option for elders wishing to take more control of their care. If the consumer needs assistance with managing the responsibilities of being an employer, a surrogate may be brought into the picture. A surrogate may manage the entire program for the consumer or may assist with specific tasks. The surrogate can be a spouse, friend, neighbor, or family member.  The surrogate cannot be the worker.

For more information about Consumer Directed Care, please call SeniorCare at 978-281-1750 and ask to speak with an Information & Referral Specialist or with your Care Manager if you are already a SeniorCare consumer.