Consumer and Counselor Experiences in the Arkansas IndependentChoices Program. Consumer Satisfaction with Personal Assistance

01/01/2004

Nine months after enrollment, consumers were generally satisfied with their care arrangements and relationships with workers hired with the allowance, but substantial proportions still had unmet needs for personal assistance.23 Ninety-four percent said they were satisfied with their overall arrangement for care, and 69 percent said they were very satisfied, regardless of age or whether the consumer or a proxy responded. Nearly all consumers who hired a worker with the allowance and had paid help during the two weeks before the interview were satisfied with their relationship with the worker and how and when the worker performed tasks (Table 6, Appendix Table A.23a and Table A.23b).24

Consumers also scored workers well on particular aspects of caregiving. Most consumers reported that their workers completed all tasks, never neglected them, were never rude or disrespectful, and did not take belongings without asking. However, about 40 percent of consumers reported that workers sometimes arrived late or left early, or provided help when it was not wanted.25 These proportions were similar for proxy and self-respondents, and most were similar for elderly and nonelderly consumers. The sole exception was that nonelderly consumers were somewhat more likely to report workers providing unwanted help (42 percent, versus 33 percent for elderly consumers) (Table 6, Appendix Table A.23a and Table A.23b).

A substantial proportion of consumers reported that they needed more help with housework (40 percent), personal care (33 percent), transportation (29 percent), and routine health care (28 percent).26 These proportions were similar for elderly and nonelderly consumers, except that a lower proportion of nonelderly consumers reported an unmet need for personal care (27 percent, versus 35 percent for elderly consumers). Proxy respondents, however, were consistently more likely than self-reporting consumers to report unmet need for assistance with different types of care: housework (43 percent among consumers with proxy respondents versus 38 for self-responding consumers), personal care (44 versus 25 percent), transportation (32 versus 27 percent), and routine health care (38 versus 22 percent). The differences between self- responding consumers and proxies may have resulted from differences in perception about the consumers' need for care. Or, consumers who used proxy respondents may have been more impaired than self-responders, which, in turn, may have led to a difference in unmet needs (Table 6, Appendix Table A.23a and Table A.23b).

TABLE 6: Satisfaction with, and Unmet Need for, Personal Assistance
  Percentage
CURRENT SATISFACTION WITH OVERALL CARE ARRANGEMENTS
Very satisfied 68.6
Satisfied 25.4
Dissatisfied 6.0
AMONG THOSE WHO HIRED WITH ALLOWANCE AND HAD PAID IN PAST TWO WEEKS (BEFORE INTERVIEW), SATISFIED WITH:
Relationship with paid caregiver 99.8
How paid caregiver helps with personal carea 99.5
How paid caregiver helps with routine health careb 99.0
How paid caregiver helps with housework or community choresc 99.0
Times of day help provided 96.9
AMONG THOSE WHO HIRED WITH ALLOWANCE, PAID CAREGIVER
Always or almost always completed all tasks 87.1
Never neglected consumer 92.0
Never left early or arrived late (among those with regular schedule) 60.5
Never was rude or disrespectful 90.6
Never helped when help was not wanted 63.7
Never took belongings without asking 96.6
HAD UNMET NEED FOR HELP WITH:
Housework or community choresc 40.1
Personal carea 32.6
Routine health careb 28.1
Transportationd 29.0
SOURCE: MPR nine-month interview conducted in Arkansas between August 1999 and January 2002. NOTE: Satisfaction with overall care includes responses for 621 consumers in the evaluation treatment group who responded for themselves or who had a proxy respondent who was not also their paid worker but who thought they could provide the consumer's opinion. Satisfaction with paid caregivers includes responses for 440 consumers who hired a worker with the monthly allowance during the nine months following random assignment, who had paid personal assistance in the most recent two weeks before the evaluation's nine-month follow-up interview during which the consumer was at home, and who responded for themselves or who had a proxy respondent who was not also their paid worker. Unmet need includes responses for 671 consumers in the evaluation treatment group who responded for themselves or who had a proxy respondent who was not also their paid worker. Roughly five percent of consumers who hired workers with the allowance had disenrolled from IndependentChoices and were likely reporting about PAS received from agency workers.
  1. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  2. Routine health care includes taking medications, checking blood pressure, and doing exercises.
  3. Housework includes light housework, yard work, meal preparation, and shopping.
  4. Transportation includes both medical and nonmedical transportation.

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