Easing the Burden of Caregiving: The Impact of Consumer Direction of Primary Informal Caregivers in Arkansas.

Although providing personal care to a family member with disabilities often is rewarding, it can also be emotionally, physically, and financially burdensome. Caregiver burden may be exacerbated if paid personal care services (PCS), such as those provided by Medicaid-certified personal care agencies, are unsatisfactory. Consumer-directed Cash and Counseling programs provide eligible Medicaid beneficiaries with a monthly allowance to direct their PCS as they see fit. This article assesses the effect of consumer-directed PCS on the primary informal caregivers of Arkansas beneficiaries who voluntarily participated in the Cash and Counseling Demonstration and Evaluation. The demonstration randomly assigned beneficiaries to a program in which they could direct their own PCS (the treatment group) or rely on traditional agency services (the control group). At followup, the caregivers of treatment group members provided fewer hours of assistance than did their control group counterparts and reported better emotional, physical, and financial well-being.