A new study  found that people whose primary caregiver is a paid family member or friend report significantly better outcomes than those supported by agency-employed staff — a finding with direct implications for self-direction programs. Compared to those with paid non-family staff as their main helper, those with a paid family caregiver were 2.3 times more likely to always get enough help with activities of daily living (ADLs), 1.5 times more likely to say their services and supports always meet their needs and goals, and 1.4 times more likely to participate in activities with others as much as they want. People with paid family caregivers also reported the lowest caregiver turnover rates — a key driver of poor outcomes. The report recommends expanding paid family caregiving options while continuing to invest in the broader direct care workforce.

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