The decision-making processes and preferences of older Australians purchasing home support services: An explorative inquiry using a "think-aloud" technique

Consumer-directed care (CDC) programmes, in principle, provide consumers with choices around who provides care services to them, what services and when. However, literature around consumer behaviour of older adults, especially concerning the factors that may support home care choices, is sparse. The purpose of this study was to understand the decision-making processes and spending preferences of community-dwelling seniors assessed eligible for CDC home care services. We completed an explorative inquiry using a "think-aloud" technique with eligible consumers in South Australia. The inquiry had two components. First, consumers used imitation money to simulate the purchase of home care supports while talking out loud their decision-making processes. Then, semi-structured interviews were completed to identify underlying thoughts that informed the decisions made and spending preferences. Fifteen consumers, mean age 82 years (range 70-94), participated. The most frequently prioritised choice was domestic assistance. However, choices were made based on a perceived hierarchy of need (due to limits placed on available budgets for care). Interview data revealed that the decision making and service preferences were also based on limited knowledge about what was available. Consumers revealed perceived value in purchasing expert advice to guide their choices and preference for relational not transactional service delivery.