This study investigates how self-directed care, specifically through England’s Direct Payments system, affects the well-being of older adults with disabilities. Using data from the English Longitudinal Study of Ageing collected between 2012 and 2023, the researchers analysed outcomes for 568 individuals aged 65 and older who received either Direct Payments or managed care. The analysis, conducted using propensity score matching, revealed that Direct Payments helped reduce unmet care needs but did not significantly impact depressive symptoms or overall quality of life. The positive effects were more pronounced among those who were younger, had experienced less physical decline, and had previously reported that their care needs were being met. The findings suggest that Direct Payments can improve care outcomes by addressing unmet needs, particularly for individuals with greater health resources.
