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American Journal of Alzheimer's Disease and Other Dementias®
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Factors associated with family caregivers' choice not to use services

Edith M. Hamilton, PhD, RN, CS

Jean W. Braun, DSN, RN, CS

University of Missouri-Kansas City, School of Nursing, Kansas City, Missouri.

Paul Kerber, PhD

Computer Resource Center, University of Kansas, School of Business, Lawrence, Kansas.

Christine Thurlow, MSN, RN, C

Older Adult Program, Research Medical Center, Kansas City, Missouri.

Irma Schwieterman, MSN, RN

University of Missouri-Kansas City, School of Nursing, Kansas City, Missouri.

The purpose of this descriptive study was to determine adaptation by family caregivers of persons with Alzheimer's disease who did not use community services. Previous research has focused on the use of services, highlighting the need for studies examining factors associated with service nonuse. Lawton and Nahemow's ecology model of adaptation and aging served as the foundation for this study; the relationship between personal competence and environmental press depicts a level of adaptation.

A mail and telephone survey of 70 caregivers revealed reasons for not using services to which they had been referred, as well as patterns of adaptation to caregiving. Personal competence, measured as perception of caregiving mastery, emerged as a significant factor in service nonuse. Caregiver gender and daily hours of caregiving, an environmental press factor combined with perception of mastery to most often correctly classify respondents' high and low adaptation. Strategies for enhancing caregiver competence should be given highest priority by primary health care professionals.

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 11, No. 4, 29-38 (1996)
DOI: 10.1177/153331759601100405
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