AIMS: The aim of this study was to predict South Florida family caregivers' need for and use of informal help or formal services, specifically, to explore the predictive power of variables suggested by the Caregiver Identity Theory and the literature and develop and test a structural model.
BACKGROUND: In the USA, most of the care to older adults is given by family members. Caregivers make economic and social sacrifices that endanger their health. They feel burdened, if they receive no assistance with their tasks; however, services available are not sufficiently used.
DESIGN: This cross-sectional correlational study was a survey of family caregivers in their home, using standardized and/or pre-tested scales and a cognitive status test of their patients.
METHODS: A random sample of 613 multiethnic caregivers of frail elders were recruited in home care and community agencies. The interviews were held between 2006-2009. Analyses involved correlation and regression analyses and structural equation modelling. Outcome measures were need and use of family help and formal services.
RESULTS/FINDINGS: The model yielded excellent fit indices replicated on three random samples of 370. The patients' functional limitations yielded the strongest predictive coefficients followed by caregiver stress. Cultural indicators played a minor role.
CONCLUSION: The lack of a link between resource need and use suggested access barriers. Important for policy makers and service providers are the delivery of high-quality services and the use of a personal and individualized approach with all ethnicities. Quality service includes understanding the caregiving situations and requires a trusting relationship with family caregivers.