The role of cultural factors on clients' attitudes toward caregiving, perceptions of service delivery, and service utilization.

The purpose of the present study was to gain a better understanding of the role of culture in the use of respite services. Culture was defined in three different ways: (1) ethnicity (African-American, Hispanic/Latino, or White); (2) relationship of the caregiver to the care receiver (spouse, adult-child, or other); and (3) geographic location (urban or rural). All three of these classifications were significantly related to the use of respite services, even after controlling for elders' income. Two sets of potential intervening variables that might explain the effects of culture on respite use were investigated: caregivers' attitudes and beliefs, and clients' evaluation of aspects of service delivery. When these variables were controlled, the main effects for relationship of the caregiver to the care receiver and geographic location on respite use were no longer significant. The effect of ethnicity on respite use persisted in the presence of these controls, but was greatly diminished. The results suggest specific avenues by which respite providers can increase appropriate service use among caregivers of dementia patients.