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Purpose: This descriptive study explored attitudes toward community-based long-term care services and factors influencing service utilization among Japanese American families., Design and Methods: Using grounded theory methodology, the Japanese American sample included 26 family caregivers, 4 persons receiving care, and 14 professional providers (n = 44)., Results: Attitudes toward services were identified along six dimensions: ability to meet care needs, autonomy in daily life, quality of care and staff, cost, emotional connotations, and social and physical environment. Participants used formal services in a dynamic manner, meeting both episodic and chronic needs. Families played an active role in sustaining and augmenting the caregiving situation, regardless of living arrangement., Implications: This research highlights the range of criteria included in attitude formation about services and the dynamic nature of the interplay between families and formal services.

This study used grounded theory to explore how long-term care services are perceived and what factors influence family caregiving and long-term care service utilization choices among Japanese Americans. Family and generational perspectives elucidated a dialectic between forces of integration into the broader culture, and reconnection with the culture of origin within the context of powerful ethnically based historical and generational experiences. This study describes the evolution of the values underlying service delivery and family expectations and demonstrates the dynamic relationships among cultural expectations, historical context, and service evolution for a group of members involved in the caregiving experience.