Community service use attitudes of older spousal caregiver-care recipient couples: Gender differences and dyadic congruence

This study examined gender differences and dyadic congruence on the community service use attitudes of 30 older spousal caregiver-care recipient couples. Drawing from a model of factors influencing community service use and a rational choice framework, this cross-sectional survey operationalized service use attitudes employing seven attitude subscales adapted from the Community Service Attitude Inventory (Stommel, Collins, Given, & Given, 1999).;For the total sample, older females as a group reported a significantly higher mean score on the Wait-And-See Attitude compared to older males. Older males as a group reported a significantly higher level of Preference for Informal Care compared to older females. In the caregiver sub-sample, female spousal caregivers reported significantly higher levels of Confidence in Service System compared to male spousal caregivers. Male spousal caregivers reported a significantly higher Worry and Fear Attitude compared to female spousal caregivers. In the care recipient sub-sample, female spousal care recipients reported a higher Wait-And-See Attitude compared to male spousal care recipients. On within-dyadic congruence, evaluated using intraclass correlation coefficients, spousal caregiver-care recipient dyads displayed moderate to strong patterns of congruence on the total number of attitudinal scale items. Finally, spousal caregivers' Concern for Opinion of Others, Pride in Family Independence, and Rejection of Government Assistance attitude scores were negatively related to the level of reported unmet service need. A Wait-and-See Attitude was positively related to the level of reported unmet service need.;These exploratory findings support that researchers and practitioners must better understand not only older couples' existing service use patterns, but also those specific attitudes, beliefs and perceptions that may facilitate and impede their preference and demand for future services that may help preserve and improve health and quality of life. The study addresses implications for clinical practice and future research.