Date of Award

Summer 2017

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Services Research

Committee Director

Karen Karlowicz

Committee Member

Christianne Fowler

Committee Member

Carol Mansyur


The number of Americans expected to live into their 80’s and 90’s is growing at an increased rate in the United States, and the numbers of those aging adults with multiple chronic conditions also continues to grow. It is estimated that by 2050, there will be 89 million adults over the age of 65 years living in the United States. For a variety of reasons, including policy, personal, and financial reasons, many aging adults are choosing to “age in place” or to remain in the community. With the increase in the numbers of aging adults in the community, the ability to locate quality and affordable informal caregiving options has become an essential need. Aging adults with chronic conditions, especially those with a high disease burden, have significant limitations in their ability to carry out day-to-day activities, have higher psychosocial needs, and have a higher mortality rate. Caregivers for aging family members often experience higher levels of burden and stress.

The purpose of this dissertation was to examine health related, community-based service use by informal caregivers caring for aging adults who identify as having an unmet need. Unmet needs in this study included the physical, mental, and/or tangible needs of the informal caregiver. Using a non-experimental, descriptive study design; predisposing, enabling, and need factors that traditionally influence health care service utilization by informal caregivers for aging adults in Virginia was studied. Results showed that demographic factors of the informal caregiver, willingness of the aging adult to access services, and stress and burden influenced community based, health service use. Findings further showcased a need to explore family dyads and a need for more comprehensive survey research among the informal caregiving population. Overall, this study highlighted the complexities of service utilization among informal caregivers and that use of services is influenced by a variety of complex factors.