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community-based long-term care, culturally sensitive services, family caregiving, Japanese Americans



  1. Young, Heather M. PhD, ARNP, FAAN
  2. McCormick, Wayne M. MD, MPH, FACP
  3. Vitaliano, Peter P. PhD


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.