The stress associated with caring for an impaired elderly family membe
r has been well documented. Spousal caregivers In particular may jeopa
rdize their own health while attempting to meet the demands of caregiv
ing. Formal support services have been developed and are aimed at redu
cing the stress associated with caregiving. However, simply providing
services does nor ensure utilization. Research documents the low utili
zation of services by the elderly, particularly spousal caregivers, bu
r fails to explain it adequately. The author explores the gaps in curr
ent understanding of the issues and identifies the subjective meaning
associated with service we as an important but overlooked determinant
of service utilization. Selected case studies demonstrate the importan
ce of this understanding for effective intervention.