Dementia is a multifaceted disease characterized by a decline in cognitive functioning that can impair social functioning and eventually impair a person's ability to care for oneself and the fifth leading cause of death for adults 65 years and older. An estimated 5.7 million people in the United States had a diagnosis of dementia in 2018; with total payments for health care, long-term care and hospice estimated at $277 billion. The impaired psychological and behavioral functioning characteristic of dementia negatively influences quality of life (QOL) of persons with dementia (PWD) and their caregivers. The studies in this Dissertation will examine, from a cultural context, the variability that exists within the caregiving process for African American dementia dyads concerning: 1) formal care use by the dyad, 2) the associations of various factors within the family with QOL of both members of the dyad and 3) the associations between decision-making of the PWD, formal care use and QOL of African American PWDs and their caregivers.