News Release

CWRU nurse researchers find effort takes its toll on unpaid family caregivers

Peer-Reviewed Publication

Case Western Reserve University

According to AARP, the annual cost of unpaid elder caregiving – work that falls mainly on the backs of family members – runs about $450 billion.

While some companies document the physical and emotional toll that the workplace takes on their employees, exactly how draining caregiving might be has never really been measured.

So Case Western Reserve University nurse researchers studied it.

"Without knowing the impact of effort, we have two vulnerable people at risk for health issues—the caregiver and the care receiver," said Evanne Juratovac, assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University and the study's lead investigator.

Juratovac was part of a research group that analyzed the effort of 110 family members for the study, "Effort, Workload, and Depression Symptoms in Family Caregivers of Older Adults: Conceptualizing and Testing a Work-Health Relationship." It was published in the international journal, Research and Theory for Nursing Practice (Vol. 26, No. 2, 2012).

The study is among the first to zero in on energy used to meet the demands and responsibilities of caregiving. Participants were surveyed about their activities and how they applied to mental, physical, emotional or time-related effort.

Researchers studied the physical, mental, emotional and time-related cost of home caregiving – the toll of which is usually energy overload.

While it's been known that caregivers can develop depression, this study found that "higher effort by the caregiver correlated with higher depressive symptoms," Juratovac said.

One participant, for example, said the effort "felt like pushing an elephant up a mountain." Another was constantly physically exhausted from the mental work. And another, who had to travel to provide parent care in the home, was taxed by the time and energy in having to juggle and rearrange schedules. Physical and mental effort sapped their energy the most.

But researchers were surprised to learn that a caregiver's effort was not eased when outside professional help or other family members stepped in.

Knowing what kinds of effort is expended would help in the development of interventions to ease this workload, yet maintain quality care for the recipient, Juratovac said.

The study's average caregivers were 58.5 years old (with 44 percent over age 60) and were mostly women (64 percent). The average age of the person receiving care was about 82. More than half of the caregivers were employed and were caring for one of their parents.

The caregiver's main health concerns were arthritis, back problems, hypertension and fatigue. Caregiving ran the gamut, from ordering medicines to full-time care.

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Contributing to the study were Diana Morris, Florence Cellar Associate Professor of Gerontological Nursing; Jaclene Zauszniewski, Kate Hanna Harvey Professor in Community Health Nursing, May Wykle, Marvin E. and Ruth Durr Denekas Professor from the Frances Payne Bolton School of Nursing, and Aloen L. Townsend, professor from the Mandel School of Applied Social Sciences.


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