The purposes of this study were to describe effort as experienced by family caregivers in doing the work of caregiving to older adults and to investigate a possible relationship between effort and depressive symptoms in family caregivers. Effort is exerting energy to perform a workload; to balance the demands of work and prevent adverse health outcomes. Caregiving is work that is associated with disproportionately prevalent adverse health outcomes, including depression. With the theoretical influences of stress process and demand-control theory, a hybrid theoretical explanation was developed to conceptualize effort in caregiving and the effects of exerting energy to perform the caregiving workload on family caregivers.
A non-probability sample of caregivers was recruited in the community. Caregivers completed a mailed questionnaire that characterized the caregiving situation; and measured their workload; effort; and depressive symptoms. The final sample was 110 caregivers; mostly female; approximately 58 years old; Caucasian; employed full time; living with the care receiver, receiving some help from other family caregivers; and not receiving help from formal caregivers older adult care receivers. Qualitative and quantitative data were obtained to describe four types of effort: physical; mental; emotional; and time-related. Many caregivers suggested that effort is multidimensional and several had difficulty placing their descriptions of effort into discrete types of effort. All four types of effort were significantly positively correlated with depressive symptoms, workload time, workload difficulty, and overload. Higher workload time, difficulty, and overload were related to more depressive symptoms. Poorer caregiver health and lower care receiver functional ability were related to more depressive symptoms, higher effort, and more overload. Higher levels of mental and emotional effort were reported, perceived physically, and highly intercorrelated. Self-assessed health, care receiver ADL, and overload predicted depressive symptoms. No direct effects were observed of effort on depressive symptoms. Model testing and methodological triangulation are recommended to investigate these relationships further. This information has the potential to guide health care providers and policy makers toward preventive physical and mental health care of family caregivers; the nation’s primary caregivers of older adults.