Moderating Effect of Work on Burden and Hospice Family Caregiver Well-Being

Hospice family caregiving is often physically and emotionally taxing, but it is unclear how employment status impacts hospice caregiver burden and well-being. To examine the relationship between caregiver burden and well-being, and the moderating role of employment status (i.e., working, not working). This was a secondary data analysis of baseline data from a longitudinal observational study of family caregivers of home hospice cancer patients in the United States. Descriptive statistics, correlations, hierarchical linear regressions, and moderation analyses were used. Baseline data included demographics, preparedness for caregiving, perceived burden, and well-being (i.e., global health, positive affect and well-being, anxiety, depression). The majority of the 90 participants were White (86.7%), married (71.1%), and college educated (85.6%). The mean age was 58.27 ± 14.22, 53.3% cared for a spouse, and 56.6% worked full or part time. After controlling for demographics, and using employment status as a moderator, greater caregiver burden was significantly associated with lower global health (β = -0.82 [-1.22 to -0.42], p < 0.001), positive affect and well-being scores (β = -0.69 [-1.03 to -0.36], p < 0.001), and higher depression (β = 0.24 [0.12-0.37], p < 0.001) and anxiety scores (β = 0.22 [0.07-0.37], p < 0.005). Employment status significantly moderated the relationship between burden and global health (β = 0.65 [0.22 to 1.08], p < 0.005), and burden and positive affect and well-being (β = 0.45 [0.06 to 0.84], p < 0.05). At high levels of burden, workers had greater well-being than nonworkers. More burdened hospice caregivers may experience worse well-being, especially among nonworking caregivers. Employment may be a protective factor for highly burdened hospice family caregivers.