A study from the Case Western Reserve University nursing school provides a profile of women with the dual responsibilities of full-time paid work and unpaid care for an elderly family member.

"We often hear caregivers talk about 'how much time and effort it takes' to provide care for their family members or neighbors," said Evanne Juratovac, PhD, RN (GCNS-BC), assistant professor of nursing at the Frances Payne Bolton School of Nursing and the study's lead researcher, "so we examined the experience of doing the workload on these women caregivers as the 'workers."

She said the study is similar to how industry measures the impact of workload (including the time and difficulty of the tasks) and effort (the perceived energy it takes to do the work).

The results of the study, published in Women's Health Issues, richly described the experiences of 46 women caregivers who work full-time and participated in the researchers' larger mixed-methods study in 2012.

The women, who averaged 51 years of age and the majority of whom cared for their parent, appeared to report health experiences that were related to the demands on their time and energy.

"While several of the women reported overall good health, the severity of depression suggests that these caregivers' mental health is in jeopardy," Juratovac said.

For example, some women may have experienced more depression related to their living situation or relationship to the care recipient; yet, some women experienced depressive symptoms that may be related to the presence of help from other family members or formal outside agencies.

The American Association for Retired Persons (AARP) and the National Alliance for Caregiving (NAC) report that about half of the 66 million family caregivers nationally also work outside the home.

And women provide more than half of the free caregiving, which AARP and NAC estimate would cost more than $450 million annually if someone were paid to do the work.

"These savings to society may overshadow the cost it has on the caregivers' economic stability and health," Juratovac said. It is known from national surveys (e.g., Metlife®) that caring for someone at home can cost employed women caregivers in obscured ways, as they may pass up job advancement, lose employment benefits by working fewer hours, and strain household budgets to pay for caregiving expenses.

Juratovac said she hopes the detailed findings promote a discussion among policymakers and employers to help employed caregivers facilitate their dual workloads.

She suggests, for example, flexible work schedules that allow employed caregivers to manage their responsibilities on behalf of their care recipient (such as consulting with health care providers) when necessary during the work day, while maintaining their productivity and managing their responsibilities in the paid workplace.

And since the researchers found it difficult to characterize the variety of "part time" employment experiences, suggestions were made - for research and for industry - to improve methods for measuring the time and effort that caregivers spend in caregiving tasks and other tasks over time, in order to more fully understand their full workload.