Beyond Burden: The Role of Life Balance In Buffering the Effects of Caregiving Intensity on Depressive Symptoms Among Unpaid Family Caregivers of Older Adults

Background and Purpose: Unpaid family caregivers provide the majority of care to older adults and are at high risk of experiencing adverse mental health. Compared to other non-family unpaid caregivers, unpaid family caregivers experience higher rates of psychological distress, such as anxiety and depressive symptoms, yet modifiable protective factors such as life balance remain understudied. Guided by the Life Balance Model by Matuska and Christiansen (2008), this study examines life balance, the degree to which caregivers maintain satisfying engagement across health, relational, identity, and interest domains, in buffering the burden of depressive symptoms of caregiving. Three hypotheses were tested: (H1) higher caregiving intensity will be significantly associated with lower caregiver life balance; (H2) higher caregiver life balance will be significantly associated with lower levels of depression; and (H3) life balance moderates the intensity-depression relationship.

Methods: The study sample was drawn from the National Study of Caregiving Dataset (NSOC Round 13) (N = 2,958), a nationally representative sample of unpaid family caregivers of adults aged 65 and older. Life balance was operationalized as a four-domain proxy composite capturing health, relationship, identity, and interest using validated NSOC items. Caregiving intensity was operationalized as a standardized composite of the frequency of assisting with activities of daily living (ADL) and instrumental activities of daily living (IADL). Depressive symptoms were assessed using the PHQ-2. Sequential ordinary least squares regression models with robust standard errors were estimated, controlling for gender, race/ethnicity, and educational attainment. All continuous predictors were mean-centered before computing interaction terms.

Results: The overall adjusted model was statistically significant, R² = 0.111, F(9, 2948) = 38.18, p < .001, explaining 11.1% of the variance in depressive symptom severity. Caregiving intensity was significantly associated with lower life balance (β = -0.017, SE = 0.004, p < .001). Life balance was strongly and negatively associated with depressive symptoms (β = -2.125, SE = 0.135, p < .001). When added to a baseline model containing only caregiving intensity (Model 1: R² = 0.013), life balance explained an additional 9.6% increase in variance (Model 2: R² = 0.111, ΔR² = .096), approximately eight times more variance than caregiving intensity alone. The overall moderation was not supported (β = -0.133, p = .240). Female caregivers reported significantly higher depressive symptom severity than male caregivers (β = 0.152, SE = 0.051, p = .003). Caregivers with a bachelor’s degree or higher reported significantly lower depressive symptoms compared to those with less than a high school diploma (β = -0.235, p = .035).

Conclusions and Implications: Life balance was a strong, independent, and modifiable protective factor against caregiver depression symptoms, explaining substantially more variance than caregiving intensity alone. For social work practice, routine assessment of life balance must be part of caregiving assessment. Future research should administer the full Life Balance Inventory (LBI) with caregiving populations and use longitudinal designs to establish causal direction.