The Impact of Spousal Caregiving on Financial Well-Being: An Analysis of Subjective Financial Strain

Background: Spousal caregiving for older adults living with chronic and disabling conditions brings unexpected out-of-pocket costs, employment disruption, and financial strain that may adversely affect caregiver health. Caregivers often enter this role without anticipating that care needs may persist for years. In the United States, despite the heavy reliance on spousal caregivers to help older adults remain in the community, little is known about how spousal caregivers’ financial strain changes over time. Objective: To compare subjective financial strain between caregiving and non-caregiving spouses, including whether differences in financial strain change over time. Methods: Using longitudinal data from the Health and Retirement Study, we examined the relationship between spousal caregiving and subjective financial strain. Results: Bivariate analyses revealed that spousal caregivers ( n = 289) were less likely than non-caregiving spouses ( n = 3624) to report being able to pay bills (odds ratio [OR] = 0.67, P = .012) and financial satisfaction (OR = 0.63, P = .012). Population-averaged logistic regression models showed that caregivers had 27% lower odds of meeting monthly expenses (OR = 0.73, P = .008) and 26% lower odds of being financially satisfied (OR = 0.74, P = .010). Associations between caregiving and financial strain did not change over time. Conclusions: The persistent financial disadvantage observed among spousal caregivers relative to non-caregiving spouses suggests gaps in current support systems. As trusted care partners, nurses are well-positioned to identify financial strain early in caregiving and support spousal caregivers through referral to services to mitigate harmful effects.