Care Burden, Financial Strain, and Depressive Symptoms: Sex-Stratified Pathways to Multidimensional Quality of Life Among South African Retirees

In South Africa, retirement often coincides with unpaid caregiving for frail spouses, grandchildren, and other dependants. Guided by the stress-process model and related appraisal perspectives, this cross-sectional study examined whether financial strain and depressive symptoms were, individually and sequentially, associated with links between household care burden and seven quality of life (QoL) domains, and whether these patterns differed by sex. We analysed Wave 7 (2023/2024) Gauteng City-Region Observatory Quality of Life survey data for 1,987 pensioners aged 60 years and older who reported regular caregiving (men = 767; women = 1,220). Partial least-squares path modelling with 5,000 bootstrap resamples was used to estimate direct and indirect associations. In the combined sample, higher care burden was associated with greater financial strain, and greater financial strain was associated with more depressive symptoms and lower scores on several QoL domains, particularly life satisfaction, safety, services, and perceived socioeconomic status. Care burden was also positively associated with civic participation. In the sex-stratified models, the burden–financial strain–depressive symptoms pattern was evident among women but not among men. Both men and women showed a positive direct association between care burden and participation. These findings are consistent with the view that the material and emotional correlates of later-life caregiving are multidimensional and may differ in patterning between men and women. Because the data are cross-sectional, the results should be interpreted as associations rather than causal effects. These findings indicate that policy responses that combine targeted cash and psychosocial support for female retirees, alongside stipend-funded “care-champion” roles that harness older men’s civic engagement, could help mitigate the downsides of intensive later-life caregiving.