The purpose of this study was to compare employed and non-employed caregivers of heart failure (HF) patients on caregiver appraisal, caregiver health-related quality of life (HRQL), and patient hospitalizations. The study used a cross-sectional design. Caregivers were interviewed face-to-face in a structured interview. Caregiver appraisal was measured using the Caregiver Reaction Assessment. Caregiver HRQL was measured using the Quality of Life Index. Hospitalization data was recorded from patient electronic medical records. Among 50 adult children and spousal caregivers of HF patients with multiple co-morbidities and frequent hospitalizations, employed caregivers perceived lower health risks associated with caregiving than non-employed caregivers, t(48) = 2.64, p < .01. Non-employed caregivers (n = 31) had higher levels of perceived health risks (M = 2.48; SD = 1.05) compared to caregivers who were employed (M = 1.76; SD = .68). Employed caregivers had significantly higher mean scores in total HRQL, t(48) = -2.7, p < .01; health and function HRQL, t(48) = -2.3, p < .05; family HRQL, t(48) = - 2.4, p < .05; and social and economic HRQL, t(48) = -3.3, p < .01. There were no significant differences between the employed and non-employed caregiver groups on the number of patient hospitalizations or days hospitalized in the previous 12 months. Considering the negative reactions to HF caregiving reported by others, maintaining caregiver employment may enhance or maintain the caregiver‟s financial, mental and physical well-being. Nursing care to improve caregiver HRQL could focus on ways to maintaining the independence and safety of the patient at home or respite services that would support continued caregiver employment.