Who cares? Grandparent/grandchild households

Grandparenting, health, and well-being: a systematic literature review

Whether grandparenting is associated with improved health or well-being among older adults is a salient question in present-day aging societies. This systematic review compiles studies that consider the health or well-being outcomes of grandparenting, concerning (1) custodial grandparent families, where grandparents are raising grandchildren without parental presence; (2) three-generation households, where grandparents are living with adult children and grandchildren; and (3) non-coresiding grandparents, who are involved in the lives of their grandchildren. Review was based on literature searches conducted in September 2019 via Web of Science, PubMed, PsycINFO, and Ebsco. We screened 3868 abstracts across four databases, and by following the PRISMA guidelines, we identified 92 relevant articles (117 studies) that were published between 1978 and 2019. In 68% of cases, custodial grandparenting was associated with decreased health or well-being of grandparents. The few studies considering the health or well-being of grandparents living in three-generation households provided mixed findings (39% positive; 39% negative). Finally, in 69% of cases, involvement of non-coresiding grandparents was associated with improved grandparental outcomes; however, there was only limited support for the prediction that involved grandparenting being causally associated with grandparental health or well-being. Despite this, after different robustness checks (counting all nonsignificant results, taking into account the representativeness of the data and causal methodology), the main finding remains the same: the most negative results are found among custodial grandparents and three-generation households and most positive results among non-coresiding grandparents.

Grandparental partnership status and its effects on caring for grandchildren in Europe

Grandparents are important childcare providers, but grandparental relationship status matters. According to several studies, caregiving is reduced after grandparental divorce, but differential responses by grandmothers versus grandfathers have often been glossed over. To explore the effects of relationship status on grandparental care, we analysed data from the Survey of Health, Ageing and Retirement in Europe (SHARE) comparing four grandparental relationship statuses (original couple, widowed, divorced, and repartnered) with respect to grandmothers' and grandfathers' provision of care to their birth children's children. When proximity, kinship laterality, and grandparents' age, health, employment, and financial status were controlled, divorced grandmothers without current partners provided significantly more childcare than grandmothers who were still residing with the grandfather, those who had new partners unrelated to the grandchildren, and widows without current partners. Grandfathers exhibited a very different pattern, providing substantially less grandchild care after divorce. Grandfathers in their original partnerships provided the most grandchild care, followed by widowers, those with new partners and finally those who were divorced. Seemingly contradictory findings in prior research, including studies using SHARE data, can be explained partly by failures to distinguish divorce's effects on grandmothers versus grandfathers, and partly by insufficient controls for the grandmother's financial and employment statuses.

Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey

Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis). Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents' physical and emotional capacities.

Custodial grandmothers' psychological distress, dysfunctional parenting, and grandchildren's adjustment

An adaptation of the Family Stress Model (FSM) with hypothesized linkages between family contextual factors, custodial grandmothers' psychological distress, parenting practices, and grandchildren's adjustment was tested with structural equation modeling. Interview data from 733 custodial grandmothers of grandchildren between ages 4-17 revealed that the effect of grandmothers' distress on grandchildren's adjustment was mediated by dysfunctional parenting, especially regarding externalizing problems. The effects of contextual factors on grandchildren's adjustment were also indirect. The model's measurement and structural components were largely invariant across grandmothers' race and age, as well as grandchildren's gender and age. Group differences were more prevalent regarding the magnitude of latent means for model constructs. We conclude that parenting models like the FSM are useful for investigating custodial grandfamilies.

All in the family: the impact of caring for grandchildren on grandparents' health

OBJECTIVES

The purpose of this study was to examine the effects of caring for grandchildren on health behaviors and mental and physical health among older adults.

METHODS

Using a sample of 12,872 grandparents aged 50 through 80 from the Health and Retirement Study, we examined the relationship between stability and change in various types of grandchild care and subsequent health, controlling for covariates and earlier health.

RESULTS

We found no evidence to suggest that caring for grandchildren has dramatic and widespread negative effects on grandparents' health and health behavior. We found limited evidence that grandmothers caring for grandchildren in skipped-generation households are more likely to experience negative changes in health behavior, depression, and self-rated health. We also found some evidence of benefits to grandmothers who babysit.

DISCUSSION

Our findings suggest that the health disadvantages found previously among grandparent caregivers arise from grandparents' prior characteristics, not as a consequence of providing care. Health declines as a consequence of grandchild care appear to be the exception rather than the rule. These findings are important given continuing reliance on grandparents for day care and increasing reliance on grandparents for custodial care. However, the findings should be tempered by the recognition that for a minority of grandparents, coresidential grandchild care may compromise health.

Grandmothers' diaries: a glimpse at daily lives

Little information exists about the daily lives of women who are grandmothers, and the differences in daily stresses based on caregiving status to grandchildren. This content analysis examines the stresses of 64 grandmothers as grouped by caregiver status (grandmothers raising grandchildren, grandmothers living in multigeneration homes, non-caregivers to grandchildren) as recorded in three-week diaries. The nature of salient issues and stressful interactions differed by caregiver groups. Grandmothers raising grandchildren reported more stresses related to grandchildren's routines, activities, and school progress, more time pressure, and difficult interactions with grandchildren. The diary entries of grandmothers in multigenerational homes reflected their supplemental role in childcare, and sometimes stressful interactions with other family members. Grandmothers with no routine caregiving to grandchildren reported more involvement with those outside the immediate family. Many general concerns about the well-being of the family represent commonalities in grandmothers despite differences in current caregiving roles to grandchildren.

Elevated depressive symptoms among caregiving grandparents

OBJECTIVE

To determine whether caregiving grandparents are at an increased risk for depressive symptoms.

DATA SOURCE

National sample (n=10,293) of grandparents aged 53-63 years in 1994, and their spouse/partners, who took part in the Health and Retirement Study (HRS).

STUDY DESIGN

Grandparents were surveyed in 1994 and resurveyed every two years thereafter, through 2000. Over that period, 977 had a grandchild move in or out of their home. These grandparents served as their own controls to assess the impact of having a grandchild in the home. Data Extraction. Depressive symptoms were measured using an abbreviated form of the Center for Epidemiologic Studies-Depression (CES-D) scale, scored 1-8, with a score > or =4 associated with depression "caseness".

PRINCIPAL FINDINGS

At the time of the 1994 interview, 8.2 percent of grandparents had a grandchild in their home. However, there was substantial variation across demographic groups (e.g., 29.4 percent of single nonwhite grandmothers, but only 2.0 percent of single white grandfathers had a grandchild in residence). The impact of having a grandchild in the home varied by grandparent demographic group, with single grandparents and those without coresident adult children experiencing the greatest probability of elevation in depressive symptoms when a grandchild was in residence. For example, single nonwhite grandmothers experienced an 8 percentage point increase in the probability of having a CES-D score > or =4 when a grandchild was in their home, compared to when a grandchild was not in their home, controlling for changes in health care, income, and household composition over time (95 percent CI=0.1 to 15.0 percentage points).

CONCLUSIONS

Grandparents have a greater probability of elevated depressive symptoms when a grandchild is in their home, versus when a grandchild is not in their home. Single women of color bear a disproportionate burden of the depression associated with caring for grandchildren. Since an increasing number of grandparents function as a de facto safety net keeping their grandchildren out of formal foster care, identifying strategies to support the health and well-being of caregiving grandparents is an emerging priority.

Caregiving to children and grandchildren and risk of coronary heart disease in women

OBJECTIVES

We examined the relationship between burden of providing care to non-ill children and grandchildren and incidence of coronary heart disease (CHD) among women.

METHODS

A prospective cohort study was conducted as part of the Nurses' Health Study among 54,412 women aged 46 to 71 years who were registered nurses. Women answered questions about their child care responsibilities.

RESULTS

We documented 321 incident cases of CHD during 4 years of follow-up. Multivariate analyses showed that caring for non-ill children 21 hours or more per week and caring for non-ill grandchildren 9 hours or more per week (vs no caregiving) were associated with an increased risk of CHD (relative risks were 1.59 and 1.55, respectively).

CONCLUSIONS

High levels of care provision to grandchildren (and possibly children) may increase the risk of CHD among women.

Grandparent visitation rights: an inappropriate intrusion or appropriate protection?

Increased divorce rates, longevity in multi-generational families, and activism by older persons are a part of the context in which the role of grandparents in the family, an overview of grandparent visitation statutes, and controversy about visitation rights are discussed. The history and characteristics of grandparent visitation statutes, the process of filing, and criteria used to grant visitation provide insight into the complexities of the request for, and determination of, these rights. Family dynamics interact with a myriad of state statutes to suggest implications for research and policy.

Health of grandmothers: a comparison by caregiver status

OBJECTIVES

In this cross-sectional study, stress, coping, social support, and health were compared in 86 primary caregiver grandmothers, 85 partial/supplemental caregiver grandmothers in multigenerational homes, and 112 noncaregiver grandmothers. Whether support and coping reduced effects of stress on the physical and mental health of grandmother caregivers, including mediating and moderating effects, was examined.

METHODS

A convenience sample completed a mailed questionnaire that included measures of stress, health, support, and coping.

RESULTS

Primary caregivers reported worse self-assessed health, but partial/supplemental caregivers reported a tendency toward more depression and more instrumental support. Noncaregivers reported the least stress and less active and avoidant coping. Coping and subjective support added to the variance of depression and self-rated health. Subjective support and avoidant coping mediated between stress and health, and active coping moderated the effects of stress on health.

DISCUSSION

Implications of these findings relative to the health of grandmothers by caregiver status are discussed.