To grandmother's house we go ... and stay. Children raised in intergenerational families

Depression and Caregiver Mastery in Grandfathers Caring for Their Grandchildren

Kin caregiving research tends to focus on the experiences of grandmothers. Often unnoticed and underserved are grandfathers who also take on this responsibility. Here, two groups of grandfathers participated in focus group interviews to discuss their experiences as caregivers to their grandchildren. Common themes for the grandfathers were the feeling of missing freedom, experiencing child rearing differently now than they had with their own children, and fear of what would happen to the children should their health fail. Thirty-three grandfathers also answered questions about themselves; their grandchild; need, use, and satisfaction with formal services; depression; and caregiving mastery. A sample of 33 grandmothers selected from a previous study was matched to the grandfathers on age, race, and marital status. Differences in depressive symptoms between the grandfathers and grandmothers were statistically significant. There was no statistically significant difference between the grandparent caregivers on caregiving mastery. These findings suggest that there may be differences in the impact of caregiving for grandmothers and grandfathers. These differences should be further investigated.

Caring and Retirement: Crossroads and Consequences

As older workers move closer to retirement, they are more likely to take on caring roles. This may affect their health, retirement plans, and income security. Retired men and women experience the caring role differently, with men less likely to be adversely affected and more likely to accept services and to derive satisfaction from caring. Carers make an important contribution to the lives of the people they care for and to the community. Caring is a productive role that can be sustained into older age, as long as the carer's health and well-being are maintained. More research is needed on the relationship between retirement and caring, to explore the extent of caring and its impact on retirement plans, income, and the physical and mental health of retired carers. This information could then be built into retirement planning to better prepare older workers for this important role. Caring roles and retirement intersect in several ways. About 6 million Americans, 2.6 million Australians, and 6 million people in the United Kingdom are informal carers. People (especially men) are more likely to take on caring roles as they get older and leave the paid workforce. The need to care for a spouse or older relative can be an unanticipated outcome or a precipitator of retirement. Retirement may coincide with illness or disability of a parent or spouse, or may be forced by the demands of caring. Caring may bring about major changes to retirement plans. The financial impact of having been a carer during one's working life may also be felt most keenly on retirement, through the lack of opportunities for savings and retirement fund co-contributions.

A home-based nutrition and physical activity intervention for grandparents raising grandchildren: a pilot study

Five African American grandparents raising their grandchildren participated in a home-based nutrition and physical activity intervention. The primary goals were to increase grandparents' knowledge and skills in selecting and preparing healthy foods and to increase the grandparents' and grandchildren's physical activity levels. Results revealed that grandparents' concerns regarding their chronic diseases and desire to prevent health problems in their grandchildren served as motivators. Following the intervention, grandparents scored higher on nutrition and physical activity knowledge and their self-efficacy improved, although most health status indicators remained unchanged. Self-reported changes included walking more, reading food labels, and switching to a healthier type of fat.

Grandparent caregivers

Although grandparent caregiving is not a new phenomenon in the United States, there has been a dramatic increase in grandparent-headed households in the last two decades. Many of these care providers are older and feel somewhat unprepared to raise a new generation of children. As a result, grandparent caregivers are at risk for multiple physical, mental, and emotional problems due to the stresses and strains of care provision. This article summarizes characteristics of grandparent caregivers in our society, the challenges that they face, and how organizations are attempting to assist these older adults with their care provision responsibilities. Recommendations for future research and intervention design will also be discussed.

Grandparents Raising Grandchildren: A Response to a Nutrition and Physical Activity Intervention

This pilot study explored the impact of an educational program on nutrition and physical activity knowledge of urban African-American grandparents raising their grandchildren. The program was integrated into a community-based intervention, Project Healthy Grandparents, and was implemented during the first 15 minutes of 10 grandparent support groups and parenting classes. Subjects included 22 grandparents who attended at least six sessions and completed pre- and posttests of nutrition and physical activity knowledge. Participants' posttest scores were significantly higher than their pretest scores (P<0.05), indicating an increase in knowledge. Eighteen grandparents provided insights about diet and physical activity and barriers to lifestyle changes during an audiotaped focus group. Based on analysis of the focus group's discussion, three major influences on healthful eating and physical activity emerged, including financial considerations, presence of grandchildren in the home, and preference for traditional cultural foods. Themes from the focus group were consistent with responses on the nutrition and physical activity knowledge test. Satisfaction with the program was very high and no specific recommendations for improvements were made. Results can guide future nutrition interventions for this target group and potentially contribute to grandparents' improved health and ability to care for their grandchildren.

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.

GRANDMOTHER CAREGIVER REACTIONS TO Caring for High-Risk Grandchildren "I could write a book!"

During the past decade there has been an increase in the prevalence of grandmothers raising their grandchildren because of parental drug use and child neglect and maltreatment in the United States. A study was designed and conducted to examine the relationship between caregiver burden and caregiver physical health for grandmothers raising their high-risk grandchildren. The sample consisted of 104 grandmothers. The findings indicated that caregiver physical health correlated strongly with level of burden and financial status. Further analysis suggests physical health variables had an observable impact on caregiver burden. Because this study indicates, from descriptive and correlational statistics, that the well-being of the grandmother and grandchild are both linked to the grandmother's physical health, there are numerous nursing interventions that may support a positive outcome for both. The provision of emotional and psychosocial support, coupled with health education and periodic health evaluations, are known to improve a grandmother's perception of her own health. Nurses can use the measures of caregiver burden to develop care plans targeting the health issues most likely to improve a grandmother's functional ability to remain the primary caregiver for a high-risk grandchild.

Grandmother caregivers and caregiver burden

PURPOSE

To describe the experience of grandmothers who are parenting their grandchildren, and determine the amount of caregiver burden felt by the grandmothers.

STUDY DESIGN AND METHODS

This descriptive correlational study had a sample of 104 grandmothers, reporting on 249 custodial grandchildren. Grandmothers completed the Caregiver Reactions Assessment to determine perceived physical health, family support, financial status, and caregiver burden.

RESULTS

Overall, grandmothers perceived the health of their grandchildren as excellent. Of the grandchildren who had been born prematurely (30%), the primary health problems were hyperactivity and asthma. Parental drug use was reported as the reason for child placement with the grandmother in 80% of the cases. The range of time grandchildren had been living with the grandmother was 6 months to 15 years. Low ratings of grandchild physical health correlated with low ratings of grandmother physical health, which correlated strongly with low levels of self-esteem, a strong perception of poor family support, and poor financial status, all of which represent measures of caregiver burden.

CLINICAL IMPLICATIONS

This study demonstrated that the well being of the grandmother and grandchild are both linked to good physical health. Thus, indicators of poor health for both grandchild and grandmother must be identified early. Grandmothers in this study were surprised at how much had changed in every aspect of child health since they had raised their own children. Nurses working with grandmothers who have custody of grandchildren should understand the dynamics of the relationship, the possibility of caregiver burden, provide anticipatory guidance about the changes in child care and child healthcare in the 21st century, and help link grandmothers who have little support to community programs.

Empowerment: a case study of a grandmother caring for her HIV-positive grandchild

A case study methodology is used to explore the meaning and development of empowerment in a grandmother who is the primary caregiver of a child with HIV infection. Empowerment to this grandmother meant being strong, coming to grips with life's challenges, and then moving on. Empowerment developed over the grandmother's life span as a result of developmental and situational experiences such as motherhood, disclosure of the HIV diagnosis, sharing her positive and negative feelings with others, gaining knowledge about HIV, making management decisions, and her increasing sense of spirituality. This grandmother manifests her empowerment through her public commitment to influence others positively about HIV infections through speaking, writing, and leadership in groups. Clinical implications are discussed.

African American grandmothers' perceptions of caregiver concerns associated with rearing adolescent grandchildren

In 1996, grandparents were the sole providers of care for 269,000 grandchildren. Research findings indicate that grandmothers are usually the primary caretakers of grandchildren. Previous issues associated with raising grandchildren vary, but usually relate to the grandparents' health, financial concerns, or lack of social support. This qualitative descriptive study was designed to describe African American grandmothers' perceptions about the burdens of raising adolescent grandchildren. Using this approach, the researchers were able to study the richness and diversity of the grandmothers' perceptions. Data were collected from 35 grandmothers through a focus group (n = 7) and during a 4-day intervention research study (n = 28) entitled "Grandmother-Grandchild Health Promotion Program." Numerous concerns were voiced by both groups, but those stated most frequently were associated with the well-being of grandchildren (grandchildren's sexual behavior, potential drug use, and potential risk of encountering violence) and relational conflicts with adult children. Unexpected findings were the absence of stated concerns associated with the grandmothers' financial situation or health. Recommendations for intervention, clinical practice, and research are discussed.

Psychological distress in grandmother kinship care providers: the role of resources, social support, and physical health

OBJECTIVE

The purpose of the present study was to investigate predictors of psychological distress in grandmother kinship care providers. More specifically, it was hypothesized that social support, family resources, and physical health would predict psychological distress in grandmothers raising grandchildren.

METHOD

One hundred and two grandmothers raising grandchildren in parent-absent homes completed the Brief Symptom Inventory, Short Health Form-36, Family Resource Scale, Family Support Scale, and a questionnaire requesting background and demographic data.

RESULTS

Results indicated that psychological distress was predicted by family resources, participants' physical health, and to a lesser extent, social support.

CONCLUSION

The findings indicate that family resources, social support, and physical health affected psychological distress in grandmothers raising grandchildren. Grandmothers who reported fewer resources, less social support, and poorer physical health tended to experience higher levels of psychological distress. This study suggests that greater attention be given to interventions aimed to decrease psychological distress and improve the financial resources and physical health of grandmothers raising grandchildren.

The changing role of grandparenthood

For many grandparents in America, caring for grandchildren has become a full-time responsibility that has led to multiple stresses. Raising grandchildren may cause financial stress, cramped living quarters, role restriction, and social isolation among this group. However, advantages to this role among grandparents can include greater life satisfaction and a positive influence on the other generations within the family. Nurses and other health providers can play an essential role in assisting grandparents caring for grandchildren by strategically building family strengths and cohesiveness.