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The mental and physical health of grandmothers who are raising their grandchildren
Abstract
Like other family caregivers, the great majority of grandparents raising grandchildren are female. Recent research indicates that 14.5% of American grandmothers have raised a grandchild for six months or more. This study uses a nationally representative sample, the National Survey of Families and Households, to compare the mental and physical health of caregiving (n = 147) and noncaregiving grandmothers (n = 1874), within the context of several other key demographic variables. Analyses indicate that, in comparison to noncaregiving grandmothers, caregiving grandmothers are more likely to have significant levels of depressive symptomatology (32% versus 19%) and to have some limitations in their activities of daily living (56% versus 44%). Implications of these findings for practice, research, and policy are discussed.
... The overwhelming sense of responsibilities can lead caregivers to neglect their own physical and emotional health because they give priority to the needs of their grandchildren (Mills, Gomez-Smith, & De Leon, 2005). Fuller- Thomson and Minkler (2000) found that caregiving grandmothers are more likely to have significant levels of depressive symptomatology and to have some limitations in their daily activities versus noncaregivers. Many grandmothers find themselves with the responsibility of updating their parenting skills. ...
... Fuller- Thomson and Minkler (2000) further found that grandparents with physical or emotional problems had higher levels of personal stress and depression than their peers raising grandchildren without significant problems. Although grandmothers have health disadvantages, caring for grandchildren does not seem to make them worse. ...
... Grandparent caregivers who left their work to assume full time caregiving often experience increased social isolation and became less secure financially (Fuller- Thomson & Minkler, 2000). The dilemma of working or not working brings up issues of self-esteem and self-worth for many grandparents; as well as the realities of more modest income and increased stress (DeToledo & Brown, 1995, p. 24). ...
... As a result of the strained family conditions under which care is typically assumed, custodial grandparenthood is often unanticipated, involuntary, and indefinite and is therefore a risk factor for psychological distress (Pearlin, 1993). Several studies comparing grandparent caregivers to noncaregivers have identified greater depression and worse health (Fuller-Thomson & Minkler, 2000b;Solomon & Marx, 2000) in national samples, and caregiving grandparents were more depressed than noncaregivers in an Alameda County study (Strawbridge, Wallhagen, Shema, & Kaplan, 1997). ...
... Sample selection decisions in the study of relatively rare populations must be viewed in light of the unique nature of the population being studied. The most often used random sample of a couple hundred caregiving grandparents (see Fuller-Thomson & Minkler, 2000b;Minkler, Fuller-Thomson, Miller, & Driver, 1997) presents low power and makes subgroup analyses difficult. Pruchno (1999;Pruchno & McKenney, 2000), in her national study of African American and White caregiving grandmothers, recruited a large sample of over 700 through media ads. ...
... For White grandmothers, three of five indicators showed no differences, but the custodial family was related to higher affect (positive and negative), a somewhat ambiguous result. Most studies of grandparent well-being have focused on the comparison between caregiving and noncaregiving grandparents, showing greater depression and lower physical well-being for the former (Fuller- Thomson & Minkler, 2000b;Solomon & Marx, 2000). One study compared custodial and coparenting grandparents with noncaregiving grandparents (Szinovacz, DeViney, & Atkinson, 1999). ...
This study addressed well-being of grandmothers raising grandchildren in coparenting and custodial households in a sample of African American, Latino, and White grandmothers.
A sample of 1,058 grandmothers was recruited through the schools and media. Grandmothers raising or helping to raise school-aged grandchildren in Los Angeles were interviewed, and analyses were conducted within ethnic groups.
African American grandmothers experienced equal well-being in coparenting and custodial families; however, if the stresses related to the parents' problems were removed by statistical control, they favored the custodial arrangement. Latino grandmothers had greater well-being in coparenting families, reflecting a tradition of intergenerational living. White custodial grandmothers experienced somewhat higher levels of affect (positive and negative) but showed no difference in other types of well-being.
The cultural lens through which grandparenthood is viewed has a marked impact on the adaptation to custodial or coparenting family structures.
... One study suggests that grandparent and other kin caregivers face similar challenges in raising children, but their experiences may vary due to age and resources (Denby et al., 2014). In general, kinship caregivers are likely to be older (AECF, 2012;Bavier, 2011) and have disadvantages, such as being less educated than other caregivers (Bavier, 2011;Ehrle & Geen, 2002) as well as poorer physical health (Fuller-Thomson & Minkler, 2000;Leder, Grinstead, & Torres, 2007) than non-kinship caregivers. ...
... Even after an initial adjustment period, grandparent caregivers' psychological functioning continues to experience challenges. For example, grandmother caregivers were more likely to have depressive symptoms than grandmothers who were not caregivers (Baker & Silverstein, 2008;Fuller-Thomson & Minkler, 2000). ...
Informal kinship caregivers provide the majority of out of home care to children who can no longer safely stay with their biological parent. Yet their parenting challenges are understudied since they are often left out from child welfare and other service systems. This mixed methods study, using a survey and focus groups of grandparent and other kin, examined predictors and sources of parenting stress. Quantitative findings suggested that the kinship family's needs and the caregiver's health and emotional well-being adversely affected parenting stress. Grandparent caregivers experienced an elevated level of parenting stress compared to other kin caregivers. Qualitative findings suggested that financial strains, concerns over children's behavior, navigating service systems and difficult relationships with birth parents contributed to their stress. It appeared that grandparent caregivers faced special challenges due to generational gaps, guilt and concerns over birth parents.
... Over the course of the last several decades, several researchers have focused their efforts on defining the rapidly growing population of grandparent-headed families (Fuller-Thomson & Minkler, 2000a, 2000bFuller-Thomson & Minkler, 2001;Hayslip et al., 1998;Pruchno, 1999) as well as examining the physical and emotional effects of raising grandchildren Kelley, Yorker, & Whitley, 1997;Minkler, Fuller-Thomson, Miller, & Driver, 2000;Sands & Goldberg-Glen, 1998Silverstein & Vehvilainen, 2000). While much research has looked at grandparents raising grandchildren in general, little research has focused on grandparents raising grandchildren with 5 disabilities in particular (Emick & Hayslip, 1999;Force, Botsford, Pisano, & Holbert, 2000;Kolomer, McCallion, & Janicki, 2002). ...
... This broadened view must include grandparents as primary caregivers of children with, and without, disabilities. Since grandparent caregiving has been linked to negative outcomes such as decreased peer-network interaction and social isolation, depression, and lowered life satisfaction (Burton, 1992;Fuller-Thomson & Minkler, 2000b;Kelley et al., 2000), it is important to identify social support resources that may facilitate positive development among grandparent caregivers (Landry-Meyer et al., 2005). Families who do not have the necessary resources and supports may not be able to adequately rear healthy, competent children (Hobbs et al., 1984). ...
... Previous studies suggest financial hardship, housing limitations, lack of transportation and day care, and inadequate material resources are reasons grandparents experience high levels of anxiety, frustration, and fear (Landry-Meyer, gerard, & guzell, 2005;Waldrop & Weber, 2001). Further, as grandparents experience the effects of aging, they become anxious about parenting grandchildren as their health fails and functioning declines (Fuller-Thomson & Minkler, 2000;Whitley, Kelley, & Sipe, 2001). ...
... A large body of research describes the concept of empowerment and empowerment practice (Chadiha, Adams, Biegel, Auslander, & gutierrez, 2004;Cox & Parsons, 1996;Dunst, Trivette, & Deal, 1988;Freire, 1983;gutierrez, 1994;Kieffer, 1984;Parsons, 1991;rappaport, 1987). There is a consensus among authors that empowerment is a process by which individuals assume control over their lives and motivate others to act for positive social change. ...
Empowerment practice is an approach to help marginalized families reduce their sense of powerlessness. The present study explores empowerment practice with a sample of low-income African American custodial grandmothers. It specifically describes how the effects of a strengths-based community service program influenced caregivers' sense of empowerment. Using the Family Empowerment Scale, the results suggest that the service intervention supports the empowerment dimensions and three subscales (knowledge, advocacy, and self-efficacy); the results did not support the competency subscale. Although all age groups experienced an increase in empowerment, older grandmothers had significant differences in perceptions regarding social systems, as well as a sense of competency as compared with younger grandmothers. Implications for service delivery and future research are presented.
... Stress may also result from problems with the grandchild's parent – problems that precipitated the grandparent's entry into the caregiving role such as drug or alcohol abuse (Pillemer & Suitor, 1991). Finally, grandparents raising grandchildren are at particular risk for financial strain, are at elevated risk of living in inadequate housing conditions (Minkler & Fuller-Thomson, 2005) and are likely to experience poor health outcomes (Minkler & Fuller-Thomson, 1999). Within the context of the multiple jeopardy experienced by caregiving grandparents—in terms of the unexpected and ambiguous nature of the caregiving role, the strains associated with the tasks of caregiving, the social and emotional pathologies present in younger generations, and the challenges associated with poor socioeconomic and health status—it is not surprising that this group of grandparents has been shown to be at elevated risk of depression. ...
... These grandparents may benefit from support groups designed to provide emotional support for grandparents who are dealing with these difficult issues. However, it is important to remember that during the transition into raising a grandchild, many grandparents are experiencing financial strain and issues of housing adequacy either due to or exacerbated by the assumption of care for a grandchild (FullerThomson & Minkler, 2003;Minkler & Fuller-Thomson, 2005). These problems may contribute to the high levels of depression observed among grandparents who have recently begun care for a grandchild as much as the emotional strain experienced by these grandparents. ...
Using the Health and Retirement Study, this research examines well-being among grandparents raising grandchildren during middle to late life, specifically looking at how other roles in which a grandparent is participating (such as worker, volunteer, parent or caregiver) may influence depressive symptoms among grandparent caregivers. Results indicate that grandparents who have recently begun raising a grandchild experience lower levels of well-being when compared to grandparents who are not raising a grandchild regardless of the grandparent's level of participation in roles beyond that of grandparent caregiver, while grandparents who have been raising a grandchild for longer periods of time seem to benefit from their participation in multiple roles. However, a higher level of participation in outside roles is associated with a decline in well-being among grandparents who stopped raising a grandchild, suggesting that, for these grandparents, participation in multiple roles acted mainly as a stressor, rather than as a resource.
... The salient areas of study within this shift of focus have been custodial grandparents vis-a-vis epidemics (e.g., HIV and drug epidemic of the 1980 and 1990) or other factors that impact the safety of children (e.g., child abuse) (Fuller- Thomson & Minkler, 2000;Minkler, Roe, & Robertson-Beckley, 1994;Whitley, Kelley, & Sipe, 2001). Others have examined grandparents as resources during stressful times, such as divorce or illness in family life courses (Ruiz & Silverstein, 2007;Silverstein & Ruiz, 2006). ...
Regardless of nation and culture, grandparents have been instrumental in the survival of families and communities as well as the preservation of cultures. This study explored the meaning and roles of grandparenting among Maori grandparents in New Zealand as a possible platform for advancing the conversation on the significance of grandparents in the lives of people across cultures. Participants interviewed included 17 Māori grandparents to great, great grandparents in Aotearoa New Zealand, living in intergenerational homes. A phenomenology approach was used to analyze the data. Five themes were extracted that elucidated the meaning of the roles of grandparenting from the perspective of Māori grandparents: Elders’ responsibilities from a cultural perspective; support, resources, and assets; sociopolitical and economic challenges; current state of Elders’ and role in family, and benefits and rewards. Implications and recommendations are discussed towards a more systemic and culturally responsive support of grandparents.
... mental health issues [6]. Grandparents parenting grandchildren have been demonstrated in multiple studies to have higher levels of depression than grandparents who are not raising grandchildren [7][8][9]. The mechanisms underlying this low level of happiness, however, are unknown. ...
INTRODUCTION: The responsibility of grandparents caring for their grandchildren comes with stress to the grandparents that can have an impact on their emotional health and psychological well-being. The aim of the study was designed to assess the level of stress and associated factors among grandparents raising their grandchildren of employed parents at selected area of Bangalore. MATERIALS AND METHODS: A cross-sectional descriptive research design and non-probability purposive sampling technique was used was used among 100 grandparents rearing their grandchildren at selected area of Bangalore. Modified parental stress scale (Berry and Jones 1995) was used to collect data from subjects. Descriptive, inferential statistics and chi-square was used to observe the association. P-value <0.05 level was considered as significant. RESULTS: The majority (53%) of the respondents had moderate level of stress. A significant association was found with stress and selected socio-demographic variables like age, marital status, education level, religion, type of family, number of grandchildren, number of hours involved in child rearing per day, pre-existing medical/mental illness, and reasons for providing basic need of grandchildren (p< 0.05). Female grandparents had more stress compare to male grandparents. CONCLUSIONS: The grandparents rearing their grandchildren have mild and moderate level of stress and with comparison of male and female grandparent’s stress, female grandparents are more stressed compare to male grandparents.
... A prospective cohort study conducted as part of the Nurses' Health Study showed higher rates of saturated fat consumption, hypertension, and diabetes among grandmothers caring for their grandchildren than those who were not (Lee et al., 2003). Another study found that caregiving grandmothers were more likely than non-caregivers (32% vs. 19%) to be categorized as depressed (Fuller-Thomson & Minkler, 2000). Given the increasing prevalence of GHHs, their greater vulnerability to T2DM, and the lack of information about the experiences of rural GHHs, we employed a socioecological approach to examine and describe the overall health and T2DM specific risk factors of GHHs. ...
Objective
The purpose of this study is to assess type 2 diabetes mellitus (T2DM) risk factors in grandparent caregivers living in a rural environment.
Methods
Clinical measures (hemoglobin A1c [HbA1c], blood pressure, and lipids) and self-reported data on social environment factors were attained. Data were analyzed via Pearson’s correlation and regression models.
Results
By clinical definition of diabetes (HbA1c ≥ 6.5%), 21% were prediabetic and 28% had undiagnosed T2DM. There was an association between the number of individuals in the home and triglycerides ( r = −.25), high-density lipoproteins (HDL; r = .43), and body mass index (BMI; r = .39). Guardianship status had a significant association with BMI ( r = −.38). There was a significant association between low-density lipoprotein (LDL; r = −.32) and access to community shared resources. In the adjusted linear model, the number of grandchildren in the home had a significant relationship with HDL (β = .012, p = .021) whereas the number of individuals living in the home had a statistically significant relationship with HDL (β = .026, p < .000) and BMI (β = .046, p = .02). In addition, 15% of participants reported being food insecure.
Discussion
Efforts are needed to identify and screen at-risk populations living in geographically isolated areas. Considerations should be given to leveraging existing community resources for grandparent caregivers via schools, health systems, and government agencies to optimize health and well-being.
... They also fi nd rewards and positive life experiences from these relationships (Poindexter, 2001). Older caregivers often report poorer health than their noncaregiving counterparts and have higher incidences of depression (Fuller -Thomson & Minkler, 2000). Like older adults infected with HIV, older caregivers must also confront issues of stigma, discrimination, and the potential detriments and benefi ts of disclosure. ...
This chapter presents an overview of social work practice implications that can arise when the experience of HIV and aging intersect. It is important to consider HIV and aging together for two reasons. First, medical and/or social service practitioners still frequently fail to identify and serve HIV-infected midlife and older adults; thus, HIV-infected persons over the age of 50 often remain hidden and their needs unaddressed. Second, the caregivers of HIVinfected younger adults or children with HIV are often mid-life and older persons, who may be grieving, unprepared, unsupported, hidden, and frail. While there is no certainty regarding the number of HIV-positive adults being cared for by older adults, it has been estimated that half of the persons with AIDS are being cared for by older relatives.
... As the FES (Koren et al., 1992) reflects a strengths perspective (Early, 2001), in the context of empowerment, it was developed specifically to assess empowerment in families with children with emotional disorders. This is relevant to custodial grandfamilies, as among them, difficulties in grandchildren's social, emotional, and behavioral functioning are not uncommon, either in reaction to the changes in their family structure or in response to the newly formed family unit (see Castillo, Henderson, & North, 2013;Fuller-Thomson & Minkler, 2000;Hayslip & Kaminski, 2006). ...
The Family Empowerment Scale (FES) was developed specifically to assess empowerment in families with emotional disorders. Its relevance to custodial grandfamilies is reflected in the difficulties in grandchildren's social, emotional, and behavioral functioning, wherein such difficulties may be explained via either reactions to changes in their family structure or in their responses to the newly formed family unit. Utilizing 27 items derived from the 34-item version of the FES, which had represented differential levels of empowerment (family, service system, community) as indexed by one's attitudes, knowledge, and behavior, we explored the factor structure, internal consistency, construct, and convergent validity of the FES with grandparent caregivers. Three-hundred forty-three (M age = 58.45, SD = 8.22, n Caucasian = 152, n African American = 149, n Hispanic = 38) custodial grandmothers caring for grandchildren between ages 4 and 12 years completed the 27 FES items and various measures of their psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. Factor analysis revealed three factors that differed slightly from the originally proposed FES subscales: Parental Self-Efficacy/Self-Confidence, Service Activism, and Service Knowledge. Each of the factors was internally consistent, and derived factor scores were moderately interrelated, speaking to the question of convergent validity. The construct validity of these three factors was evidenced by meaningful patterns of statistically significant correlations with grandmothers' psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. These factor scores were independent of grandmother age, health, and education. These findings suggest the newly identified FES factors to be valuable in understanding empowerment among grandmother caregivers.
... The caregivers' relationships with other family members can become strained after they assume care of the children (Hairston, 2007). In addition, high rates of mental health issues occur with grandparents (Fuller-Thomsen & Minkler, 2000;Minkler, Fuller-Thomsen, Miller, & Driver, 1997). ...
The number of children who reside with a relative because of parental incarceration has increased over the past two decades. Although these children are at risk for negative outcomes, some protective factors, such as a strong and nurturing caregiver experience, buffer the effect of parental incarceration. This study examined the experiences of 72 caregivers and 127 children to learn whether caregivers' stress and strain, readiness and capacity, perceptions of child well-being, and unmet service needs are associated with permanency intentions. The study found strong inclinations against adoption, high intentions toward guardianship, and strong associations between these permanency choices and caregivers' experiences and their reports of unmet service needs and makes recommendations for policy, practice, and research advocacy.
... Full-time parenting of grandchildren has been associated with increased psychological distress, poorer physical health, and lower social support and material resources in both grandmothers and grandfathers, as compared to normative or community samples of their peers (Butler & Zakari, 2005; Goodman et al., 2004; Goodman & Silverstein, 2002; Kelley, Whitley, Sipe, & Yorker, 2000; Musil & Ahmad, 2002). More specifically, data drawn from over a decade of national surveys has suggested that GPG are significantly more likely to report limitations in activities and functions of daily living (i.e., ADLs and IADLs), live below the poverty line, and are almost twice as likely to report clinically relevant levels of depression as compared to their peers (Thomson & Minkler, 2000; Mills, Gomez-Smith, & DeLeon, 2005; Minkler & Fuller-Thomson, 1999). Qualitative research in the US and Australia has served to support the above survey data and graphically highlight the personal and familial impact of parenting grandchildren (Baldock & Petit, 2006; Orb & Davey, 2005; Fitzpatrick, 2004; Waldrop & Weber, 2001). ...
Grandparent-headed families are increasingly prevalent in Australia and are one of the fastest growing forms of out-of-home care of children in contact with our public welfare system. However, there is minimal information regarding the characteristics and experiences of Australian grandparent-headed families who assume care through the intervention of child protection services, or those who arrange parental care of their grandchildren privately. Evidence is needed on which to build a policy or service framework to address the health and wellbeing of these grandparents, and ensure quality and safe care of children and young people who are no longer able to live with their biological parents(s).
... This arrangement comes at substantial cost, however, frequently triggering clinically significant stress levels as difficulties of caring for children outweigh rewards (Daly & Glenwick, 2000;Mackintosh et al., 2006). Indeed, most caregiving grandparents-not just those precipitously thrust into an emergency coparenting role-assume these roles with some ambivalence (Brooks-Gunn & Chase-Lansdale, 1995;Burton & Bengtson, 1985;Caldwell et al., 1998;Chase-Lansdale, Brooks-Gunn, & Zamsky, 1994;Daly & Glenwick, 2000;East & Felice, 1996;Goodman & Silverstein, 2002;) and face significant health-related costs (Fuller-Thomson & Minkler, 2000;Goodman & Silverstein, 2002). ...
To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full‐text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ).
Using new methods designed to assess coparenting between incarcerated mothers of preschool‐aged children and the maternal grandmothers caring for the children during their absence, we examined relationships between coparenting quality during the mother's jail stay and both concurrent child behavior problems and later coparenting interactions following mothers' release and community reentry. Forty mother–grandmother dyads participated in joint coparenting discussions during the incarceration, with a smaller subset completing a parallel activity at home 1 month postrelease. Both women also participated in individual coparenting interviews during the incarceration, and reported on child behavior problems. Mother–grandmother coparenting interactions exhibited an overall structure similar to that documented in nuclear families, with population‐specific dynamics also evident. The observational system demonstrated good interrater and internal reliability, and showed associations with maternal (but not grandmother) reports and descriptions of the coparenting relationship via interview. Greater coparenting relationship quality during incarceration was associated with fewer concurrent child externalizing behavior problems, and predicted more positive coparenting interactions postrelease. Findings suggest that the coparenting assessments were useful for understanding mother–grandmother coparenting relationships in these families and that importantly, these relationships were tied to children's functioning. Avenues for future research and considerations for intervention efforts are discussed.
... Grandparent caregivers suffer higher than average rates of activity limitation (Minkler & Fuller-Thomson, 1999), chronic conditions (Strawbridge, Wallhagen, Shema & Kaplan, 1997), and poor subjective well-being (Minkler & Fuller-Thomson, 1999;). The children in their care are likely to have suffered from parental abuse, neglect, instability, and/or death and as a result may display high levels of behavioral problems (Billing, Ehrle, & Kortenkamp, 2002;Edwards, 2006), often compounded by high rates of poverty and inadequate housing conditions (FullerThomson & Minkler, 2003;Minkler & Fuller-Thomson, 2005;Mutchler & Baker, 2004). Although households consisting of single grandmothers raising grandchildren have even higher rates of poverty than households consisting of single mothers and their children, the participation of caregiving grandparents in public assistance programs is relatively low (). ...
As a consequence of increased divorce rates, the proliferation of single-parent families, and patterns of economic stagnation, parents are increasingly relying on extended family to care for children. In the past few decades, a substantial increase in the number of grandparents raising grandchildren has been observed within the United States. Grandparents who raise their grandchildren are particularly vulnerable, as are the grandchildren in their care; however, U.S. policy currently presents many barriers, gaps, and unintended consequences for grandparent caregivers. In this paper, we use two theoretical paradigms 1) structural lag and 2) the political economy of aging perspective to argue that U.S. policy has not kept pace with the reality of the family and - as a result - those families who are most vulnerable often receive the least support. We propose that as family forms become more diverse a redefinition of the family to one that is less bound by residence and biology, to one based more on function, will be required.
... The ability of MFGs to directly enhance families' social networks and support (McFarlane et al., 2003), to facilitate connections with others with shared experiences (Ostroff et al., 2004), and to increase engagement in services among urban families who are African American and Latino (McKay, Harrison, Gonzales, Kim, & Quintana, 2002) is likely to support their effectiveness with families affected by maternal incarceration and substance use problems. Especially given the feelings of embarrassment and stigma that may accompany their daughters' incarceration and substance use problems (Thomson & Minkler, 2000; Hungerford, 1996; Roe et al.,. Proc., Vol. ...
The alarming rate of incarceration of women disproportionately affects women of color, frequently intersects with the women's substance use problems, and often results in grandmothers providing care for their grandchildren during their daughters' incarceration. Numerous factors complicate the grandmothers' caregiving experiences and contribute to strains that exceed those typically associated with grandparent caregiving. Such complicating factors include the stresses associated with their daughters' substance use problems and incarceration; the complex biopsychosocial needs of many of their grandchildren; the challenging relational issues they must address; and often, the long-term, multifaceted effects of poverty. Despite the critical roles they play, the multiple vulnerabilities they face, and the potential for multigenerational, culturally relevant family interventions to yield gains for all three generations, grandmothers have received little attention in intervention research with this group of families. This paper provides a theoretical and empirical rationale for the inclusion of caregiving grandmothers in interventions and research with families affected by maternal incarceration and substance use problems, in general, and for the promise of multifamily groups, in particular. Strategies for tailoring multifamily groups with this population of families are also included.
... As a result, children living in grandparent-headed homes dramatically increased between 1980 and 1994. In 1980 an estimated 2.2 million children lived in grandparentheaded homes and by 1994, this number had increased to between 3.7 and 3.9 million children, approximately a 70% increase within a 14-year period (Burnette, 1997;Fuller-Thomson & Minkler, 2000;Hanson & Opsahl, 1996;Mullen, 1996). ...
There have been growing reports of older women and men caring for their grandchildren and great grandchildren. Many of these grandparents are caring for children with developmental disabilities. To systematically examine the effectiveness of a support group intervention for such grandparents, we recruited 97 grandparents through three agencies in New York City and assigned them to treatment and wait list control conditions. Significant reductions in symptoms of depression and increases in sense of empowerment and caregiving mastery were found for the treatment group. Similar effects were found for the control subjects when they later received the intervention.
... However, as with other racial and ethnic groups, without a random sample comparison of caregiving and non-caregiving AI/AN, it is unclear whether these levels of financial insecurity and health problems are greater than or similar to those experienced in the wider AI/AN community. As noted earlier, quantitative research in the general population suggests that grandparent caregivers are significantly more likely than their non-caregiving peers to have physical limitations and clinically relevant levels of depressive symptoms as well as a substantially greater likelihood of low income (Fuller-Thomson & Minkler, 2001;Strawbridge et al., 1997), but this has not been documented in the AI/AN community using nationally representative data. ...
This article documents the prevalence and national profile of American Indian/Alaskan Native (AI/AN) grandparents who are raising their grandchildren, based on data from the American Community Survey/Census 2000 Supplementary Survey. In 2000 there were estimated to be nearly 53,000 AI/AN grandparent caregivers age 45 and older in the United States. Almost half of the caregiving grandparents had been raising a grandchild for five years or longer. The findings reveal a portrait of grandparents committed to raising their grandchildren despite the fact that many were living in extreme poverty, with ill health, and with limited resources and services. One-third of grandparent caregivers were living below the poverty line, and only one-quarter of these were receiving public assistance. Even when compared with their noncaregiving AI/AN peers, grandparents raising grandchildren were disproportionately female, poor, living with a functional disability, and living in overcrowded conditions. Implications for social work practice are presented and recommendations for policy and research are discussed.
... While some jurisdictions count kinship care (the placement of children with relatives) as part of family foster care, none of the participants in the focus groups were kinship caregivers. However, while no kinship caregivers participated in these focus groups, previous research has evidenced that kinship families are equally challenged regarding health and mental health needs, not only of the children, but also of the caregivers (Altshuler, 1999;Berrick, 1997;Dubowitz, Feigelman, Harrington, Starr, Zuravin, & Sawyer, 1994;Fuller-Thomson & Minkler, 2000;Pasztor, Goodman, Potts, Insuasti, & Rvmnels, 2002). Relatives caring for younger family members under the auspices of the child welfare system have a separate set of challenges. ...
It is well documented that children enter foster care with special health and mental health needs and, while in care, those conditions are often exacerbated. However, less attention has been given to foster parents who have the most contact with these children. Results are presented from a national study on the developmental, health and mental health care needs of children in foster care that included foster parents' perspectives and observations. Their role in improving child well being is explained and recommendations for policy, practice and advocacy also are included.
... In terms of their health, grandparents raising such children, especially grandmothers, report high rates of depression and/or multiple chronic health problems (Burton, 1992;Dowdell, 1995;Minkler et al., 1997). In one national study (Fuller-Thomsen & Minkler, 2000), 32% of caregiving grandmothers met the clinical criteria for depression, in contrast to 19% of noncaregiving grandmothers. According to the U.S. Census Bureau, grandmothers raising children reported their general state of health as: poor or fair -33.6%; good -31.2%; ...
This paper reviews research findings on caretaking-related problems associated with the absence of parents from the home following incarceration. It focuses on the impact of incarceration on the welfare and adjustment of urban African American children and on the assumption of caretaking responsibilities by other caretakers, principally maternal grandmothers. Noting the complex situational difficulties involved and the potential burdens associated with surrogate parenting in general, and with this population in particular, the service-provider implications of this parenting arrangement are considered in this review. Findings indicate that problems associated with incarceration of parents tend to be intergenerational and vary considerably in complexity and severity. To the extent that they impact the children involved, these issues should be addressed in coordinated service delivery focusing on prevention.
Over 2.4 million grandparents are responsible for raising their grandchildren (custodial grandparents; CGs). CGs have high levels of stress and many experience financial hardship. Additionally, their grandchildren are vulnerable to psychological disorders. Parenting research has found low-income, child behavioral problems, and stress are clearly linked with dysfunctional parenting strategies. The current study examined how these factors are associated among grandfamilies. 79 CGs of 6- to 12-year-old grandchildren completed measures of general stress, parenting stress, parenting strategies, and child behavior. It was hypothesized that parenting stress would be more strongly correlated with both dysfunctional parenting and child behavioral problems compared to general stress. Further, it was hypothesized that both parenting stress and dysfunctional parenting would predict child behavior and that general stress would not explain additional variance in child behavior. Finally, income was expected to moderate the associations between parenting stress and child behavior, as well as dysfunctional parenting and child behavior. Parenting stress was significantly correlated with parenting and child outcomes, and general stress was similarly associated. Parenting stress and dysfunctional parenting were predictive of child outcomes. However, general stress did explain additional variance in child behavior over and above parenting stress and parenting. Further, income did not moderate the associations of parenting and child behavior, nor parenting stress and child behavior. Consistent with previous research, grandparents’ parenting and general stress were high, grandchildren had high levels of behavioral problems and many families had low-income. Our findings highlight the need for a comprehensive treatment approach when working with grandfamilies.
Involuntary job loss during the COVID-19 pandemic adds challenges, especially for custodial grandparents that are taking care of grandchildren. Grandparents are relatively vulnerable, and they need more attention and support when facing the negative impacts of COVID-19. This study analyzed cross-sectional survey data collected from 234 custodial grandparents via Qualtrics Panels in June 2020 in the United States. After using the Propensity Score Weighting adjustment, results from logistic and Ordinary Least Squares regression showed that compared with grandparents that did not lose their job during the pandemic, grandparents that did had more parenting stress and worse mental health. Moderation analysis also showed that social support was a significant moderator of the relationship between job loss and mental health, but not the relationship between job loss and parenting stress. The findings and implications are discussed.
Grandparenting: Contemporary Perspectives is one of the first books of its kind to offer a dedicated account of the social and psychological research on this important life stage. Reflecting the contemporary positive approach to ageing, it covers many of the issues that impact the grandparent experience today, such as care-giving and changing family structures, to reveal the health and wellbeing benefits of the grandparent role. It examines biological, psychological, social/familial, gender, cultural and economic dimensions to map out the current landscape in this emerging field. Moore and Rosenthal draw on quantitative and qualitative, experimental, survey, observation and case study research, including unique data on grandfathers. They examine how people respond to the challenges and possibilities of grandparenting, and how this influences intergenerational relationships and adapting to growing older. The book provides a comprehensive, up-to-date evidence base for students in health, sociology and psychology and those interested in gerontology and the lifespan.
The purpose of this study is to examine and compare caregiver stress and the factors that affect both the grandmothers providing childcare support and the working mothers entrusting their children in Korea. Data were collected from 130 households in which grandmothers took care of grandchildren under the age of six. The data were analyzed using descriptive statistics, t-test and hierarchy multiple regression analysis. Grandmothers providing childcare were found to experience a relatively higher level of caregiver stress. There were significant differences between the grandmothers and working mothers in terms of caregiver stress and family relationship. Self-rated health condition, age, the number of grandchildren in care, and the quality of relationships with adult children were found to be predictable variables to grandmothers’ caregiver stress, Factors contributing to working mothers’ caregiver stress were of based on the quality of relationships with the grandmothers and social support. Based on these results, I discuss practical implications to ease caregiver stress in family members in households providing childcare support by grandparents.
This study purposed to survey grandparents' difficulties in parenting their grand children at grandparent-grandchild households in South Jeolla rural areas. This study was conducted through in-depth interviews from January to October, 2008. The subjects were eight grandparents living with their grandchildren in Boseong-gun, Gangjin-gun, Yeonggwang-gun, Hampyeong-gun, Haenam-gun and Damyang-gun in South Jeolla province. The results are as follows: the grandparents' difficulties in parenting grandchildren are divided into four categories of variable factors: 'Difficulties related to grandparents themselves'; 'Difficulties related to their grandchildren'; 'Difficulties related to early childhood education institution: and 'Difficulties related to their grandchildren's peer group or surrounding people'. The main difficulties in these categories are 'poor, aging and weak conditions of grandparents: 'conflicts in their parenting attitude to have compassion on grandchildren: 'grandparents' not enough educational support to grandchildren due to their ignorance about today's education system: and 'anxiety about the possibility for their grandchildren to be abandoned once again.' These results can be used as a piece of basic information for desirable supports to grandparent-grandchild households.
Sources of support and quality of life of 50 grandmother-headed families raising grandchildren with and without disabilities were examined. Comparative analyses revealed significant differences between grandmothers raising grandchildren with and without disabilities in regard to sources of support and family quality of life. Informal support was significantly higher for grandmothers raising grandchildren without disabilities. In addition, grandmothers raising grandchildren without disabilities rated satisfaction with all aspects of family quality of life except parenting as significantly higher than grandmothers raising grandchildren with disabilities. Correlational analyses showed a moderate correlation between sources of support and family quality of life for both groups of grandmothers. While total informal social support was significantly correlated with satisfaction ratings of family quality of life for both groups of grandmothers, total formal support was significantly correlated with satisfaction ratings of family quality of life only for grandmothers raising grandchildren with disabilities. Multiple regression analyses revealed a significant relationship between presence of child disability and satisfaction ratings of family quality of life.
One-fifth of children aged below five with employed mothers benefit from grandparent provided child care as their main source of daycare in the US. Using data from the health and retirement study, we investigate how grandchild care needs relate to intergenerational transfers of time and money and grandparents’ labor supply behavior. We find that grandparents with a new born grandchild are more likely to provide grandchild care while married grandparents are also more likely to be employed and provide financial help. Grandparents with grandchildren living close by provided higher time transfers while married grandmothers with resident grandchildren also worked longer hours.
Grandparents who raise their grandchildren have become more prevalent as an alternate family form that is, by its very nature, intergenerational in character. This paper explores the state of our knowledge about such grandparents in light of the following themes: (1) the diversity among grandparent caregivers, (2) the importance of social support for such persons and the impact of raising a grandchild on relationships with others, (3) theoretical perspectives on grandparents raising their grandchildren, (4) the salience of issues related to parenting among grandparent caregivers, and (5) interventions with custodial grandparents. The implications of these issues for current and future cohorts of grandparent caregivers are discussed, as are directions that future work with such grandparents might take in light of these issues.
Using data generated from the Global Risk Assessment Device, mental health and disrupted family processes were examined in a sample of 166 court-involved youth being raised by grandparents. Race and gender mean differences were found with regard to both mental health symptoms and disrupted family processes. Specifically, Caucasian male adolescents reported higher mental health symptoms and disrupted family processes than African American males. Also, females in the sample generally reported higher disrupted family processes than males, with African American females reporting significantly higher average disrupted family processes than African American males. Despite mean differences associated with gender and race, when entered as predictors, neither main effects nor interactions of gender or race were related to mental health symptoms. Disrupted family processes were predictive of higher mental health symptoms. Family-targeted interventions with court-involved youth being raised by grandparents would likely benefit the mental health of these adolescents.
Drawing from family stress theory, this study examined the associations among caregiver stress, social support, and stress outcomes measured by life satisfaction and generativity among grandparents raising grandchildren. Social support was hypothesized to moderate the association between caregiver stress and stress outcome indicators. Using survey data from a non-probability sample of 133 grandparent caregivers with full-time responsibility of raising at least one grandchild, regression analysis demonstrated that caregiver stress is associated negatively with life satisfaction and generativity. Informal and formal social support was found to have a beneficial influence on stress outcomes that generalizes to grandparent caregiver participants regardless of the amount of stress they experience. Contrary to predictions, social support did not buffer the association between caregiver stress and life satisfaction nor the association between caregiver stress and generativity. A high degree of perceived informal support was found to function as a detriment to grandparents under conditions of high stress through lowered generativity. Results suggest the need to examine the functional role of social support in the caregiving context.
This study examined how adolescents raised solely by grandparents navigated their relationships with their parents and grandparents and how these relationships were influenced by the caregiving context. Forty-one adolescents participated in qualitative, semistructured interviews. Findings suggest that relationships with parents were primarily companionate or marked by distance and distrust. Grandchildren had strong emotional bonds to their grandparents, although they also negotiated several sources of stress. Participants also reported feelings of gratitude because of the positive influence their grandparents had on their lives. Caregiving context shaped grandchildren’s interdependence with their parents and grandparents in numerous ways. Findings highlight the complexity of grandchildren’s family relationships and underscore the value of a systemic approach to understanding youth who are being raised by grandparents.
Increasing numbers of children are being raised by grandparents (CRBG). Grandparents provide a familial connection to these children, yet they tend to experience stressors that limit their effective functioning as surrogate parents. The children also experience stress that attenuates psychosocial well-being. In this article, the phenomenon of CRBG is described and social support is advanced as a theoretical framework to guide the development of prevention and intervention services. The article contributes to the theoretical and applied knowledge base as perhaps the first scholarly work that conceptualizes a specific four-factor social support model to mediate the school-related risk of CRBG and to promote their psychosocial well-being.
Over the past few decades there has been a dramatic increase in children being raised by grandparents due to a variety of factors including child maltreatment, parental abandonment, substance abuse, and incarceration. The purpose of this study is to examine the extent of behavior problems in children being raised by grandmothers and to determine factors in their current environment that are related to child behavior problems. The study draws on McCubbin's resiliency model of family stress, adjustment and adaptation.The sample comprised of 230 children ages 2 to 16years who were being raised by grandmothers in parent-absent homes. The families were predominantly low income and African American. The grandmothers ranged in age from 37 to 80years. Grandmothers responded to several self-report measures pertaining to child behavior problems, family resources, social support, and caregiver psychological distress. Trained research assistants completed a standardized observational measure of the home environment.Results indicated that 31.3% of child participants scored in the clinically elevated range for total behavior problems, with 21.3% and 32.6% scoring in the elevated range for internalizing and externalizing behaviors, respectively. Hierarchical regression analyses revealed that of the variables examined, increased psychological distress in grandmothers was most predictive of child behavior problems, followed by less supportive home environments and fewer family resources.Results of the present study underscore the need for interventions that focus on reducing child behavior problems, as well as enhancing the parenting skills of grandmothers raising grandchildren. Findings also support the need for strategies to reduce stress in grandmother caregivers and to improve access to resources needed to provide supportive home environments for their grandchildren.
This study explores the phenomenon of grandparent caregiving in two different cultural contexts, the U.S. and China. We begin with an overview of the evolution of grandparent caregiving in the U.S., including the strengths and service needs of this population. We then provide background information on left-behind children and grandparents in rural China. With this group in mind, we review a range of evidence-based practices, programs, and policies that have been implemented to support grandparent caregiving in the U.S. Keeping in mind the similarities and differences between the two societies, we conclude with recommendations for adapting these interventions to the Chinese context. This comparative approach furthers our knowledge of how families in diverse contexts around the world are adapting to the challenges of grandparent caregiving and contributes to the building of a core evidence base for interventions.
Evidence suggests that children in out-of-home care function better when placed in kinship compared with foster care. Less is known about the functioning of children in the unique form of kinship care where grandparents are caring full-time for their grandchildren in informal care arrangements. As grandparent carers are increasingly taking on this role, it is timely to investigate the functioning of the children in this form of care and the characteristics of the grandparents themselves. We compared the functioning of children in the two types of care. We also investigated carer characteristics, including the relationship between child functioning, social support and daily hassles on carer stress. One hundred fourteen cares and 180 children were assessed on a range of demographic and clinical measures. Children in grandparent care were displaying better behavioural and adaptive functioning than children living with foster carers. Grandparent carers reported higher levels of distress in the carer role. Predictors of carer stress included severity of child behaviour problems and daily hassles. Both group of carers and the children in their care would benefit from increased support from treatment services.
Extensive studies of fitness in senior adults ages 60–90 years by Rikli and Jones (2001)13.
Rikli , R. E. and Jones , C. J. 2001 . senior fitness test manual , Champaign, IL : Human Kinetics . View all references have demonstrated that functional fitness (the ability to perform normal, everyday activities safely and independently without undue fatigue) is essential to maintaining an independent lifestyle. In the case of custodial grandparents, functional fitness enables them not only to be more independent but also to be more effective caregivers. Project Grandfamilies Health Watchers, a program funded in part by a grant from the Johnson & Johnson/Rosalynn Carter Institute Caregivers Program, was based on the premise that formal support in the form of psychoeducational groups, goal setting, and in-home monitoring would be effective in improving the physical functionality and cardiovascular health as well as the nutrition and mental health of custodial grandparents. Eighteen caregiver grandparents and 21 grandchildren residing in Forrest and Jones counties in southern Mississippi completed the year-long program. The program proved to be successful in improving the physical and emotional health of custodial grandparents.
In the past few years there has been increasing recognition of the growing population of grandparents who are responsible for raising their grandchildren. These families face many issues and concerns that necessitate both supports and interventions that can assist them. Empowerment training that is relevant to their needs and the issues they face is an intervention that can be effective in helping grandparents meet the challenges presented by their grandchildren and the communities in which they live.
Globally, a growing number of grandparents are caring for their grandchildren. The impact and burden associated with increases in custodial grandparenting, however, may differ by culture. In the United States, the caregiving role has been shown to be a significant source of stress for older adults. In cultures in which grandparents are more commonly involved in the care of young children, however, increasing caregiving roles may not be viewed as stressful. This study examines the impact of caregiving on perceived and physiological measures of stress among 640 Luo elders (60+) in western Kenya, where high HIV prevalence among younger-to-middle aged adults has led to a heavy burden of orphan care. Perceived stress levels were measured using the Luo Perceived Stress Scale (LPSS). Salivary cortisol and casual blood pressure were used as biomarkers of stress. Results were analyzed using random mixed effects models. Overall this study showed that caregivers have higher levels of perceived stress than non-caregivers. For women, household composition, including the number of orphans and adults in the homestead impacted perceived stress. Among men, those who perceived caregiving as burdensome had higher perceived stress. Despite the association between caregiving and perceived stress, there was a minimal relationship between caregiving and the two biomarkers of stress. This may be because caregiving is superimposed onto other stressors and therefore has a minimal physiological impact. These results highlight the importance of local context in determining the impact of the caregiving role on older adult well-being.
Place influences rural women's health when distance and lack of anonymity contribute to a reluctance to seek care. A qualitative design was used to explore relationships between place and the health of rural grandmothers raising grandchildren. The study generated findings concerning theory related to perceptual experience of rurality, identifying "Cushioning," as a basic social concept and "Weathering," "Paradoxical Place," and "Community Mothering" as subconcepts. Physical and mental wear and tear, distance, isolation and unraveling community mothering undermined "Cushioning" and reflected in self-health neglect narratives. Findings underscore the importance of place to the health of rural women raising grandchildren.
To examine the impact of an intervention to improve the health of grandmothers raising grandchildren in parent-absent homes.
A longitudinal, pretest-posttest design.
The sample was composed of 529 female caregivers with a mean age of 56.7 years (range 38-83) who were predominantly low-income African Americans. Data were collected prior to the intervention and again at 12 months when the intervention was complete. The intervention involved home visitation by registered nurses and social workers, as well as other support services. The Short Form-36 was used to assess physical and mental health, using eight multi-item scales.
A comparison of pre- and posttest mean scores on the SF-36 indicated significantly (p < .003) improved mean scores for vitality, physical effects on role functioning, emotional effects on role functioning, and mental health. No significant differences were found for other attributes.
These preliminary findings suggest that grandmothers raising grandchildren may benefit from a home-based intervention designed to improve health attributes. Implications for nursing practice, policy, and research are presented.
The health of grandmother caregivers is critical to their ability to parent grandchildren successfully. Nurses practicing in a variety of settings are in a unique position to identify and address the health challenges of grandmothers who are raising grandchildren.
We examined the relationship between burden of providing care to non-ill children and grandchildren and incidence of coronary heart disease (CHD) among women.
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.
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).
High levels of care provision to grandchildren (and possibly children) may increase the risk of CHD among women.
An increasingly prevalent family constellation is a home headed by a grandparent who is raising grandchildren. We explore
the state of our knowledge about such grandparents with particular attention to its implications for service providers and
researchers. In our review we address several key areas: (a) the costs and benefits of raising a grandchild; (b) the heterogeneity
of custodial grandparent caregivers; (c) the critical need for social support among custodial grandparents; (d) parenting
practices and attitudes among grandparents raising grandchildren; and (e) helping efforts at multiple levels with custodial
grandparents. We also discuss directions for research and practice concerning custodial grandparents.
This study explores how grandchild care in conjunction with grandparents' retirement affects depressive symptoms, using data from the Health and Retirement Survey. The findings demonstrate that retirement moderates the influence of grandchild care obligations on well-being, measured by depressive symptoms. For retired men, freedom from grandchild care obligations is associated with heightened well-being. Among women, continued employment seems to protect against potential negative effects of extensive grandchild care obligations on well-being. The results for men seem most in line with the argument that family care obligations spoil retirement, whereas the results for women suggest a scenario that is most compatible with the role enhancement thesis.
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.
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.
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.
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.
Although support groups are the most popular source of education and support for the growing number of grandparents who are rearing their grandchildren, the nature and efficacy of these groups have not been documented. This article presents data from an exploratory study of an 8-week school-based small group intervention. Comparison of pre- and posttest measures showed a reduction in depressive symptoms and in use of distancing as a coping strategy. Seeking social support and planful problem solving increased, as did knowledge about grandparent- related social services. Implications for social work practice and future research are discussed.
Based on data from the 1988 National Health Interview Survey and the Child Health Supplement, we compared the health of women 40 years of age and over living four family structures: alone, solely raising grandchildren, married with spouse only, and married with spouse and grandchildren. We found that, in general, women solely raising grandchildren have poorer health compared to women of a similar age living in other family structures and considerably worse health than women with spouses raising grandchildren.