Grandparents Raising Grandchildren and Health Effects

Health Effects and Impact of Grandparents

Grandparents Raising Grandchildren,Consequences of Grand Parents Raising,Custodial Grandparents ,Focus of Grand Parents Children Raising,How Grand Parent Caregiver Affected During Care Taking .

Grandparents Raising Grandchildren

    According to the 2000 Census Supplementary Survey, an estimated 6 million or 8.4% of children in the US live with nonparental relatives, a 173% increase since 1970 and a 78% increase since 1990 (US Bureau of the Census, 2001). 

    Of the 6 million children living with nonparental relatives, 75% are being raised by grandparents. Although this phenomenon impacts all racial and economic groups, the most significant rises have been among African Americans and low-income families.

    The most common antecedents to children being raised by grandparents-while often interrelated-include child abuse and neglect, substance abuse, mental illness, incarceration, homicide, and HIV/AIDS among parents (Dowdell, 1995; Kelley, Yorker, Whitley, & Sipe, 2001).     

    While some children have been removed from the care of their birth parents by the child protection system and placed with foster parents, many more are with grandparents through informal arrangements among family members (Yorker et al., 1998). 

    While caregiver burden among those providing for elderly parents or spouses has been studied extensively over the past few decades, only recently has it been examined among older adults raising grandchildren and great-grandchildren. 

    With the dramatic rise in the number of grandparents raising grandchildren in households that do not include either birth parent, research on this population has only recently evolved. 

    Researchers studying this phenomenon represent a number of disciplines including nurses, sociologists, gerontologists, and psychologists. Nurse researchers have made important contributions to empirical knowledge related to the impact of the caregiving role on grandparents raising grandchildren.

Consequences of Grand Parents Raising

    Recent research indicates that raising grandchildren was associated with negative consequences for the well being of grandparents. 

    For instance, numerous studies indicate that grandparents raising grandchildren are at an increased risk for physical health problems, with some health problems serious enough to jeopardize their ability to provide care for their grandchildren (Dowdell, 1995; Whitley, White, Kelley, & Yorker, 1999). 

    Based on a nationally representative sample, researchers found that grandmothers raising grandchildren were more likely than non-care-giving grandmothers to report their health as fair or very poor (Fuller-Thomson & Minkler , 2000). These grandmothers were also more likely to report physical limitations when performing daily living activities. 

    Similarly, Dowdell found that 45% of the custodial grandmothers identified themselves as having a physical health problem or illness that seriously affected their general health, with single grandmothers more likely than married grandmothers to report health pro problems. 

    In a prospective cohort study as part of the Nurses' Health Study, researchers found that providing high levels of care to grandchildren increases the risk of coronary heart disease (Lee, S., Colditz, Berkman, & Kawachi , 2003).

Custodial Grandparents 

    In a study involving 102 custodial grandmothers, almost half self-reported their health as only fair or poor (Whitley et al., 1999). Health assessments by registered nurses indicated that 25% of the participants were diabetic, 54% were hypertensive, and 80% met the criteria for obesity, which is associated with cardiovascular problems. 

    Participants scored significantly worse in the areas of physical functioning, bodily pain, social functioning, role functioning, and general health than national norms on a standardized self-report measure of health.

    Researchers consistently have found that assuming full-time parenting responsibilities for grandchildren was associated with increased rates of psychological distress, including depression, in grandparents ( Burnette , 1998; Emick & Hayslip , 1999; Force, Botsford, Pisano, & Holbert , 2000; Fuller-Thomson, Minkler , & Driver, 1997; Kelley, Whitley, Sipe, & Yorker, 2000; Szinovacz , DeViney , & Atkinson, 1999). 

    In a study of African-American women raising grandchildren, Minkler and Roe (1993) found that 37% of grandmothers raising grandchildren reported their psychological health had worsened since assuming full time caregiving responsibilities, with the majority (72%) reporting feeling "depressed" in the week prior to data collection. 

    In another study, researchers found that nearly 30% of grandparents raising grandchildren had psychological distress scores in the clinical range, which is indicative of a need for mental health intervention (Kelley, Whitley, et al.).

Focus of Grand Parents Children Raising 

    Grandparents raising children with special needs or behavioral problems experience even higher rates of psychological distress. In one study, researchers found that grandparents raising special-needs children reported poorer mental health well-being than those raising children without special needs (Brown, DR, & Boyce-Mathis, 2000).

     Other studies have found that grandparents raising grandchildren viewed as difficult or as having behavioral problems experienced more negative effects than grandparents' raising children viewed as normal ( Hayslip , Emick , Henderson, & Elias, 2002; Pruchno & McKenney, 2002). 

    While many of the studies discussed above involve relatively small and homogeneous populations, researchers analyzing data from the National Survey of Families and Households reported similar findings. For instance, when researchers compared custodial grandparents to noncustodial grandparents, they found that custodial grandparents were almost twice as likely to be categorized as depressed (Fuller-Thomson et al., 1997). 

    Even after controlling for depression that preexisted the onset of caregiving, custodial grandmothers had higher rates of depression. Minkler and Fuller-Thomson (2001) also found that custodial grandmothers were more likely than noncustodial grandmothers to have significant levels of depressive symptomatology.

How Grand Parent Caregiver Affected During Care Taking 

    A number of factors have been identified as contributors to increased psychological distress, including depression, in grandparent caregivers. Some of the most well-documented correlates included poor physical health, social isolation, and financial difficulties. 

    For example, in one study, researchers found that family resources, participants' physical health, and to a lesser extent social support predicted levels of psychological distress in grandparents raising grandchildren (Kelley et al., 2000). 

    Other factors contributing to mental health status that have been. Identified by researchers include circumstances involved with the onset of assuming full-time parenting responsibilities (eg, abandonment by, addiction in, incarceration or death of their adult child), changes in role demands, conflict with the children's parents, behavior problems of grandchildren, and legal issues ( Caliandro & Hughes, 1998; Dowdell, 1995; Emick & Hayslip , 1999; Yorker et al., 1998).

    By assuming full-time parenting responsibilities, grandparents are often faced with in-creased financial pressures at or near a time in their lives when income is dramatically decreased. This decrease in income is most often related to retirement and living on fixed incomes or from having to leave full-time employment because of the demands of full-time parenting, especially when the grandchildren have special needs. 

    While some families may be entitled to Temporary Assistance to Needy Families (TANF) cash benefits, the monthly payments are typically nominal and insufficient for adequately housing, clothing, and feeding children. Furthermore, a lack of resources has been found to contribute to increased psychological stress in grandparents raising grandchildren (Kelley et al., 2000).

    Findings from several studies portray grandparent caregivers as socially isolated from peers due to demands of raising children at a point in their lives when they would otherwise have few childcare responsibilities (Fuller-Thomson & Minkler , 2000; Hay slip, Shore, Henderson, & Lambert , 1998; Musil , 1998). 

    The social isolation typically reported by grandparents raising grandchildren is important given that social support is a mediator of psychological distress in grandparents raising grandchildren (Kelley et al., 2000).

    Further research on the well-being of custodial grandparents is needed. Longitudinal studies would contribute to knowledge of the long-term impact of this type of caregiving. 

    Experimental studies will be necessary to determine which intervention strategies are most effective in improving the physical and mental health of this population. An increase in policy-relevant research is needed to address the health care, financial, and housing needs of grandparents raising grandchildren.