Grandparents Raising Grandchildren Health Effects and Impact of Grandparents
Grandparents have always played an essential role in the family unit, but in recent years, the number of grandparents raising their grandchildren has significantly increased. This phenomenon is largely driven by various socio-economic and health-related challenges faced by the parents of these children. While stepping in to raise grandchildren can provide stability for the child, it often places a considerable burden on the grandparents, affecting their physical and mental health, financial stability, and social well-being. This article explores the impact of grandparents raising grandchildren, the consequences for their well-being, and the challenges they face as caregivers.
Grandparents Raising Grandchildren
The 2000 Census Supplementary Survey estimated that about 6 million children in the United States, or 8.4% of the child population, were living with non-parental relatives. This figure marked a dramatic increase of 173% since 1970 and 78% since 1990 (US Bureau of the Census, 2001). Out of the 6 million children, 75% were being raised by their grandparents. This trend cuts across all racial and economic groups but has been most pronounced among African Americans and low-income families.
Several factors contribute to the rise in grandparents taking on the role of primary caregivers for their grandchildren. These include child abuse, neglect, parental substance abuse, mental illness, incarceration, parental death, and the HIV/AIDS epidemic (Dowdell, 1995; Kelley, Yorker, Whitley, & Sipe, 2001). While some of these children have been formally placed with grandparents by the child protection system, many more live with their grandparents through informal family arrangements (Yorker et al., 1998).
Despite the growing prevalence of grandparents as primary caregivers, research on the burden and impact of caregiving on this population has only recently evolved. In contrast to the extensive research on caregiver burden among those providing care for elderly relatives, the challenges faced by grandparents raising grandchildren have not received as much attention until recent years. Researchers from various disciplines, including nursing, sociology, gerontology, and psychology, have begun to explore the physical, emotional, and financial toll of this caregiving role.
Consequences of Grandparents Raising Grandchildren
While taking on the responsibility of raising grandchildren can provide a sense of purpose and joy, recent research indicates that it is also associated with negative consequences for the well-being of grandparents. Studies show that grandparents raising grandchildren are at an increased risk of physical health problems, some of which can seriously affect their ability to continue providing care (Dowdell, 1995; Whitley, White, Kelley, & Yorker, 1999).
A nationally representative study found that grandmothers raising grandchildren were more likely than non-caregiving grandmothers to report their health as “fair” or “very poor” (Fuller-Thomson & Minkler, 2000). These grandmothers were also more likely to experience physical limitations in performing daily activities. Similarly, Dowdell (1995) found that 45% of custodial grandmothers reported having a physical health problem or illness that significantly affected their general health. Single grandmothers, in particular, were more likely to report health issues compared to married grandmothers.
The stress associated with raising grandchildren can also increase the risk of more severe health problems. In a prospective cohort study conducted as part of the Nurses’ Health Study, researchers found that providing high levels of care to grandchildren was associated with an increased risk of coronary heart disease (Lee, S., Colditz, Berkman, & Kawachi, 2003).
Custodial Grandparents
Custodial grandparents—those who have full legal or informal responsibility for their grandchildren—often face more significant health challenges than non-custodial grandparents. In a study involving 102 custodial grandmothers, nearly half of the participants self-reported their health as “fair” or “poor” (Whitley et al., 1999). Registered nurses who assessed the participants’ health found that 25% were diabetic, 54% were hypertensive, and 80% were classified as obese, a condition closely linked to cardiovascular problems.
In addition to physical health challenges, custodial grandparents experience higher rates of psychological distress, including depression. Numerous studies have shown that assuming full-time parenting responsibilities for grandchildren is linked to increased levels of psychological stress and depression (Burnette, 1998; Emick & Hayslip, 1999; Force, Botsford, Pisano, & Holbert, 2000; Fuller-Thomson, Minkler, & Driver, 1997; Kelley, Whitley, Sipe, & Yorker, 2000; Szinovacz, DeViney, & Atkinson, 1999).
For example, in a study of African-American grandmothers raising grandchildren, Minkler and Roe (1993) found that 37% of grandmothers reported a decline in their psychological health after assuming full-time caregiving responsibilities. A majority (72%) of these grandmothers reported feeling “depressed” in the week leading up to data collection. Another study found that nearly 30% of grandparents raising grandchildren had psychological distress scores in the clinical range, indicating the need for mental health intervention (Kelley, Whitley, et al.).
Focus of Grandparents Raising Children
Grandparents raising children with special needs or behavioral problems face even higher levels of psychological distress. Research has shown that these grandparents report poorer mental health outcomes compared to those raising children without special needs. For instance, Brown and Boyce-Mathis (2000) found that grandparents raising children with special needs had worse mental health well-being than those raising children without such challenges.
In cases where grandchildren have behavioral problems or are considered difficult, grandparents experience even more negative effects. Hayslip, Emick, Henderson, and Elias (2002) found that grandparents raising children with behavioral issues reported more negative consequences than those raising children perceived as “normal.” Similarly, Pruchno and McKenney (2002) found that behavioral problems in grandchildren significantly increased the strain on custodial grandparents.
While many studies on the impact of caregiving on grandparents have involved relatively small, homogeneous populations, findings from the National Survey of Families and Households suggest similar trends. Researchers found that custodial grandparents were almost twice as likely to be categorized as “depressed” compared to non-custodial grandparents (Fuller-Thomson et al., 1997). Even after controlling for pre-existing depression, custodial grandmothers were found to have higher rates of depressive symptoms. Minkler and Fuller-Thomson (2001) reported similar findings, noting that custodial grandmothers were more likely to have significant levels of depressive symptoms compared to their non-custodial counterparts.
How Grandparent Caregivers Are Affected During Caretaking
Several factors contribute to the increased psychological distress experienced by grandparents raising grandchildren. Among the most well-documented correlates of psychological distress are poor physical health, social isolation, and financial difficulties. For example, a study by Kelley et al. (2000) found that family resources, physical health, and social support were significant predictors of psychological distress in grandparents raising grandchildren.
The circumstances surrounding the onset of caregiving responsibilities, such as the abandonment of grandchildren by their parents, parental addiction, incarceration, or death, can also contribute to mental health challenges. Additionally, changes in role demands, conflict with the children’s parents, behavioral problems in the grandchildren, and legal issues can further exacerbate stress and depression in grandparent caregivers (Caliandro & Hughes, 1998; Dowdell, 1995; Emick & Hayslip, 1999; Yorker et al., 1998).
Financial pressures are another major source of stress for grandparents raising grandchildren. Many grandparents face increased financial burdens at a time in their lives when their income is either fixed or dramatically reduced due to retirement. In some cases, grandparents may have to leave full-time employment to care for their grandchildren, particularly if the children have special needs. While some grandparents may be eligible for Temporary Assistance to Needy Families (TANF) benefits, these payments are often insufficient to meet the housing, clothing, and food needs of the grandchildren. The lack of financial resources has been shown to contribute to increased psychological stress in grandparents raising grandchildren (Kelley et al., 2000).
Social isolation is another challenge frequently faced by grandparents who assume full-time parenting responsibilities. Research suggests that grandparents raising grandchildren often become socially isolated from their peers due to the demands of child-rearing (Fuller-Thomson & Minkler, 2000; Hayslip, Shore, Henderson, & Lambert, 1998; Musil, 1998). Social support, which plays a critical role in mediating psychological distress, is often limited for these caregivers (Kelley et al., 2000).
Conclusion and Future Research
Further research is needed to better understand the well-being of custodial grandparents and the long-term effects of caregiving on their physical and mental health. Longitudinal studies could provide valuable insights into the enduring impact of raising grandchildren, while experimental studies could help identify which intervention strategies are most effective in improving health outcomes for this population. Additionally, more policy-relevant research is needed to address the health care, financial, and housing needs of grandparents raising grandchildren.
As the number of grandparents raising grandchildren continues to rise, health care providers, policymakers, and community organizations must work together to develop support systems that address the unique challenges faced by these caregivers. Providing access to health care services, mental health support, financial assistance, and social resources can help mitigate the physical, emotional, and financial toll that caregiving can have on grandparents. With appropriate support, grandparents can continue to provide stable and nurturing environments for their grandchildren while maintaining their own well-being.