Depressive Symptoms Among Grandparents Raising Grandchildren: The Impact of Participation in Multiple Roles

Keeping Us Young? Grandchild Caregiving and Older Adults' Cognitive Functioning

Objective

This study investigates longitudinal associations between providing care to grandchildren and cognitive functioning. It also examines heterogeneity in these relationships.

Background

Grandchild caregiving may support older adults' cognitive functioning by providing social engagement and emotional meaning. However, studies caution that time- intensive or custodial grandchild caregiving can take a toll on grandparents. The cognitive health implications of grandchild caregiving may thus depend on contexts including time spent providing care and living arrangements. They may also vary across sociodemographic groups and have greater effects on older adults who are more vulnerable to cognitive decline.

Method

Data came from the 1998-2016 waves of the Health and Retirement Study (HRS) and represented over 11,000 U.S. adults age 50+. Using linear growth curve and dynamic panel models, the analysis explored relationships between level of grandchild care and cognitive functioning over time and across sociodemographic, family, work and health characteristics.

Results

Those providing 100-199, 200-499 or 500+ hours of care to grandchildren had better cognitive functioning than non-caregivers regardless of whether they lived with grandchildren. Positive links between grandchild caregiving and cognition were stronger for lower income, non-working, and unpartnered adults and grew with age and functional limitations.

Conclusion

These findings suggest that providing care to minor grandchildren may help support cognitive functioning as adults age. They also support the hypothesis that more vulnerable or isolated groups of older adults may benefit the most from grandchild caregiving.

Healthy Outcomes through Peer Educators: Feasibility of a peer support diabetes prevention programme for African-American grandmother caregivers

AIM

To assess the protocol feasibility and intervention acceptability of a community-based, peer support diabetes prevention programme (DPP) for African-American (AA) grandmother caregivers at risk for diabetes.

MATERIALS AND METHODS

Grandmother caregivers were randomized in a 2:1 ratio to DPP (active comparator) or DPP plus HOPE (Healthy Outcomes through Peer Educators; intervention). DPP + HOPE incorporated support from a peer educator who met with participants in person or by telephone every week during the 1-year intervention. Outcomes included: (1) recruitment rates, outcome assessment, and participation adherence rates assessed quantitatively; and (2) acceptability of the programme assessed through end-of-programme focus groups.

RESULTS

We successfully consented and enrolled 78% (n = 35) of the 45 AA grandmothers screened for eligibility. Eighty percent of participants (aged 64.4 ± 5.7 years) were retained up to Week 48 (74% for DPP [n = 17] and 92% for DPP + HOPE [n = 11]). All grandmothers identified social support, neighbourhood safety, and access to grocery stores as influences on their health behaviours. At Month 12, the active comparator (DPP) group and the intervention group (DPP + HOPE) had a mean change in body weight from baseline of -3.5 ± 5.5 (-0.68, -6.29) kg and - 4.4 ± 5.7 (-0.59, -8.2) kg, respectively.

CONCLUSIONS

This viable study met the aim of educating and equipping AA grandmothers with the practical and sustained support needed to work toward better health for themselves and their grandchildren, who may be at risk for diabetes. The intervention was both feasible and acceptable to participating grandmothers and their organizations.

Is intergenerational care associated with depression in older adults?

Background

It has become an alarming issue that older adults in China are facing mental health issues, causing severe depression. In this context, intergenerational care, in which grandparents care for young children instead of the young parents, is gaining importance. This study aims to explore the correlation between intergenerational care and depression among older adults, seeking alternative approaches to enhancing their quality of life. This study concludes that intergenerational care is an effective strategy for promoting active aging.

Methods

This study used multiple linear regression, propensity score matching, and additional analysis of heterogeneity, mediation, and moderation effects, with data from the 2018 CHARLS survey.

Results

The results indicated a negative correlation between intergenerational care and depression among older adults. The correlation was stronger for females and younger older adults people. Additionally, social activities served as a mediator between intergenerational care and depression among older adults, and health satisfaction positively moderated this relationship.

Conclusion

This study posits that intergenerational care serves as an effective approach for promoting active aging. It emphasizes the necessity for supportive government policies and community-family collaborations to encourage intergenerational care and its beneficial impact on mental health among older adults.

A study of the effect of number of children on depression among rural older women: empirical evidence from China

The association between early reproductive events and health status in later life has always been of interest across disciplines. The purpose of this study was to investigate whether there was an association between the number of children born in the early years of elderly women and their depression in later life based on a sample of older women aged 65 years and above with at least one child in rural China. Data from the Chinese Longitudinal Healthy Longevity Survey in 2018, this study used the ordinary least square method to conduct empirical research. This study has found a significant correlation between an increase in the number of children and depression in older rural women. When considering the sex of the child, the number of daughters had a greater and more significant impact on depression. Number of children may exacerbate depression of older women through declining self-rated health and reduced social activity, while increased inter-generational support alleviated depression. The association between number of children born and depression also existed in urban older women, though not significant. Therefore, it is suggested to accelerate the improvement of supporting policies related to childbirth, developing a healthy and scientific fertility culture, and improving rural maternal and child health services. Women should be assisted in balancing their roles in the family and in society, and in particular in sharing the burden of caring for children. Targeted efforts to increase old-age protection for older people.

Implementing a Grandfamily Intervention During the COVID-19 Pandemic: Responses and Adaptations

The COVID-19 pandemic complicated efforts to deliver interventions to marginalized populations at risk of contracting COVID-19. Grandfamilies are one such group. GRANDcares Plus (GC+) is an intervention designed to help grandfamilies build resilience. It was scheduled to launch shortly after the COVID-19 pandemic began and consequently was heavily influenced by the pandemic. This paper discusses responses and adaptations made in implementing GC+ during the pandemic. Primary information sources included facilitators, COVID-19 information outlets, grandfamilies, and the project site coordinator. As a result, adaptations were made to facilitator training, CDC guidelines/recommendations were employed, potential participants needs and concerns were considered, and additional strategies were incorporated to support grandfamilies. This knowledge translational article contributes to social work by providing insights into identifying, managing, and responding to unexpected challenges. Given the increasing occurrences of unanticipated crises, it is crucial to develop and maintain effective tools for sustainable deliveries of services during difficult times.

Age-Dependent Differences in Frequent Mental Distress (FMD) of US Older Adults Living in Multigenerational Families versus Living Alone

Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2020 and compared FMD (≥14 poor mental health days in the past 30 days = 1; 0 otherwise) of older adults (≥65 years) living in multigenerational families versus living alone in 36 states. After controlling for covariates, findings indicate 23% lower odds of FMD among older adults living in multigenerational households compared to counterparts living alone (adjusted odds ratio (AOR): 0.77; 95% confidence interval (CI): 0.60, 0.99). Findings also show that the reduction in the odds of FMD with each 5 year increase in age was larger among older adults living in multigenerational families by 18% (AOR: 0.56; 95% CI: 0.46, 0.70) compared to older adults living alone (AOR: 0.74; 95% CI: 0.71, 0.77), and this difference was significant at the 5% significance level. Multigenerational living may have a protective association with FMD among older adults. Further research is needed to identify multigenerational family and non-kin factors that translate into mental health advantages for older adults.

Grandchild care and life satisfaction of older adults: Empirical evidence from China

Background

In China, grandchild care plays an important social role later in life. The effects of grandchild care on physical health and depression in older adults have been illustrated. However, there is a gap in research on grandchild care and life satisfaction of older adults specifically based on the Chinese experience.

Method

Based on 7,079 individuals' data from 2018 China Longitudinal Aging Social Survey (CLASS), this study explored the impact of grandchild care on older adults' life satisfaction by using Ordinary Least Squares (OLS), Propensity Score Matching (PSM), and instrumental variables (IV) models.

Results

The empirical results indicated that (1) life satisfaction was significantly higher for older adults who undertook grandchild care compared to those who did not; (2) non-coresiding grandparents showed higher life satisfaction than those non-carers, and this effect was not found in custodial grandparents or three-generation household grandparents; (3) higher life satisfaction of grandchild caregivers was achieved through reduced loneliness, enhanced self-efficacy, and increased emotional support from children, with the latter being the greatest contribution; and (4) the improving effect of grandchild care on life satisfaction was found mainly in the group of older adults who were male and in rural households.

Conclusion

There was a significant difference in life satisfaction between older Chinese adults who provided grandchild care and those who did not. Efforts in terms of old age policy protection and family relationships should be made to enhance the subjective well-being of older adults.

Sleep Quality and Disability for Custodial Grandparents Caregivers in the Southern United States

Sleep quality amongst caregivers with disability may have been compounded by the COVID-19 pandemic. We evaluated differences in sleep quality amongst custodial grandparents from a southern state that were identified through state-based Kinship Care support groups coordinators and online. Participants ( N = 102) completed the Pittsburgh Sleep Quality Index and self-reported disability statuses. Gamma tests showed a strong negative relationship between disability and sleep duration indicating fewer hours of sleep, higher use of sleep medication and greater sleep disturbances. Disability is not significantly related to sleep latency, sleep efficiency, and daytime dysfunction. T-tests showed no strength of relationship between disability and overall sleep quality. During the first year of the COVID-19 pandemic, custodial grandparents with disability had greater issues with their sleep quality than those without disability. Sleep, as it pertains to its overall preponderant role in maintaining good health, should be examined amongst custodial grandparent caregivers and those with disability.

The quality of relationships with adult children and depressive symptoms among grandparents

Objectives: The present study aims to identify distinct types of relationships between grandparents and their adult children, measure the associations between these relationship types and depressive symptoms among grandparents, and determine whether these associations vary by grandparent status. Method: This study uses data from a sample of 1,196 grandparents age 51 and older from the 2014 Health and Retirement Study. Latent class analysis (LCA) is applied and identifies types of grandparent-adult children relationships. Ordinary Least Squares (OLS) regression models are used to estimate the association between relationship types and depressive symptoms by grandparent status.Results: LCA identified four grandparent-adult children relationship types: amicable, ambivalent, detached, and disharmonious. Custodial and co-parenting grandparents were most likely to report having an ambivalent relationship with their adult children. Among co-parenting and custodial grandparents, disharmonious relationships were associated with more depressive symptoms.Conclusion: Interventions are suggested to improve emotional relationships with adult children and dyadic family relationships among grandparent families.

The impact of adult children rural-urban migration on left-behind parents' health: Evidence from China

Population aging and rural-urban migration have posed challenges to the elderly support system in developing countries that lack social safety net and services. Given that there is no consistent conclusion in the literature on whether adult children's internal migration can improve or impair their left-behind parents' health, little is known about the effect mechanisms. This paper investigates the comprehensive impact of adult children's migration on the health of their parents in rural China by analyzing the income effect and time allocation effect. The empirical analysis uses the rural sample of the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015, and 2018. We found that adult children migration can improve parents' physical health, mainly thanks to the income effect. The analysis of the mechanism found that although the income effect has a positive effect on parents' health, the time allocation effect has a negative effect on parents' health because of the lack of care and increased working hours of parents. Our findings suggest that providing social care services and enhancing intergenerational communication can be practical strategies to mitigate the negative effect of children's migration to rural left-behind elderly parents.

The Higher the Children's Achievements, the Better the Elderly Health? Evidence From China

Health, an important indicator for measuring the elderly's life and wellbeing, is an important part of positive and healthy aging. Children's achievements are closely linked to their parents' health. However, existing literature does not cover how children's achievements impact the health of their elderly parents. Data were derived from the 2014 Chinese Longitudinal Aging Social Survey; this study includes 6,793 elderly people ages 60 and older as samples. A multiple linear regression model was used to analyze the correlation between children's achievements and their elderly parents' health statuses in China. The results show that the higher the children's income and education, the better their health of their elderly parents. Living patterns, children' financial support to their parents, and social capital play a mediating role in the relationship between children and their elderly parents. These findings provide further insight into potential factors associated with the children's achievements and elderly health.

The long-term effects of dual caregiving on the caregivers' well-being among middle-aged and older adults in Taiwan

OBJECTIVES

As life expectancy is prolonged, older people may face increased burdens related to supporting multi-generational family members. This study is aimed toward examining the effects of such an emerging type of informal care on the well-being of caregivers.

METHODS

Participants aged 50 and over from the Taiwan Longitudinal Study on Aging (1996-2007, n = 4,217) were analyzed. We categorized caregiving status according to different care recipients: 1) older adults only, 2) grandchildren only, 3) both older adults and grandchildren (dual caregiving), and 4) non-caregivers. Well-being was measured based on depressive symptoms and degree of life satisfaction. Generalized Estimation Equation models were used to examine the association between types of caregiving and the caregivers' state of well-being.

RESULTS

After adjusting for all covariates, caregivers of older adults had significantly more depressive symptoms and less life satisfaction than non-caregivers, especially when caregiving for adults with ADL problems. In contrast, caregivers of grandchildren were not significantly affect either depression or life satisfaction as compared with non-caregivers. Interestingly, caregiving for both older adults and grandchildren had no significant effect on depression but positively affected the degree of life satisfaction.

CONCLUSION

Our findings highlight that simultaneously taking care of both older adults and grandchildren can buffer negative feelings in caregivers or even improve their mental health.

Caring trajectories and health in mid-life

Previous research has found varied effects of informal care provision on the carer's health status. Few studies have, however, examined this relationship dynamically. This paper is the first to analyse trajectories of care among men and women in mid-life and their impact on health outcomes using a nationally representative prospective cohort study. Data from three waves of the United Kingdom (UK) National Child Development Study (N = 7,465), when the respondents were aged 46, 50 and 55, are used to derive care trajectories capturing the dynamics of care provision and its intensity. Logistic regression investigates the impact of caring between the ages of 46 and 55 on the carers' report of depression and poor health at age 55. At age 46, 9 per cent of men and 16 per cent of women provided some level of informal care; rising to 60 per cent for both genders at ages 50 and 55. Just 7 per cent of women and 4 per cent of men provided care at all observation points, with the most common trajectory being ‘starting to care’ at ages 50 or 55. New carers experienced a lower risk of depression at age 55, reflecting that they may not have experienced the caring role long enough to have an adverse impact on their wellbeing. The findings highlight that the majority of individuals with surviving parents experience caring at some point during mid-life, underlining the need for further longitudinal research to better understand the complex relationships between care-giving and health for different groups of cares.

Peers empowering peers-feasibility of a peer educator training program to prevent diabetes

Background

This study assessed the feasibility and acceptability of the Healthy Outcomes through Peer Educators (HOPE) training program designed to train African American (AA) grandmothers to serve as peer educators for other AA grandmothers who are at risk for diabetes. The newly trained peer educators will provide the needed encouragement and positive reinforcement essential for successful sustainable health behaviors to grandmothers enrolled in a subsequent Diabetes Prevention Program.

Methods

Thirty AA women between the ages of 49–72 were enrolled in the pre-post single group study. The participants were required to attend a 2-h Diabetes Prevention Program session every week for 16 weeks. The sessions covered the role of the peer educator and encouraged participants to increase their physical activity and consume more servings of fruits and vegetables daily. We noted the number of participants who successfully completed the training and solicited their perspective regarding the strengths of the program and suggestions to improve the program. The Wilcoxon Signed Ranks Test was performed to evaluate changes in body weight, self-reported physical activity, and fruit and vegetable intake from baseline to week 16.

Results

Ninety three percent (n = 28) of enrollees completed the training program. All (n = 28) the peer educator trainees indicated that they would recommend the program to a friend and 93% (n = 26) reported that the program met their needs. The participants (n = 28) felt that the training prepared them to offer support to other grandmothers in their community. A Wilcoxon Signed Ranks Test revealed that participants body weights were significantly lower after completion of the 16 week training program (median = 156.5 lbs., n = 28) compared to baseline (median = 163.0, n = 28), Z = − 4.43, p < 0.05. Fruit and vegetable intake increased significantly (median = 5, n = 28) at week 16 compared to week one, (median = 2, n = 28) Z = 4.46, p < 0.05. Participants were more physically active at week 16 (median = 150 min per week, n = 28) compared to week 1, (median = 30 min per week, n = 28) Z = 4.62, p < 0.05.

Conclusions

The peer educator training component of HOPE was found to be feasible and acceptable as evidenced by our successful recruitment and retention of participants. Participation in the peer educator training program also resulted in improvement in health behaviors.

Grandparenting, Social Relations, and Mortality in Old Age

Guided by a convoy model of social relations, this study investigates the relationships between grandparenting status, social relations, and mortality among community-dwelling grandparents age 65 and older who are caring for their grandchildren. The data were drawn from the 2008 and 2016 waves of the Health and Retirement Study (N = 564). Latent class analysis was used to identify the social network structure based on six indicators of interpersonal relationships and activities. A series of hierarchical Weibull hazard models estimated the associations between grandparent caregiving, social relations, and mortality risk. Results of survival analyses indicate that co-parenting and custodial grandparents had higher all-cause mortality risk than grandparents who babysat occasionally; however, for custodial grandparents, the association was not significant once social relation variables were added to the model. This study suggests that community-based support may be beneficial to older grandparents and improved relationship quality is integral to the well-being of older adults.

"It helps me find balance": older adult perspectives on the intersection of caregiving and volunteering

Caregiving is an increasingly prevalent experience that can negatively impact health and well-being. Volunteerism, long associated with positive benefits for older adults, is one potential strategy that can be used to counteract caregiver stress. A national cohort of existing older adult volunteers was engaged to explore the intersection of volunteering and caregiving through qualitative analysis of respondent comments using the lens of role theory. Survey responses from 533 older volunteers were analyzed. Role conflict and role enhancement themes were examined, with time constraints and reduced energy emerging as the perceived causes of conflict between the caregiver and volunteer roles. Caregivers discussed benefits to their caregiving role, including respite, learning, access to information and resources relevant to caregiving, increased socialization and improved physical and cognitive health. Findings indicate that volunteering can be framed as a health and well-being intervention for caregivers.

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

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

Needs assessment of caregivers of children with disabilities in resource-limited settings

Objective: This study aimed to identify and classify the needs of caregivers of children with disabilities living in resource-limited settings and develop a framework for need assessment.

Participants and Methods: This study was conducted in the Maha Sarakham Province, Thailand, with 15 caregivers caring for children with disabilities recruited from hospitals, the Association for the Disabled, and primary health centers. Semi-structured interviews were conducted in local dialects, recorded, transcribed, converted into standard Thai, and then into English for thematic analysis. Meaning units corresponding to caregivers’ needs were extracted, interpreted, coded, and hierarchically organized into subcategories by comparing similarities and differences among the extracted codes. The subcategories were further grouped and abstracted into categories, and then domains of caregivers’ needs were formed.

Results: Nineteen categories were identified across five domains of caregivers’ needs: health and medical, welfare, educational, social, and informational. Although basic medical treatment was covered, specific support, such as referral to a specialist, rehabilitation, or psychological support, was limited. Financial support and relief from the care burden are the main welfare needs. Educational needs were identified to provide knowledge to children and to offer respite to their caregivers. Social needs revealed ethical problems that arose because of strong rural community ties, making it difficult to maintain privacy. Informational needs were intertwined with the other four domains. In rural areas, where parents of children with disabilities migrate to cities to find work, the special needs of grandparents who were primary caregivers of the children needed to be addressed.

Conclusion: This study provides a conceptual framework for comprehensive needs assessment and policy development for caregivers of children with disabilities living in resource-limited settings.

"My problems aren't their fault": Mexican American women managing diabetes while caring for grandchildren

Diabetes affects many aspects of family life for the Mexican American (MA) population. Caregiving grandmothers, the traditional family nurturers, are often simultaneously managing their type 2 diabetes (T2DM). The purpose of this qualitative descriptive study was to describe the perceptions of MA grandmothers managing T2DM while caring for a grandchild. Eight participants were interviewed. Participants consistently reported feeling a personal responsibility for their T2DM self-management as well as for the health and wellbeing of their families, including their grandchildren. Regardless of associated caregiving stress, grandchildren were described as the main source of positive motivation for T2DM self-management.

Activity Profiles among Older Adults: Latent Class Analysis Using the Korean Time Use Survey

This study empirically explored the activity profiles of Korean older adults by considering a wide range of activities simultaneously and further investigated the socioeconomic factors associated with activity profiles. Gender differences in activity profiles were examined in-depth. Latent class analysis (LCA) was used to identify activity profiles based on a nationally representative sample of older adults from the most recent two waves of the Korean Time Use Survey (n = 3034 for 2014 and n = 3960 for 2019). Multinomial logistic regression analysis was employed to further examine the factors associated with the activity profiles. The findings revealed four distinct activity groups, although there were differences in activity profiles between the two waves. Several sociodemographic factors, such as gender, age, assets and income, were significantly associated with the activity profiles. Findings from this study can inform policy makers seeking interventions that enhance the overall well-being of older adults through activity engagement.

Is caring for grandchildren good for grandparents' health? Evidence from a fourteen-wave nationwide survey in Japan

Background

Enhanced female labor force participation is raising the importance of grandparents’ caring for their grandchildren. However, previous studies have reported mixed results of the association between grandchild care and grandparents’ health.

Methods

Longitudinal data of 33,204 individuals born between 1946 and 1955 were collected from a 14-wave nationwide panel survey conducted from 2005 to 2018. We examined how caring for at least one co-residing grandchild aged <6 years was associated with grandparents’ psychological distress (defined by five or higher Kessler 6 score) and poor self-rated health in pooled cross-sectional, fixed-effects, and 3-year follow-up logistic models.

Results

While pooled cross-sectional models showed a positive association between grandchild care and grandparents’ health, the fixed-effects or follow-up logistic models did not find any significant association between them. In the case of grandmothers, the odds ratio of reporting psychological distress in response to caring for grandchildren was 0.98 (95% confidence interval [CI], 0.89–1.08) and 1.04 (95% CI, 0.85–1.27) observed from fixed-effects and 3-year follow-up models, respectively, compared to 0.86 (95% CI, 0.81–0.91) in the pooled cross-sectional model. Similar patterns were observed for self-rated health for grandmothers, while grandfathers’ health outcomes were not sensitive to grandchild care. These results contrasted with those of caring for parents, which had almost consistently a negative association with grandparents’ health.

Conclusion

The results suggest that caring for grandchildren does not have a beneficial or detrimental effect on grandparents’ health.

Development of Learning Media for the Elderly to Promote Child Health in the Community

The purpose of this study was to develop learning media for the elderly to promote child health. The participants consisted of 172 elderly people aged 60 years and older in a suburban village of northern Thailand. This study consisted of a survey questionnaire and focus group discussions and was divided in to two phases: (1) exploring the needs of the elderly in the knowledge of child health and (2) developing learning media, so that the elderly can learn how to promote child health and evaluate its efficiency in the trial process. Results showed that the participants mostly preferred the topic of activities of daily living (ADL) in children. The learning media contributes two major contents: (a) knowledge of child development in five types of ADL performance, brushing, eating, dressing, bathing, and toileting, and (b) methods in teaching ADL skills in children. The digital contents in the learning media were proposed to experts for professional approval. Efficiency of the learning media was evaluated after the trial, when the participants expressed their opinion, and the users perceived that the learning media was effective, motivating, easy to use, and simple in the terms used, as well as appropriate in the sequence of contents and pictures and font, size, and color of the text.

Consequences on depression of combining grandparental childcare with other caregiving roles

Objective: This study examines the effect of combining grandchild care with other care roles on depression among individuals aged 50 to 84. Previous research investigating the health consequences of multiple care roles among older adults found mixed evidence, with most studies being predominantly cross-sectional.Methods: We use longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE) to understand how grandparents' mental health, measured as depressive symptoms, is affected when combining multiple care roles. We estimate logistic regression models, for grandfathers and grandmothers separately, to investigate how depression at wave 2 is affected by multiple care roles at wave 1, controlling for depression at baseline.Results: Consistent with previous studies, we find that providing grandchild care only reduces risk of depression for grandmothers, but not for grandfathers. For both genders, we find a higher risk of depression among those who provide intensive care to co-residents. The negative effect of grandchild care on depression found for grandmothers disappears if they also provide other types of care. In particular, grandmothers who provide care both to grandchildren and to a sick or disabled person show a higher risk of depression compared to those who only provide grandchild care.Conclusions: While multiple caregiving roles are not common, it is important to understand their combined effect on caregivers' health. Grandmothers who provide childcare and other intensive types of care may lose the positive effects grandchild care exert over their wellbeing.

Benefits of Grandparental Caregiving in Chinese Older Adults: Reduced Lonely Dissatisfaction as a Mediator

Objective

The purpose of the present study is twofold: (1) to investigate the differences in terms of physical and mental health between those who provide grandparental care and those who do not and (2) to explore the mechanism that connects grandparental caregiving and health-related outcomes.

Methods

Two studies (a cross-sectional and a short-term longitudinal follow-up) were conducted. The cross-sectional study (Study 1) examined 148 older adults who provided grandparental care and another 150 older adults who did not. A small longitudinal follow-up study (Study 2) was conducted among 102 older adults randomly selected from Study 1, of which 52 were older adults who provided grandparental care, and another 50 older adults were those who did not. Health status (measured by SF-36), lonely dissatisfaction (measured by Lonely Dissatisfaction Subscale of PGC-MS), and cognitive functions (measured by subscales of WAIS) as well as demographics were measured in both studies.

Results

Results of both the cross-sectional and longitudinal studies showed that, compared with older adults who did not provide grandparental care, those providing grandparental care had significantly better physical and mental health as well as reduced lonely dissatisfaction. Further path analysis showed that lonely dissatisfaction mediated the association between providing grandparental care and enhancement in functions such that providing grandparental care could reduce lonely dissatisfaction, which, in turn, could improve their physical and mental health even after controlling for their cognitive functions.

Discussion

These results suggest that providing grandparental care can improve older adults’ physical and mental health through reduced lonely dissatisfaction.

Grandparents Raising Grandchildren: What Have We Learned Over the Past Decade?

BACKGROUND AND OBJECTIVES

In this manuscript, we update the literature over the last decade in addressing several new content areas that have emerged in the grandfamilies literature, along with issues that are still important to understanding grandparents raising their grandchildren today.

RESEARCH DESIGN AND METHODS

The social science and gerontological literature since 2004 was accessed, reviewed, organized topically, and integrated, based upon an exhaustive PsychINFO literature search.

RESULTS

Our review indicates an ongoing and/or growing emphasis on (a) the strengths of grandparent raising grandchildren, (b) diversity among grandfamilies along a number of parameters, (c) the social-interpersonal, cultural, and policy-related contexts of grandfamilies, (d) process-focused research, (e) parenting, parenting skills, and family relationships, (f) grandparent psychological distress, (g) targets for and the efficacy of interventions with grandfamilies, and (h) methodological issues relevant to the study of grandfamilies.

IMPLICATIONS

We discuss the implications of our findings in terms of more completely understanding grandfamilies along a number of parameters, as well as presenting specific recommendations for future research and practice.

Suicidal Ideation of the Elderly According to Their Involvement in Grandchild Care

The purpose of the present study was to examine the severity of suicidal ideation of the older adults according to the amount of involvement in grandchild care. Data for this research were drawn from a cross-sectional study conducted on community-dwelling adults aged 65 years or older. The 922 participants were divided into three groups according to their involvement in grandchild care: 18.5% had provided daily care, 12.4% had provided occasional care, and 69.1% had never cared for their grandchildren. ANCOVA analysis showed that the scores for depression was significantly lower in the group which took care of their grandchildren occasionally compared to the other two groups. The scores for suicidal ideation was significantly higher in the group which had never taken care of their grandchildren compared to the other two groups. Current study suggests that grandparenting may have a positive effect on suicidal ideation of the older adults.

Grandparenting in the United States

Grandparenting varies enormously in the United States and here we discuss that growing diversity. Relying on exchange and reciprocity, feminist, and political economic theoretical perspectives, we begin by exploring the increasing need for grandchild care and assistance in the United States and the dearth of federal and employer supports for working families. Assessing the impact of sociodemographic trends, notably the rise in single parenting and the increase in employment among grandparents, we assess the intensification of grandparenting. Then we turn to issues related to proximity, examining the pleasures and challenges of coresidential, custodial, long distance, and transnational grandparenting. Finally, we turn to the impact of grandparenting on the emotional, physical, and financial wellbeing of grandparents.

Work and the Family in Later Life: The Effects of Role Stressors, Role Enhancement, and Role Conflict on Self-Perceptions on Aging

The growing aging workforce comprises older workers with a concurrent family role. Guided by life span development and role theories, the primary study hypothesis was that rewards and stressors in the family and work domains would impact self-perceptions on aging because of the enhancement and conflict between these domains. The study sample consisted of workers older than 50 years with at least one of four family roles (spouse, parent of adult children, caregiver to an aging parent, and grandparent) from the 2010 and 2012 Health and Retirement Study ( N = 5,628). Results showed that self-perceptions on aging were impacted directly by family and work stressors and indirectly by these stressors through work-family enhancement and conflict . Work and family roles are thus crucial to the identity of adults in later life.

Double burden for women in mid- and later life: evidence from time-use profiles in Cebu, the Philippines

Using data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS, 1994, 1998, 2002, 2005, 2007, 2012), we utilize latent class analysis (LCA) to develop time use class membership to characterize the degree to which women in Cebu are subject to the double burden of work and family responsibilities in mid and later life. Results suggest that close to a third of the sample are engaged in high intensity work for pay (either outside or home-based) over eighteen years, while combining it with a substantial amount of household chores and with low level of personal time in a span of eighteen years. Our latent transition analysis (LTA) also shows that, with the addition of grandchildren into the household, some women experience a shift in time use class membership by becoming high intensity caregivers or by completely transitioning out of work arena, while others remain double-burdened with active involvement in both work and family responsibilities.

Physical and mental health of Chinese grandparents caring for grandchildren and great-grandparents

The increasing worldwide prevalence and intensity of grandparenting has attracted an attention to its health implications for caregivers against the backdrop of population aging. Thanks to prolonged life expectancy and reduced infant mortality, extended families that comprise four generations, co-residential or not, are no longer rare in China. The current study examines health consequences when Chinese grandparents provide care to not only grandchildren but also their own elderly parents or parents-in-law (i.e., great-grandparents). Drawing on data from the 2011-2013 China Health and Retirement Longitudinal Study (CHARLS), mental health was captured by levels of life satisfaction and depressive symptoms, and physical health was measured by levels of high sensitivity C-reactive protein (CRP), hypertension, high-risk pulse rate, and diabetes. Overall grandparents who cared for grandchildren only had better mental and physical health, compared with non-caregivers. There was some evidence that the 'sandwich' grandparents who cared for both grandchildren and great-grandparents reported greater life satisfaction, fewer depressive symptoms, and reduced hypertension compared with non-caregivers. The health advantage of caregiving was most pronounced in urban grandfathers whose caregiving conformed to the norm of filial piety and who did so most likely to seek emotional reward instead of an intergenerational time-for-money exchange. In contrast, rural grandmothers were the most vulnerable group and their health disadvantage seemed to arise from caring for great-grandparents. These findings highlight the importance of rural-urban context and gender role in studying the health effects of intergenerational caregiving on Chinese grandparents.

Impact of family characteristics by marital status of cohabitating adult children on depression among Korean older adults

AIM

To identify the association between different living arrangements of intergenerational household composition and depression in older adults.

METHODS

Data from the Korea Longitudinal Study of Aging, the first to fourth waves, were used. Using the first wave as baseline, our analysis included 5046 participants aged ≥60 years with at least one living child. Depression was measured using the 10-item Center for Epidemiological Studies Depression scale. Factors investigated included living arrangements according to household composition and the marital status of a cohabiting adult child. A generalized estimating equation with the logit link for binary outcomes was used to examine the association between living arrangements and depression.

RESULTS

Compared with the older adults living with a married child and grandchildren, those living alone, those living with an unmarried child, and those living with an unmarried child and grandchildren were more likely to have depression (OR 1.41, 95% CI 1.13-1.75; OR 1.40, 95% CI 1.18-1.66; OR 1.60, 95% CI 1.27-2.01). In particular, women were more likely to have depression than men in the association between living arrangements and depression.

CONCLUSIONS

Efforts should be made to provide social services for older adults living alone and those living with an unmarried child in a two-/three-generation family, in particular, for those who are female. Geriatr Gerontol Int 2017; 17: 2527-2536.

A Model for School Professionals Working with Grandparent-Headed Families

Grandparent-headed families have multifaceted needs and complicated family contexts. These nontraditional families frequently have strained relationships with their grandchildren's school systems, but there are scarce models providing effective strategies for working with them. The author used multidisciplinary theoretical literature and research outcomes to propose a model for working with grandparent-headed families in schools. First, unique needs, risk factors, and school barriers these grandparent-headed families experience are put forward. In addition, school professionals' needs for practice guidelines for their work with grandparent-headed families are described. A model for working with grandparent-headed families is proposed, built on four theories: symbolic interactionism, attachment theory, role theory, and the strengths-based approach. Implications for teaching, practice, and programming for grandparent-headed families in schools are presented.

The maintaining and improving effect of grandchild care provision on elders' mental health-Evidence from longitudinal study in Taiwan

OBJECTIVE

This study aims to determine the impact of grandchild care provision on elders' mental health by self-comparison and longitudinal study design.

METHOD

Information of 2930 grandparents from the Study of Health and Living Status of the Middle-Aged and Elderly in Taiwan were analysed. Elders' mental health was evaluated by Epidemiological Studies Depression Scale in both 2003 and 2007. Participants were divided into 4 groups based on their changing behaviour of caring for grandchildren from 2003 to 2007. Chi-square test was used to compare changes in elders' individual characteristics and total CESD scores between and within groups. ANOVA was used to compare the means of elders' depressive symptoms between groups while paired-t test was used to compare changes in elders' depression symptoms from 2003 to 2007. Logistic regression was performed to determine the associations between elders' changing behaviour of caring for grandchildren and changes in depressive symptoms.

RESULTS

Elders continuously caring for grandchildren or started to take care of grandchildren significantly felt happier and enjoyed life more than before and more than elders who do not provide grandchild care. Logistic regression analyses exploring the impact of grandchild care provision found that elders provided no grandchild care had worst mental health amongst all. Elders stopped providing grandchild care had significantly higher risk of developing depressive symptoms (OR=1.40) than elders provided no grandchild care at all time.

DISCUSSION

By self-comparison, this study illustrates how taking care of grandchildren maintains elders' mental health, especially against them from loneliness and depression.

The Impact of Caring for Grandchildren on Grandparents’ Physical Health Outcomes: The Role of Intergenerational Support

Little longitudinal data exist on grandparent caregivers and few studies have examined their physical health outcomes. This study examined the effect of caring for grandchildren on grandparents’ physical health and the role of intergenerational support from adult children. Longitudinal data derived from a survey on the well-being of older adults in China were used to conduct path analysis of previous grandparent caregivers (vs. noncaregivers) and repeated grandparent caregivers (vs. noncaregivers). The final sample was 799 grandparents aged 60 or older living in rural China. Three aspects of intergenerational support were measured: financial, emotional, and instrumental support. Repeated grandparent caregivers had better self-rated health (SRH) and fewer limitations than noncaregivers. Previous grandparent caregivers had better SRH compared to noncaregivers. Emotional support mediated the relationship between caregiving and SRH among repeated caregivers. Findings suggest that any caregiving experience (previous or repeated) provides health benefits to grandparents.

Grandparenting Roles and Volunteer Activity

OBJECTIVES

We examine whether grandparenting roles are related to formal volunteering among older adults.

METHOD

Logistic regression is used to examine the likelihood of volunteering based on grandchild care using data from the 2004 wave of the Health and Retirement Study (n = 13,785). Longitudinal analyses utilize treatment effects models to examine changes in volunteering for grandparents who begin nonresidential grandchild care between the 2004 and 2008 waves (n = 10,811).

RESULTS

Results show that grandparents raising coresidential grandchildren have lower odds of volunteering than grandparents providing no regular grandchild care. However, grandparents who provide nonresidential grandchild care are more likely to volunteer than grandparents not providing grandchild care and those raising a coresidential grandchild. Grandparents who provide nonresidential care for grandchildren engage in more volunteering before assuming grandchild care, and their volunteerism increases after becoming a caregiver for a grandchild.

DISCUSSION

Consistent with resource theory and the accumulation of roles, providing nonresidential grandchild care may draw grandparents into formal volunteer activity. The lower human capital resources evidenced by grandparents raising coresidential grandchildren may play a role in their lower likelihood of formal volunteering.

Biofeedback in Grandmothers Raising Grandchildren: Correlations Between Subjective and Objective Measures

Research shows that 20% of grandmothers raising grandchildren experience stress and depression. Heart rate variability (HRV) biofeedback may help grandmothers track and regulate their physiological response to stress. This study therefore examined correlations between coherence scores reflecting HRV and self-report measures of stress, negative emotions, and depressive cognitions in 20 grandmothers raising grandchildren. Higher coherence scores were inversely and significantly correlated with self-report measures, suggesting the need to examine the effects of HRV biofeedback on biomarkers reflecting stress and depression.

Current Situation of Postmenopausal Grandmothers Raising Their Grandchildren

As the average life expectancy of women increases, the family and social roles of postmenopausal women have become more important. With the growing number of dual-income households, postmenopausal grandmothers occupy a large role in child-rearing. Postmenopausal women mainly experience social changes as a family member along with personal changes. Postmenopausal women face changes in physical and mental aspects due to drastic hormonal changes. Grandmothers sharing the burden of raising children are actually encountering a number of challenges while dealing with hardships to adapt to physical and mental changes at the same time. It is thought to be important to understand the impact of raising grandchildren on physical and mental conditions among grandmothers experiencing hardships between social reality and personal changes from medical perspective based on sociological studies. Focusing mainly on studies on related fields, this study aims to investigate personal and social supports from medical perspective and to device practical measures.

The pathway to grandparenting stress: trauma, relational conflict, and emotional well-being

OBJECTIVES

This paper examines the mediating effect of child-grandparent conflict on the relationship between child trauma exposure and grandparenting stress.

METHODS

Data was collected from a sample of custodial grandparents who participated in kinship care or relative caregiving programs (n = 251). Grandparenting stress was measured with Parenting Stress Scale (Berry & Jones, 1995 ) modified for grandparents. A series of regression models and structural equation models (SEM) were used to test the relationship between the number of different types of child trauma exposures and grandparenting stress, and to examine the mediating effect of child-grandparent conflicts on the relationship.

RESULTS

Almost three-fourths (72%) of children had experienced at least one type of traumatic exposure. The SEM model shows that child's trauma exposure indirectly affected grandparenting stress, mediated by child-grandparenting conflicts though no direct path between the child's trauma exposure variable and grandparenting stress was found. A higher level of child-grandparent conflicts was also associated with a lower level of emotional well-being among custodial grandparents.

CONCLUSION

Based on these findings, recommendations are made about how to tailor a trauma-informed approach to the needs of custodial grandparents.

The health of grandparents raising grandchildren: a literature review

Around the world, an increasing number of grandparents are raising grandchildren in households without a biological parent. This is no less true in the United States, where grandparents raising grandchildren are at increased risk for depression and declining physical health. The purpose of this article is to explore the recent literature as it relates to the psychological and/or physical health of grandparents raising grandchildren. On reviewing 19 articles from the past 10 years, it is clear that the literature consistently verifies the health risks, especially depression, for grandparents raising grandchildren; however, the lack of research regarding grandfathers and non-African American caregivers is apparent. The factors influencing grandparents raising grandchildren are numerous, which calls for care providers to assess the needs, situations, and perceptions of grandparents individually. Finally, a need has arisen for more research suggesting and validating interventions that health care providers can use to support this population of older adults.

An investigation of activity profiles of older adults

OBJECTIVES

In this study, we advance knowledge about activity engagement by considering many activities simultaneously to identify profiles of activity among older adults. Further, we use cross-sectional data to explore factors associated with activity profiles and prospective data to explore activity profiles and well-being outcomes.

METHOD

We used the core survey data from the years 2008 and 2010, as well as the 2009 Health and Retirement Study Consumption and Activities Mail Survey (HRS CAMS). The HRS CAMS includes information on types and amounts of activities. We used factor analysis and latent class analysis to identify activity profiles and regression analyses to assess antecedents and outcomes associated with activity profiles.

RESULTS

We identified 5 activity profiles: Low Activity, Moderate Activity, High Activity, Working, and Physically Active. These profiles varied in amount and type of activities. Demographic and health factors were related to profiles. Activity profiles were subsequently associated with self-rated health and depression symptoms.

DISCUSSION

The use of a 5-level categorical activity profile variable may allow more complex analyses of activity that capture the "whole person." There is clearly a vulnerable group of low-activity individuals as well as a High Activity group that may represent the "active ageing" vision.

The protective effect of taking care of grandchildren on elders' mental health? Associations between changing patterns of intergenerational exchanges and the reduction of elders' loneliness and depression between 1993 and 2007 in Taiwan

Background

The 20th century’s rapid industrialization and urbanization brought important social changes to Taiwan, including an increased number of elders living alone, which has increased risk of depression for the elderly. This study aimed to evaluate the changing pattern regarding the effect of intergenerational exchanges on elders’ depressive symptoms from 1993 to 2007.

Methods

Data from the second-, fourth- and sixth-wave surveys of the Study of Health and Living Status of the Middle-Aged and Elderly in Taiwan were analyzed. This study collected elders’ individual sociodemographic characteristics, their self-reported health status and their intergenerational exchanges, including living with partners or with their children and their provision of care for their grandchildren. Information about elders’ depression was evaluated using the 5-item Epidemiological Studies Depression Scale (CES-D).

Changes in elders’ intergenerational exchanges and depressive symptoms were compared during these study periods (chi-square test). Then, logistic regression was performed to determine how significantly elders’ intergenerational exchanges were associated with their depressive symptoms across the three years 1993, 1999 and 2007.

Results

The prevalence of elders living with partners decreased from 1993 to 2007 by 19%, and that of living with their children decreased from 1993 to 2007 by 7%. Conversely, the percentage of elders providing care for grandchildren dramatically increased, from 9% in 1993 to 21% in 2007. Elderly people had significantly fewer depressive symptoms in 2007 than in 1993.

After adjusting for confounders, those living without a partner, living without children or providing no grandchild care had a greater risk of feeling lonely and being depressed. However, during the period 1993 to 2007, the impact on elders’ depression and loneliness of co-residing with a partner or with children decreased at the same time that the impact of their provision of grandchild care increased. In 2007, elders who provided no grandchild care were significantly more likely to feel lonely and sad as well as to have high CES-D scores; these strong associations were not found in 1993 and 1999.

Conclusions

This study illustrates how taking care of grandchildren protects against depression and loneliness in elderly Taiwanese. We argue the need, in an aging society, for improving intergenerational interaction and recommend careful evaluation of the interaction between population policies and those of social welfare, such as child care.

Stress associated with caregiving: an examination of the stress process model among Kenyan Luo elders

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.

Grandfather caregivers: race and ethnic differences in poverty

We use data from the 2006 American Community Survey to examine race and ethnic differences in the effects of marital status and co-residence of the middle generation on the likelihood of poverty among grandfathers who have primary responsibility for co-resident grandchildren (N = 3,379). Logistic regression results indicate that race/ethnicity and household composition are significant predictors of poverty for grandfather caregivers: non-Hispanic white grandfathers, those who are married, and those with a co-resident middle generation are the least likely to be poor. The effects of race/ethnicity, marital status, and the presence of a middle generation are, however, contingent upon one another. Specifically, the negative effect of being married is lower among grandfathers who are Hispanic, African American, non-Hispanic, and non-Hispanics of other race/ethnic groups compared to whites. In addition, having a middle generation in the home has a larger negative effect on poverty for race/ethnic minority grandfathers than for non-Hispanic whites. Finally, the combined effects of marriage and a middle generation vary across race/ethnic group and are associated with lower chances of poverty among some groups compared with others. We use the theory of cumulative disadvantage to interpret these findings and suggest that race/ethnicity and household composition are synergistically related to economic resources for grandfather caregivers.