Grandmothers, caregiving, and family functioning

Emotional competences as predictors of psychological wellbeing and quality of life of supplementary grandparents caregivers

Introduction

Grandparents are increasingly becoming key figures in the supplementary care of grandchildren. Based on the Resilience Model of Family Stress, Adjustment and Adaptation, the present study aims to analyze the emotional competences that canpl predict higher levels of psychological wellbeing and quality of life in supplementary grandparents caregivers.

Methods

A sample of 270 supplementary grandparents caregivers living in Spain participated. Most participants were women (71.1%), and the mean age was 67.83 years (SD = 6.26). Most participants were occasional caregivers, that is, they care for less than 10 h per week (76.3%). We conducted hierarchical multiple regression analysis, one for psychological wellbeing and the other for quality of life.

Results

The regression model for psychological wellbeing identified that age, management of caregiving stress, self-confidence in the caregiving role, management of work-life balance difficulties and emotional self-regulation explained 32.8% of its variance. The regression model for quality of life showed that age, type of grandparent caregiver, management of caregiving stress, management of work-life balance difficulties and emotional self-regulation explained 31.2% of its variance.

Conclusion

This study focuses on supplementary grandparents caregivers, whereas literature has tended to look at primary grandparents caregivers. The results highlight the role of emotional competences as predictors of supplementary grandparents caregivers' psychological wellbeing and quality of life, overcoming the usual tendency in the literature to focus on the negative consequences of grandparents caregiving for grandchildren, and emphasizing the competences that grandparents have to cope with this care in a satisfactory way, which, moreover, can be trained.

Comparison of the Quality of Life of Physically Active and Inactive Grandmothers Caring and Non-caring for Grandchildren: A Cross-Sectional Study

Background

Nowadays, grandparents have a major role in taking care of their grandchildren. Also, caring for grandchildren is a common and normative experience for many Iranian grandparents. The present study aimed to compare the quality of life of physically active and inactive grandmothers caring and non-caring for grandchildren.

Methods

This analytical cross-sectional study was conducted on 300 grandmothers at the age range of 50 to 70 years old, who lived in Bojnurd, northeastern Iran (2018). Data were collected using the questionnaires of 36-Item Short Form Health Survey (SF-36) and Baecke Physical Activity, and demographic information.

Results

The total scores of quality of life in caring physically active, physically inactive, non-caring physically active and non-caring physically inactive grandmothers were 76.95±6.33, 71.74±9.41, 75.56±5.9, and 56.06±11.23, respectively. There was a significant difference in the comparison of the quality of life score in caring grandmothers in two active and inactive groups (P<0.001). In addition, the quality of life score of non-caring grandmothers indicated a significant difference in physically active and inactive grandmothers (P<0.001).

Conclusion

According to the results of this study, it seems that caring physically active grandmothers have higher quality of life. It can be suggested that the grandmothers who care for their grandchildren may improve their health and quality of life by incorporating the programs to increase physical activities in their daily life.

Grandparents of children with cancer: a controlled comparison of perceived family functioning

PURPOSE

Grandparents can be profoundly emotionally affected when a grandchild is diagnosed with cancer. They also often provide invaluable support for the family (e.g., caring for the sick child and/or siblings). Multigenerational family functioning may therefore change. Limited research has assessed grandparents' perspectives after their grandchild is diagnosed with cancer. In this study, we aimed to (1) assess differences in perceived family functioning among grandparents of a child with cancer and grandparents of healthy children and (2) assess the cancer-specific and demographic factors related to perceived family functioning in grandparents of a grandchild with cancer.

PROCEDURE

Grandparents of a child with cancer (n = 89) and grandparents of healthy children (n = 133) completed the general functioning, communication, and problem-solving scales of the Family Assessment Device. We used multilevel models with a random intercept to detect (1) between-group differences and (2) identify factors related to perceived family functioning among grandparents with a grandchild with cancer.

RESULTS

Grandparents with a grandchild with cancer reported poorer family functioning than grandparents with healthy grandchildren. Among the grandparents with a grandchild with cancer, impairments in family functioning were correlated with fewer years since diagnosis, providing care to their sick grandchild and/or siblings and living far away from the sick grandchild.

CONCLUSIONS

The detrimental impact of childhood cancer likely extends beyond the immediate family members. Including grandparents in interventions-beginning at diagnosis-to reduce distress and increase cohesion for families of a child with cancer is warranted, particularly for grandparents who provide care to their sick grandchild or siblings.

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.

The Parents', Hospitalized Child's, and Health Care Providers' Perceptions and Experiences of Family-Centered Care Within a Pediatric Critical Care Setting: A Synthesis of Quantitative Research

Family-centered care (FCC) purports that unlimited presence and involvement of the family in the care of the hospitalized child will optimize the best outcome for the child, family, and institution. A systematic appraisal was conducted of peer-reviewed, English-language, primary quantitative research conducted within a pediatric critical care setting reported from 1998 to 2014. The aim of this review was to explore the parents', hospitalized child's, and health care providers' perception of FCC within pediatric critical care. Fifty-nine articles met the criteria that generated themes of stress, communication, and parents' and children's needs. This review highlighted that communication tailored to meet the parents' and child's needs is the key to facilitating FCC and positive health outcomes. Health care providers need to be available to provide clinical expertise and support throughout the health care journey. Future initiatives, education, and research are needed to evaluate the benefits of parent- and child-led FCC practice.

Evaluating an Online Resourcefulness Training Intervention Pilot Test Using Six Critical Parameters

Few resources are available to help grandmother caregivers to grandchildren manage their complex family situations that may have immediate and long-term consequences for themselves and their families. Resourcefulness training is an intervention designed to help grandmothers improve their ability to deal with these problems. The purpose of this pilot study was to evaluate the necessity, feasibility, acceptability, fidelity, safety, and effectiveness (i.e., effect sizes) of an online, computer-based resourcefulness training intervention that was adapted from a face-to-face intervention. Twelve grandmothers raising or living with grandchildren participated in the pilot intervention that included (a) watching an instructional video on resourcefulness, (b) completing two online questionnaires over a 6-week time period, and (c) writing in an online journal every day for 4 weeks. Data are evaluated within the context of the six parameters important to intervention development. Qualitative and quantitative results provide initial support for all six parameters. Recommendations to improve aspects of the intervention are discussed.

Impact of Protective Factors on Resilience of Grandparent Carers Fostering Orphans and Non-Orphans in Zimbabwe

Objective: This study sought to explore the impact of protective factors, health, and well-being on resilience of grandparents fostering orphans. Method: Data were collected from grandparents ( N = 327; M age = 62.4; SD = 11.2) in Zimbabwe using a survey instrument comprising the Resilience Scale and World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). Data were analyzed using hierarchical regression, predicting resilience from demographics, personal and social assets, health, and well-being. Results: Protective factors associated with resilience were personal assets (high self-esteem, problem-solving skills, and mastery) and social assets (social networks and spirituality). Grandparents with higher coping skills, younger age, and high socioeconomic status (SES) had superior personal competences for resilience than peers with lower self-rated personal attributes. Grandparents with good physical and mental health had higher resilience profiles. Discussion: Positive emotions and good health experienced by resilient grandparent carers function as protective factors to reduce the magnitude of adversity to individuals and assist them to cope well with caregiving.

Resourcefulness training for grandmothers raising grandchildren: establishing fidelity

Over one million American grandmothers raise grandchildren, and many experience stress that adversely affects their mental health. Teaching resourcefulness skills can minimize this stress. However, before testing effectiveness of resourcefulness training (RT), its fidelity must be established. This pilot intervention trial examined the fidelity of two methods of RT: expressive writing (journaling) and verbal disclosure (voice recording) using a quasi-experimental design with random assignment of 80 grandmothers to RT-expressive writing, RT-verbal disclosure, or expressive writing or verbal disclosure alone. Quantitative data (Resourcefulness Scale) and qualitative data (journals, recordings) were collected. Grandmothers with RT showed greater resourcefulness over time than those without RT, with similar effects for RT-expressive writing and RT-verbal disclosure. Evidence for the use of RT skills was found in journals and recordings. The findings provide support for RT intervention fidelity and support moving forward to test RT effectiveness in reducing grandmothers' stress and promoting their mental health.

Resourcefulness training for grandmothers: preliminary evidence of effectiveness

In this pilot study of 102 grandmothers raising grandchildren, we used a quasi-experimental, repeated measures design to examine effects of resourcefulness training reinforced by expressive writing (journaling) or verbal disclosure (digital voice recording) in reducing stress and depressive symptoms and enhancing quality of life. Resourcefulness training was compared with expressive writing, verbal disclosure, and attention control conditions. Both the expressive writing and verbal disclosure methods for reinforcing resourcefulness training were more effective than the other three conditions in reducing stress and depressive symptoms and improving quality of life. No difference was found between the two reinforcement methods. Grandmothers may benefit from learning resourcefulness skills and from practicing them in ways that best fit their needs and lifestyles.

Longitudinal analysis of resourcefulness, family strain, and depressive symptoms in grandmother caregivers

BACKGROUND

Grandmothers living with grandchildren face stressors that may increase depressive symptoms, but cognitive-behavioral strategies, such as resourcefulness, may reduce the effects of stressors on mental health.

PURPOSE

This analysis examined the contemporaneous and longitudinal relationships among intra-family strain, resourcefulness, and depressive symptoms in 240 grandmothers, classified by caregiving status to grandchildren.

METHODS

Grandmothers raising grandchildren, grandmothers living in multigenerational homes, and non-caregivers to grandchildren reported on intra-family strain, resourcefulness, and depressive symptoms using mailed questionnaires at three time points over 5 years. Structural equation modeling was used to evaluate the mediating effects of resourcefulness and the relationships between variables.

DISCUSSION

Grandmother caregiver status had significant effects on depressive symptoms and intra-family strain but not on resourcefulness. At all waves, higher resourcefulness was associated with fewer depressive symptoms, which reduced appraisals of intra-family strain.

CONCLUSIONS

Interventions focused on strengthening resourcefulness could reduce depressive symptoms over time.

Resourcefulness training for grandmothers raising grandchildren: is there a need?

Grandmothers raising grandchildren may experience stress that adversely affects their health and, thus, they may benefit from interventions to promote resourcefulness. Before conducting definitive tests about the effectiveness of resourcefulness training (RT), it is essential to determine the need for the training. This study of 126 grandmothers examined baseline resourcefulness, attrition rates from the resourcefulness training, and perceived need for RT. Baseline resourcefulness scores indicated that 72% of the grandmothers had more than a moderate need for RT. Reasons for attrition were unrelated to perceived need. After receiving RT, 88% perceived that they needed it. The results support testing RT effectiveness as the next step.

Caring for a loved one with cancer: it is my job

This study investigated the experiences of caregivers of loved ones with cancer in Lomé, Togo. The authors developed a framework that captures the experiences of 17 caregivers. The framework explains the exploratory factors that influenced the lives of caregivers from the caregivers' own perspectives. Findings showed that even though the caregivers experienced significant challenges that affected their lives and the lives of their families, because of cultural norms and expectations, they tried their best to overcome the challenges. Although some reported positive impacts on their family functioning, others reported negative impacts such as fragmentation of the family unit. Implications for practice and policy are discussed.

Grandparents in multigenerational households: the case of Portugal

Population ageing has paved the way for important and lasting multigenerational bonds, particularly between grandparents and grandchildren. Proximity is a powerful enhancer of relations, and co-residence, by involving continual proximity and long-term commitment, is particularly facilitative of significant linkages between generations. Although co-residence has generally been decreasing in Western societies, in the last decades of the millennium, a trend reversal was identified in the proportion of multigenerational households in the USA. Using data drawn from the European Community Household Panel, 1994-2001, some descriptive insights are provided that were considered to be missing in regard to the socio-demographic composition of extended households with grandparents in Portugal. Additionally, this study finds a rising trend in the proportion of multigenerational households, specifically those that include both grandparents and grandchildren. Portugal is possibly the European country that has the highest probability of exhibiting this pattern of evolution, because of the combination of its being a welfare state with limited resources, its historical reliance on family solidarity and its high level of participation of women in the labor market. Co-residence is a type of intergenerational transfer that can benefit any of the generations involved, but the direction of its net flow is still open to debate. A breakdown is made of its trend into age, period and cohort effects, in order to contribute to the discussion of the relative importance of the different generations in the shared living arrangement. Our findings suggest a mixture of interests, as well as a predominant influence of contemporary circumstances in the observed trend. These contemporary circumstances may be persistent or transient, but co-residence with grandparents is certainly an enduring mechanism, which households use in order to meet their needs.

Aging and Family Life: A Decade Review

In this review, we summarize and critically evaluate the major empirical, conceptual, and theoretical directions that studies of aging families have taken during the first decade of the 21st century. The field has benefited from an expanded perspective based on four overarching themes: (a) complexity in emotional relations, (b) diversity in family structures and households, (c) interdependence of family roles and functions, and (d) patterns and outcomes of caregiving. Although research on aging families has advanced theory and applied innovative statistical techniques, the literature has fallen short in fully representing diverse populations and in applying the broadest set of methodological tools available. We discuss these and other frontier areas of scholarship in light of the aging of baby boomers and their families.

Grandmother's Life Satisfaction and Influencing Factors by Grandparenting

PURPOSE

The study was to compare the factors of life satisfaction between grandmothers parenting and not parenting their grandchildren.

METHODS

A descriptive design with a convenience sampling was used for this study. From communities in S and U city, 85 parenting grandmothers (PG) and 103 non-parenting grandmothers (NPG) were recruited. The PG were those grandmothers who cared for preschooler grandchildren for their daughter or daughter-in-law who was employed.

RESULTS

The demographics of the two groups were similar, however the value of grandparenting was significantly higher in the PG than the NPG (t=4.56, p<.001). In the PG, strong and significant correlations were found among the value of grandparenting, health status, quality of relations with adult children, and life satisfaction. However, demographics were more related to health status and life satisfaction in the NPG. The value of grandparenting, health status, and quality of grandmother-adult children relations were found to be significant factors of life satisfaction (F=20.75, p<.001) explaining 42% of the variances. In the NPG, only health status was a significant factor (F=50.66, p<.001) explaining 33% of the variances.

CONCLUSION

This study shows that grandmothers' perceptions of grandparenting and family relationships need to be incorporated into the lifestyle in order to support parenting grandmothers' life satisfaction while grandmothers' health is the common concern of elderly women's life satisfaction.

Grandmothers and caregiving to grandchildren: continuity, change, and outcomes over 24 months

PURPOSE

Transitions in caregiving, such as becoming a primary caregiver to grandchildren or having adult children and grandchildren move in or out, may affect the well-being of the grandmother.

DESIGN AND METHODS

This report describes caregiving patterns at 3 time points over 24 months in a sample of 485 Ohio grandmothers and examines the effects of stability and change in grandmother caregiving roles (raising a grandchild, living in a multigenerational home, or not caregiving to grandchildren). Drawing on the Resiliency Model of Family Stress, the study examined caregiving stress and reward, intrafamily strain, social support, resourcefulness, depressive symptoms, mental and physical health, and perceived family functioning. Caregiver group, time of measurement, switching between caregiver groups, and baseline age, race, education, work status, and marital status were considered as independent variables within the context of a one-way treatment structure in a mixed-model multivariate analysis.

RESULTS

There were significant caregiver group effects for all variables, except mental health and resourcefulness. Grandmothers raising grandchildren reported the most stress, intrafamily strain, and perceived problems in family functioning, the worst physical health and more depressive symptoms, and the least reward and subjective support. Across groups, there were significant time effects, with worsening physical health and increased stress over time. Switching to higher levels of caregiving was associated with worsening physical health and increases in stress, intrafamily strain, and perceived problems in family functioning.

IMPLICATIONS

Recommendations for research and for practice, especially during times of caregiving transition or for grandmothers raising grandchildren, are discussed.

Grandmother caregiving, family stress and strain, and depressive symptoms

This study used the resiliency model of family stress, adjustment, and adaptation as the framework to examine the main and moderating effects of social support and resourcefulness in the relationship between family life stresses and strain and depressive symptoms in grandmothers raising grandchildren, grandmothers in multigenerational homes, and noncaregivers to grandchildren. A sample of 486 Ohio grandmothers, recruited using random and supplemental convenience methods, completed mailed surveys. Analysis of variance was used to examine differences in family life stresses and strain, resourcefulness, support, and depressive symptoms across the three groups of grandmothers. Hierarchical multiple regression analyses were used to examine whether family stresses and strains affected the grandmother's depressive symptoms and whether social support and resourcefulness moderated the relationship between family stresses and strain and grandmothers' mental health. Grandmothers raising grandchildren reported more depressive symptoms, but in multiple regression analyses of the full sample that controlled for demo-graphics, primary caregiving status was not related to depressive symptoms. More strain and less subjective support and resourcefulness were associated with higher depressive symptoms for all grandmothers, with 33% to 54% explained variances of such symptoms for each caregiving group and the full sample. Subjective support moderated the effects of strain and instrumental support moderated the effects of family life stresses on depressive symptoms. Social support and resourcefulness may help protect grandmothers from the effects of family stresses and strain, and interventions to enhance these factors may assist grandmother caregivers to achieve better mental health.

Individual and family adaptation in Taiwanese families of individuals with severe and persistent mental illness (SPMI)

The purpose of this study was to examine individual and family adaptation in Taiwanese families of persons with severe and persistent mental illness. Mediating effects of social support and meaning of family caregiving on the relationship between pile-up of demands and family adaptation were also assessed. Data were collected from 84 families using mailed questionnaires and analyzed using principal component analysis and mixed linear modeling. Adaptation was associated with lower pile-up of demands, greater social support, and more positive interpretation of family caregiving. Partially mediating effects of social support and meaning of family caregiving were supported. The results imply a need for developing culturally sensitive interventions to decrease family demands and amplify individual, family, and community strengths and resources.

Grandmother caregiving, family stress and strain, and depressive symptoms

This study used the resiliency model of family stress, adjustment, and adaptation as the framework to examine the main and moderating effects of social support and resourcefulness in the relationship between family life stresses and strain and depressive symptoms in grandmothers raising grandchildren, grandmothers in multigenerational homes, and noncaregivers to grandchildren. A sample of 486 Ohio grandmothers, recruited using random and supplemental convenience methods, completed mailed surveys. Analysis of variance was used to examine differences in family life stresses and strain, resourcefulness, support, and depressive symptoms across the three groups of grandmothers. Hierarchical multiple regression analyses were used to examine whether family stresses and strains affected the grandmother's depressive symptoms and whether social support and resourcefulness moderated the relationship between family stresses and strain and grandmothers' mental health. Grandmothers raising grandchildren reported more depressive symptoms, but in multiple regression analyses of the full sample that controlled for demo-graphics, primary caregiving status was not related to depressive symptoms. More strain and less subjective support and resourcefulness were associated with higher depressive symptoms for all grandmothers, with 33% to 54% explained variances of such symptoms for each caregiving group and the full sample. Subjective support moderated the effects of strain and instrumental support moderated the effects of family life stresses on depressive symptoms. Social support and resourcefulness may help protect grandmothers from the effects of family stresses and strain, and interventions to enhance these factors may assist grandmother caregivers to achieve better mental health.

Relationships among perceived burden, depressive cognitions, resourcefulness, and quality of life in female relatives of seriously mentally ill adults

Providing care and support to a seriously mentally ill (SMI) family member can have deleterious effects on one's health and quality of life. This study explored relationships among perceived burden, depressive cognitions, resourcefulness, and quality of life in 60 African-American and Caucasian women family members of SMI adults. Caucasians reported greater burden than African-Americans; the groups were similar in depressive cognitions, resourcefulness, and quality of life. In Caucasians and African-Americans, burden correlated with depressive cognitions and both correlated with poorer mental health. In African-Americans, burden also correlated with lower personal resourcefulness and both correlated with poorer mental health. The findings suggest a mediating role by depressive cognitions for both groups and by resourcefulness in African-Americans. Thus, both groups of women may benefit from positive thinking while African-Americans also may benefit from learning personal resourcefulness skills.

Grandmothers' transitions in caregiving to grandchildren

Many grandmothers experience transitions in their caregiving roles to grandchildren as living arrangements change and parents assume more or less responsibility. The meanings of these transitions have received little attention, yet life transitions can be stressful. This qualitative study focuses on learning how grandmothers perceive these changes in household composition and the meanings these changes have. Analysis of semistructured telephone interviews with 26 transitioning grandmothers identified themes, including mixed feelings, changes in personal freedom, flexibility with unpredictable changes, spirituality as strength, commitment to grandchildren, and role transformation. The majority of status changes were from multigenerational or primary caregiving homes to non-co-resident status. The meaning of the changes differed by status groups. The frequency of caregiving changes and the unique meanings of such changes extend our understanding of grandmothers as caregivers. Increased awareness and understanding of these meanings are important for nurses as they provide health care for this increasing population.