Shakya Family Well Being

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Family Well-Being Concerns of

Grandparents in Skipped GenerationFamiliesHolly Baker Shakya

ab, Paula M. Usita

a, Christina Eisenberg

a,

Joanna Weston

a

& Sandy Liles

a

aGraduate School of Public Health, San Diego State University, San

Diego, California, USAbDepartment of Global Public Health, University of California, San

Diego, California, USA

Version of record first published: 05 Jan 2012.

To cite this article:Holly Baker Shakya, Paula M. Usita, Christina Eisenberg, Joanna Weston & Sandy

Liles (2012): Family Well-Being Concerns of Grandparents in Skipped Generation Families, Journal ofGerontological Social Work, 55:1, 39-54

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Journal of Gerontological Social Work, 55:3954, 2012Copyright Taylor & Francis Group, LLCISSN: 0163-4372 print/1540-4048 onlineDOI: 10.1080/01634372.2011.620072

Family Well-Being Concerns of Grandparentsin Skipped Generation Families

HOLLY BAKER SHAKYAGraduate School of Public Health, San Diego State University, San Diego, California, USA

and Department of Global Public Health, University of CaliforniaSan Diego,

San Diego, California, USA

PAULA M. USITA, CHRISTINA EISENBERG, JOANNA WESTON,

and SANDY LILESGraduate School of Public Health, San Diego State University, San Diego, California, USA

This study examined the family well-being concerns of grandparents in skipped-generation families. Co-resident grand-parents who are responsible for raising their grandchildrencompleted surveys, focus groups, or individual interviews. Service

providers to skipped-generation families also participated inindividual interviews to provide an additional perspective to

grandparents concerns. Results indicated 5 levels of concerns:intrapersonal, interpersonal, organizational or institutional,

policy, and societal. Concerns at different levels were interrelatedand pointed to the need for multilevel interventions to help these

families. Implications of the findings for future interventions withskipped-generation families are discussed.

KEYWORDS family, grandparents, caregiving, quality of life

The proportion of children living in the same household with a grandparentincreased from 7% in 1991 to 11% in 2009 (Kreider & Ellis, 2011). Accordingto 2009 U. S. Census data, 7.8 million children under 18 years of age shared ahousehold with a grandparent. In 2.4 million of these households, grandpar-ents were responsible for raising a child (also known as skipped-generation

Received 28 January 2011; accepted 31 August 2011.

This research was supported by a grant from the San Diego State University ResearchFoundation awarded to Paula M. Usita.

Address correspondence to Paula M. Usita, PhD, Graduate School of Public Health,

San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-4162, USA. E-mail:[email protected]

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40 H. B. Shakya et al.

families); 39% had been raising a child for 5 or more years (United StatesCensus, 2009). The rise in skipped-generation families has been attributedto increasing problems among parents, including drug abuse, teen preg-nancy, divorce, single parent households, mental and physical illness, and

AIDS (Winokur, 2009). State welfare agencies are also increasingly relying ongrandparents, as well as other family members, to care for children removedfrom their parents as an alternative to foster care (Winokur, 2009).

Compared with children in other family structures, children in skipped-generation families disproportionately suffer from physical and emotionalhealth problems such as asthma, depression, anxiety, and ADHD (Bramlett &Blumberg, 2007; Minkler & Odierna, 2001). Rates of physical, mental,and behavioral problems among children in skipped-generation fami-lies are equivalent to those found among children in foster-care families(Dubowitz & Feigelman, 1994). These problems largely reflect the detrimen-

tal environmental, social, and physical risk factors to which most of thesechildren have been exposed to by the parent as a result ofin uterosubstanceuse, abuse, neglect, and abandonment (Minkler & Odierna, 2001).

Grandparents in skipped-generation families are vulnerable to problemssuch as depression, social isolation, and poverty (Bryson, 1999; Minkler &Roe, 1996). These grandparents frequently report difficulties accessingservices, having sufficient financial resources, lacking social support, expe-riencing personal health problems, and balancing the need for employment

with the duties of child rearing (Grinstead, 2003; Minkler & Roe, 1996).Because the caregiving role for grandparents in skipped-generation families

is most frequently assumed due to the dysfunction of the childs parent,the grandparentparent relationship is one of the major causes of stress forgrandparents. Legal struggles over child custody, disruption to the child after

visitation, and guilt and grief over failed and often conflicted relationshipswith the parent are all significant stressors for skipped-generation familiesgrandparents (Sands & Goldberg-Glen, 2000). Overall, although grandpar-ents may experience concern over the difficulties of their role, their prioritiesconsistently focus on grandchild well-being and safety (Generations United,2005).

Because the issues that impact skipped-generation grandparents rangefrom intrapersonal characteristics to community factors to policy decisions,the conceptual framework that guided this study is the social ecologicalmodel (SEM) of health and behavior. According to proponents of socialecology (Emmons, 2000; Stokols, 1992), human behavior is best understoodas an interplay between the person and the larger social context. A definingfeature of ecological models is the specification that intrapersonal factors,socio-cultural variables (interpersonal and societal), and organizational andpolicy factors can all influence individual outcomes such as behavior, health,and well-being, and that these influences are interrelated and reciprocal

(McLeroy, Bibeau, Steckler, & Glanz, 1988; McLaren & Hawe, 2005). This


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Well-Being Concerns in Skipped Generation Families 41

conceptual framework was developed partly in objection to individual levelbehavioral theories that operate on the assumption that individuals aresole actors and can be understood in isolation from the social contextsthat surround them. Ecological theories can be utilized to identify social

determinants within a population, and to address those same risk factors ininterventions that target diverse levels of societal influence (Stokols 1992).The purpose of this exploratory study was to examine the concerns

held by grandparents in skipped-generation families regarding the socialforces that influence their families well-being, drawing on the perspec-tives of grandparent caregivers and service providers. As our research isinformed by the SEM, it is able to explore the concerns of grandparentfamilies as they are impacted by phenomenon across many levels of soci-ety, from intrapersonal health concerns to policy decisions that affect theirservices. We operationalized the SEM across five societal levels, utilizing per-

spectives salient to the issues of skipped generation families. In this context,the intrapersonal level of the SEM refers to a grandparents own health ormental state and how those characteristics affect the grandparents abilityto negotiate a custodial role. The interpersonal level of the SEM includesfactors that involve the grandparents relationship, challenges, and interac-tions with others in the family, primarily the grandchild and the parent. Forthis research question, the organizational level of the SEM looks at how thefunction and structure of institutions impacts the ability of the grandparentto fulfill their role as custodial caregiver of their grandchild. Policies-levelissues can heavily impact caregiving grandparents by dictating how custo-

dial grandchildren are cared for and the resources that are available to them.Finally, societal-level concerns are consistent with Brofenbrenners idea of amacrosystem (McLaren & Hawe, 2005), or an overarching nexus of influencefrom macro-level factors such as cultural and societal norms.

A mixed-methods approach was used to enable a range of topicsto be examined, and to allow a deeper understanding of these subjectmatters to surface through the use of focus group discussions and indi-

vidual interviews. We utilized a sequential exploratory design, whereinqualitative data collection and analysis is followed by quantitative data

collection and analysis (Creswell & Clark, 2007). Using a mixed-methodsapproach enables researchers to better understand the complexity of socialphenomena (Greene, 2007; Hayslip & Kaminski, 2005).

METHODS

Design

This study began with exploratory qualitative research, first focus groups andthen individual interviews, intended to understand the concerns of grand-

parents in skipped-generation families along multiple levels of the social


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ecological model. Many of the issues we uncovered in the qualitative surveysseemed important to quantify, so we followed up our qualitative work with aquantitative survey. For instance, many grandparents mentioned challenges

with grandchild health, an issue that seemed important to quantify. Using

the information we gathered qualitatively, we then developed a quantitativesurvey to supplement our qualitative findings. Data collection procedures,both qualitative and quantitative, were approved by the San Diego StateUniversity Institutional Review Board.

Recruitment

We recruited San Diego grandparents who were caring for at least one grand-child between the ages of 2 and 18 without the assistance of the childs

parent. The inclusion criteria for grandparents in this study were the sameregardless of the data collection method.Grandparent recruitment for this study was designed to maximize the

likelihood of accessing a small and hard-to-reach population. Similar to otherstudies of skipped-generation families (Messing, 2006), we recruited par-ticipants through kinship support groups throughout San Diego County.In previous research, this recruitment approach has been successful in

yielding valuable information about these families (Messing, 2006).Service providers were paid workers from various work sectors

medical, mental health, kinshipwho had direct and regular contact with

skipped-generation families.

Data Collection

Focus group. A total of 13 grandparents participated in two focusgroups during 2008. Respondents included 10 women and 3 men with amedian age of 61. Eleven participants were White, 1 was Latina, and 1 was

African American. In one of the focus groups, a great-aunt and a great-unclewere included because their generational issues and family dynamics were

similar enough to the sample population to warrant inclusion. Three cou-ples were among the focus group participants (including the great-aunt andgreat-uncle). The majority (77%) of focus group participants were from thematernal side.

The two focus groups were held during a regularly scheduled timeand location for kinship support group meetings because some of theparticipants were already familiar with the location and were accus-tomed to attending a meeting during that time. A moderator and notetaker, both members of our research team (MPH graduate and PublicHealth doctoral student), who were trained to conduct qualitative research,

were present at each focus group. Participants completed a background


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descriptive information, asked detailed questions regarding child behavior,medication use, nutrition, exercise, diagnosed illnesses or conditions, parent-ing practices, emotional challenges of parenting, the issues most importantto grandparents, and the services of which they felt their families were most

in need. Many of the single-item questions from the survey were drawn fromthe 2003 National Survey of Child Health (NSCH, 2003) to ensure validity ofquestions and to provide comparison data against which to analyze ourresults.

The majority of the grandparents were women (90%) and the averageage was 61. Approximately one-half of the grandmothers were Hispanic,Spanish-speaking immigrants from Mexico. The proportion of paternal ver-sus maternal grandparents among survey participants is unknown. Only1 grandparent per family completed the survey

Grandparents with more than one grandchild of eligible age for the

study reported on the grandchild whose birthday was coming up next Theaverage age of the grandchild on whom they completed the survey was 9;51% girls and 49% boys. Child ethnic breakdown was 13% White, 15% Black,and 72% other, with 63% of the total sample identified Hispanic.

Surveys were completed in-person during existing kinship organizationevents such as support group meetings and other family-type meetings in thecommunity, which grandparent caregivers attend. Surveys were completelyanonymous, with no identifiers requested or collected. For the Spanish sur-

vey, a bilingual research staff translated the English survey into Spanish, thenback-translated the survey into English, and another bilingual member of the

research staff double-checked it for cultural and linguistic equivalence. Boththe English and Spanish surveys were pilot tested with older adults and wererevised as needed to clarify questions. Written consent was obtained fromgrandparents before they began the survey. No financial compensation wasoffered for completion of the survey.

Analysis

Methodological triangulation of methods and data was employed. Relying

on different methods (e.g., survey, individual interview, and focus group),and comparing the data produced by each method, increases the depthand rigor of research findings (Flick, 2002). Additionally, to ensure sharedmeaning production between the researcher and participants, we shared asummary of the research findings with the participants after all data hadbeen collected and analyzed, and requested that they provide us with oralfeedback on the interpretation of the analyzed data.

Focus groups and individual interviews. English language focus groupsand individual interviews were transcribed verbatim by the interviewer.Individual interviews that were conducted in Spanish were translated and

simultaneously transcribed into English. Each transcript was double-checked


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by another member of the research team to ensure accuracy. The checkerlistened to the audio-taped interview while reading the transcript and madecorrections as necessary. Transcribed interviews were then independentlycoded for key ideas by at least two members of the research team. After

coding each transcript, analysts met to discuss, synthesize, and revise thecodes. These initial codes were transferred into a spreadsheet program, atwhich point two of the main analysts reviewed all of the codes, collapsingsome and expanding others to create a conceptual hierarchy. Refined codes

were entered into NVivo7 (QSR International, 2006) software to organizethe hierarchies. Transcript sections were then coded according to the finalcoding outline. Revisions and adjustments of the codes were then made asthe transcript segments were selected. These changes and the final transcriptcoding were then double-checked by additional staff members. During theanalysis process, no remarkable differences were noted in the major themes

reported by grandparents or service providers, and the ideas provided by theservice providers served to reinforce those brought forward by the grand-parents. Subsequently, results from the two informant groups, as well asthe results of all grandparent caregivers, were synthesized and then ana-lyzed together in the results section. Both a written and oral summary ofthe findings was shared with grandparents who used kinship services in SanDiego County. Grandparents reported that the summary accurately conveyedtheir concerns and did not omit any important aspects of their experiences.During the meetings, grandparents had the opportunity to reiterate some oftheir concerns, and expressed appreciation for the support and interest of

the university regarding their situation.Survey. Survey data were analyzed using R 2.70, an open source statisti-

cal software (R Development Core Team, 2008). Missing data were handledusing Amelia for multiple imputation, an R package that uses simulationsto estimate missing data (Honaker, King, & Blackwell, 2009). The amountof missing data varied depending upon the variable, with the highest pro-portion being 30% of responses missing for the frequency with whichthe grandchild sees their biological mother, and the average percent ofdata missing being around 14%. Variable frequencies were calculated and

summarized using 5 multiply-imputed datasets.

RESULTS

During the analysis process, the five levels of the SEM were used to framethe data using the grandparents themselves as the point of reference, orunit of analysis: intrapersonal, interpersonal, organizational, societal, andpolicy. It is important to consider that the concerns outlined in this articleare expressions of the grandparents perspectives and are generated from a

fundamentally intrapersonal level of expression.


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Level 1: Intrapersonal

Concern 1.1: Grandparent health and aging. Grandparents frequentlymentioned that they lacked the energy that they had while parenting theirown children, and did not have the patience or motivation to engage in

the type of active engagement and play that young children need. Somegrandparents mentioned strategies that they employed to satisfy the needsof their grandchildren while not overexerting themselves, such as sitting inone place and encouraging their grandchild to run around. A subgroup ofgrandparents reported debilitating health concerns experienced either bythemselves or their spouses. In these cases, the need to invest time andmoney in self-care often conflicted with the grandparents ability to careproperly for their grandchild. One 66-year-old Caucasian great-grandmotherreported the following in an individual interview:

Its harder. Im older, its physically more demanding. . . . Im beginningto feel some of the decline in the physical abilities. I have cataracts Ididnt have before, making it hard to read. . . . Its definitely more of achallenge then it was when I was 20, 30 years younger.

Responding to the survey, some grandparents (26%) reported that theyusually or always felt that they were giving up more of their life to carefor their grandchildren than they had expected. However, 90% felt that they

were coping with the day-to-day demands of raising grandchildren either

very well or somewhat well. Grandparents seemed to have challenges withsocial support as 44% had no one to whom they could turn for emotionalhelp with parenting or raising children. Thirty-one percent of grandparentsrated their own health as good, with 29% rating their mental and emotionalhealth as poor to fair.

Concern 1.2: Choice but no choice. Many1 of the grandparentsexpressed a sense of deep personal conflict regarding the situation. Thesegrandparents typically did not expect to ever be caring for any of theirgrandchildren, and felt trapped by an obligation that they could not refuse.

A 51-year-old Caucasian grandmother who was raising her 2-year-old grand-son expressed this feeling during a focus group when she remarked, Andits not a choice. I dont think any of us chose to be here. The primaryreason that grandparents took in their grandchildren was because they wereunwilling to let the grandchild enter the foster-care system. Although thefrustration of an unsolicited caregiving role was the norm within our sample

1 The word many in this context refers to the majority of grandparents (i.e. over 50% and/ormentioned by kinship service providers as being a fundamental issue for grandparents).


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group, a few grandparents reported that the situation was not only expectedbut something that they took on willingly and happily.

Level 2: Interpersonal

Concern 2.1: Dealing with the grandchilds health issues. Challengeswith the health of grandchildren were a serious issue for the majority of thegrandparents interviewed, particularly as many health issues impacted theirgrandchildrens behavior. One of the most prevalent and distressing con-ditions for grandparents was ADHD. A 59-year-old Caucasian great-uncle

who participated in a focus group described his experience dealing with hisgrandnephews disability: Another thing . . . has attention deficit disorder.He is nudging you 100% of the time. . . . Yeah, they just want 100% atten-tion. Grandparents interviewed also reported high frequency and severity of

grandchild depression, anxiety, and asthma, which are all health conditionspositively correlated with stressful conditions during pregnancy, exposureto drugs in utero, neglect, and trauma during early childhood (Minkler &Odierna, 2001)

Survey results indicate high prevalence rates of asthma (20%), depres-sion (22%), anxiety (22%) and ADHD (31%) among grandchildren. Forty-twopercent of grandparents reported that their grandchilds mental and emo-tional health put a strain on their family between a great deal to a mediumamount. When we compare our data to statistics on children in the State ofCalifornia, we find striking differences with only 4.7% of California childrenever diagnosed with ADHD, and 2% ever diagnosed with either depressionor anxiety (NSCH, 2003).

Concern 2.2: Relationship with the childs parent. A strained and diffi-cult relationship with the grandchilds parent was another one of the moststressful aspects of being a grandparent caregiver. This stress was the resultof two different but interrelated dynamics: grandparents feeling guilty anddistressed over their childs failure as a parent, and the behavior and insta-bility of the parent negatively affecting the grandchild. One 51-year-oldCaucasian grandmother participating in a focus group shared her feelings

of failure: Theres a lot of shame for us, cause we feel like failures. . . .Wecame here devastated; we were so alone. . . . Theres a lot of shame and alot of anger.

This feeling of shame and failure increased grandparents stress overtheir family situations. Although grandparents echoed this feeling of shameover what they perceived as failed parenting, many of them also emphasizedthe culpability of the grandchilds parent in the poor choices that were made.One 58-year-old Caucasian grandmother remarked during a focus groupOur adult children decided to make choices that were bad for them, thatsputting them in, thats putting us in this role. Service providers discussed


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the need for sensitivity when discussing parenting with grandparents. Theyreported that grandparents are aware of the fact that their own situationby default seems to point to their incapacities as a parent. Whereas somegrandparents welcome opportunities for parenting classes, others resent the

idea that they are not adequately prepared to raise their grandchild.As the primary caregivers, grandparents must often mediate the inter-actions between the grandchild and the grandchilds parent. Although, insome cases, such interactions were managed without too much duress, formany of the grandparents situations involving the childs parent were dif-ficult to negotiate. Parents would come irregularly, usually with no signsof remorse over their inability to parent, and were often involved in unsta-ble romantic relationships that they prioritized over their children. Many ofthem were engaged in substance abuse. Grandparents noted that visits withparents, rather than being a source of comfort and joy, would frequently

upset and destabilize the grandchild. Although grandparents overwhelm-ingly expressed concern over their attempts to mediate the relationship withthe parent, a few of them were also keen to maintain that relationship asthey considered their own mortality.

Survey results indicate that 71% of the grandparents are the legalguardian of their grandchild. Twenty-five percent of the children had notseen their biological mother in the last 12 months, and 55% of themhad not seen their biological father in the same time period. An open-ended question inquiring the reasons that the grandparent was caringfor their grandchild elicited a variety of responses: parental drug abuse,

parental neglect, parental divorce or separation, and inability to care for thechild.

Concern 2.3: Grandchild future outcomes. An issue of tremendousimportance to all of the grandparents interviewed was their grandchildrensfuture. The grandparents were all invested in their roles as caregivers.Grandparents main priority was their grandchildrens development andfuture success, and the sacrifices they made were for the sake of theirgrandchilds well being. Grandparents in our samples were, for the mostpart, caring for children who are considered high risk, and were deeply

concerned about breaking the cycle of dysfunction and whether theywould be able to help the grandchild avoid repeating the mistakes oftheir parents. As one 64-year-old African American grandmother who par-ticipated in an individual interview shared her feelings regarding thisissue:

The kids, they think they going to do a little bit better, so sometime youdont want to let go, but you need to, to let go. . . . You want to seethem do better, but you see them doing the same thing. . . .You alwaysthinking theres some more . . . hope, cause youre doing something

positive, you hoping maybe that will rub off . . .on the child.


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Level 3: Organizational

Concern 3.1: Difficult interactions with childs school. Grandparentsof school-aged children frequently mentioned that issues and challengesaround negotiating with the childs school were a concern that affected

child functioning. Grandparents often felt that the school system did notunderstand the needs of their child and were not willing to do what is nec-essary to support those needs. A 64-year-old African American grandmother

who participated in an individual interview felt that part of her role as hergrandsons caregiver was to be his advocate at school. This was necessarybecause, in her opinion, the teachers at the school were unable to see hispotential and unwilling to put in the extra effort he needed to excel.

Level 4: PolicyConcern 4.1: Lack of financial resources. Lack of financial resources is

a pervasive problem that prevents grandparent caregivers from offering chil-dren the lifestyle they believe they need and deserve. This subtheme wasmentioned by the majority of grandparents both during the interviews andduring our follow-up sharing of findings, as well as by the service providers.One of the main issues raised by grandparents is the difference between thecompensation provided to them by the government versus that provided tofoster parents. One 66-year-old Caucasian grandmother raising her 2-year-old great-grandson lamented in an individual interview that although shereceives $340 per month from the county, the daycare that she needs to puthim in costs over $900. Grandparents in informal care arrangements (withoutcounty support), receive even less. Many grandparents try to make do with

whatever financial resources they can muster. A 60-year-old Latina grand-mother raising two grandchildren shared her frustration in an individualinterview about having to beg the childrens parents for money:

My son-in-law, he give me some money when we get the bill. He giveme $600 a month. And its hard to survive, you want to live, so hard . . .

and when I need something, I say, Please give me some money becauseI have no money. I have no money.

Concern 4.2: Challenges with the legal system. Both grandparents andkinship service providers communicated grandparent frustrations with thelegal system and how they could negotiate it to fight for the best interests oftheir grandchild. This topic was reiterated during our sharing of findings as

well. In many cases, grandparents needed to navigate the system to main-tain custody of their grandchild or to prevent what they felt were parental

visitations or custody situations that endangered the grandchild. The need


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for grandparents to secure a legal advocate was a common topic of discus-sion, and how that advocate needed to work in the best interest of the child,rather than the best interest of the parent.

Service providers shared that because negotiating the system seems

complicated and intimidating to many grandparents, some avoid interactingwith it at all. A kinship service provider explained how some grandparentsfelt fear of the legal system, and kept their grandchildren informally to avoidthe risk of having them taken away and put into a foster home. In thesecases, the grandparents were completely under the radar of child protectiveservices and were ineligible for the majority of the services available forgrandparent caregivers. Oftentimes, cases such as these occurred becausethe parent would drop off the child with the grandparent for an unspecifiedamount of time and then fail to return. Grandparents in this sort of situation

were often uncertain of their rights, and struggled to obtain services for their

grandchild without legal guardianship.

Level 5: Societal

Concern 5.1: Generational differences. Grandparents were sensitive tothe generational differences between themselves and their grandchildren,and between what they were accustomed to when they parented their ownchildren and what is acceptable parenting now. Service providers and grand-parents felt that the current environment for raising children was significantly

different than when the grandparents had raised their own children, and themajority felt that the changes were negative. Grandparents also felt that mod-ern entertainment on television models bad family values. One 74-year-oldCaucasian grandmother who participated in a focus group reminisced about

what she felt were the virtues of television programming in earlier decades:There was something that taught you, if you turned on the TV, and youcould usually find something that would teach, reinforce the values that you

were being raised with.

DISCUSSION

This study uncovered some key concerns facing grandparents raising theirgrandchildren. Survey data, focus groups, and individual interviews pro-

vided for a rich mixture of research methods that allowed us to explore awide number of issues along the multiple levels of the SEM. Our study con-firms reports by other researchers (Bramlett & Blumberg, 2007) about theconsiderably high rates of developmental, behavioral, or health problems ofgrandchildren raised by grandparents.


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Limitations of This Study

The sample of grandparents used in this study was limited to those utilizingkinship services and, therefore, the results may not be generalizable to theentire skipped-generation grandparent population. Service-using grandpar-

ents may be more high functioning, and actively involved in grandchild carethan those who do not. On the other hand, it is also possible that thesegrandparents use kinship services because they are having a harder timemanaging their role than nonusing grandparents. Also, service-using grand-parents may provide different answers to our survey and interview questionsthan non-service-using grandparents. Grandparents reported their concernthat a large number of caregiving grandparents were unaware of the sup-port groups, and were, therefore, not receiving the services for which they

were eligible.Further research should include more quantitative data with a larger

sample size to expand upon these initial findings. Although the grandpar-ents who participated in the two focus groups were mostly White, the factthat the quantitative survey data collection took place at a larger numberof support group meetings enabled data collection from Spanish-speakingLatino grandparents. More in-depth research, however, should be done tounderstand the unique concerns of each population so that service providerscan tailor their interventions appropriately.

ConclusionsOur results, along with those of others who study grandparent families(Kelley, Yorker, Whitler, & Sipe, 2001), indicate a need for comprehen-sive multilevel interventions for grandparent-headed households. A goodstarting point for interventions for skipped-generation families is to focuson the grandchild. Grandparents are taking on the role of caregiver forthe benefit of the grandchild, and much of the duress they experiencerevolves around hopes and fears for the grandchilds well-being. Improvedoutcomes for grandchildren are likely to have the added benefit of improved

grandparent well-being. Interventions that involve the school system may beparticularly attractive for grandparent-headed households. Drawing from theliterature on school-based drug prevention programs, research shows thatthose incorporating parentchild communication components were signifi-cantly more successful than those that focused solely on the child (Cuijpers,2002). Interventions using a similar approach but tailored to grandparentsand grandchildren could successfully reduce concerns for the grandparent

while simultaneously addressing child risk factors.One of the most pressing issues for skipped-generation families is the

need for greater financial resources (Minkler & Roe, 1996). A considerable


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number of grandparent-headed households fail to receive the support forwhich they are eligible or they experience delays and other difficulties inaccessing financial benefits (Generations United, 2005). In this circumstance,a dysfunctional disconnection between policy and organization creates dif-

ficulties for grandparents hoping to access resources. Policy changes thatfocus on funding to streamline and advertise services could go a long wayin making such services more easily available.

Current legislation promoting a kinship navigator system for the spe-cific purpose of supporting grandparents in service utilization, education,and financial resources has been passed by Congress, but is now in needof implementation and dissemination to grandparents around the country(Generations United, 2010). Results of pilot studies testing kinship naviga-tor intervention components found that these programs have the potentialto alleviate many grandparent concerns, but can be undermined by poorly

trained staff or inadequate outreach to vulnerable populations such as immi-grants (Casey Family Programs, 2005). Furthermore, such programs need toaddress the disparities between grandparents who are formal caregivers, andare working through the welfare system, and those informal caregivers whoare dealing with their situation outside of the system.

Grandparents in this study were overwhelmingly open to participatingin the research, as they hoped that it would result in increased allocationof resources to their population. They were also keen on having their

voices heard, and public attention given to their stories, as they believedthat the general public did not understand or sympathize with their plight,

or the plight of their grandchildren. Stirring public interest in grandparent-only families by using child-focused messages is one strategy for buildingcommunity support for these families (Generations United, 2005), and onethat the grandparents believed would help the public better understandtheir situation. Although the grandparents in this study face numerous chal-lenges, they consistently place a high priority on the well-being and positivedevelopment of their grandchildren. The results of this and other researchshow that future efforts to design and test ecologically-based interventionsto help these families are essential given the complexity of the factors

that impact their lives, and the multigenerational consequences of thoseimpacts.

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Casey Family Programs. (2005). Kinship navigator pilot project replication manual.

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