Spring 2018
Relational Fragility and the Isolational Trajectory in the Latter Stages of Life

Supporting Grandfamilies: Common Relational Issues and Support Needs Faced by Grandparents Raising Grandchildren

ABOUT THE AUTHOR

Jennifer A. Crittenden, MSW
University of Maine Center on Aging
25 Texas Ave
325 Camden Hall
Bangor, ME 04401
Jennifer.crittenden@maine.edu
207-262-7923

Jennifer Crittenden is the Assistant Director at the University of Maine Center on Aging (CoA). She has over a decade of experience in professional and community education, and program evaluation and planning. Nearly all projects under her management entail the translation of academic research into educational programs, events, and dissemination activities. She has been involved in implementing and evaluating a wide range of research, training, and community service initiatives including serving as the coordinator for the CoA Rel¬atives as Parents Program. Jennifer has an MSW from the University of Maine and is currently completing an Interdisciplinary PhD.

Jennifer A. Crittenden, MSW

SUMMARY: As the number of grandparents who are raising grandchildren increases in the U.S., so too does the need for Aging Life Care Managers who are aware of the special needs of these families. Transitioning to a custodial grandparenting arrangement often presents emotional, relational, and financial hardships for grandparents and their grandchildren. This article discusses the common challenges and relational issues faced by grandfamilies and strategies that practitioners can use to support them effectively.


Grandparents hold a special place in the hearts of their grandchildren. Often seen as guiding forces in their families, grandparents bring extra energy, wisdom, and new perspectives to the lives of their young kin. Now, more and more grandparents are taking on additional responsibilities in their families, serving as primary custodial guardians and parents to their grandchildren. The numbers of grandparent-headed households, sometimes called kinship families or grandfamilies, is growing in this country with more than 2.5 million children being raised by approximately 2.7 million grandparents and other relatives (Generations United, 2016). Stepping into the role of primary caregiver can be difficult for the grandparent and requires the family to adapt and adjust to new roles — not just for the grandparent, but also for the adult child, and grandchild.

While the reasons that children come into kinship care can be as diverse as the families themselves, the most common reason for this arrangement is tied to the growing drug epidemic in the U.S. With over a third of children placed into foster care as a result of parental substance abuse, this epidemic is having a widespread effect on families. The fallout from the growing heroin and opioid crisis can lead to kinship care when there is incarceration of one or both parents, the death of one or both parents, and/or the absence of one or both parents due to participation in substance use disorder treatment (Generations United, 2016). Additional circumstances that may lead to a kinship arrangement beyond substance abuse include physical or mental illness of the parent, child abuse and neglect, or the voluntary choice to relinquish custody to the grandparent (Child Welfare Information Gateway, 2016).

While kinship care arrangements often bring a new-found stability to the family, they create challenging dynamics and changing relationships. Practitioners serving grandfamilies need to possess knowledge of a myriad of resources and systems including aging services, child welfare, education, and social services in a time when our service systems have not kept pace with the complex needs of these families (Baker, Silverstein, and Putney, 2008). This article will touch upon some of the common issues faced by grandfamilies and how practitioners can best support this growing cohort of older adults who are pulling double duty as “grandma” or “grandpa” and “mom” or “dad.”

Relationship Dynamics of Grandfamilies

While all points in the caregiving trajectory are important, the transition point into caregiver has been identified as critical for grandparent health and well-being. Recent research shows that when compared to other grandparents, custodial grandmothers are more likely to experience stress, poor self-rated health, and depression and less likely than their non-custodial peers to have support in their caregiving. Custodial grandmothers also report lower levels of perceived rewards connected with their kinship caregiving duties. These effects are magnified for grandmothers as they transition into caregiving roles over time (Musil et al., 2010). The implications for this study suggest that the transition point is an important one for caregivers and one where practitioners can provide support and guidance to address potential negative effects for grandparents.

The changing dynamics of transitioning to a kinship care arrangement may provide emotional challenges for all involved. As relationships between grandparents and their adult children, grandchildren, and others in the family change, the family unit is challenged to accommodate these new arrangements. One common occurrence in these families is a sense of ambivalence, or conflict, among family members. Conflicts may arise between grandparents and their adult children over issues such as visitation with the child(ren), different parenting approaches, or long standing relationship issues between parent and adult child. Part of this conflict derives from role ambiguity when grandparents now hold more than one role and the adult child may be challenged to maintain their role within the family. To address role conflict and ambiguity, practitioners are encouraged to help the family facilitate discussion around changing roles and expectations first through “joining” or bonding with the family and then exploring whether or not the family is at a point where it is seeking to reestablish old family structures or if new family role and expectations will be built together (Letiecq, Bailey & Dahlen, 2008). Helping grandparents to express these sources of ambivalence and work through them is an important step to addressing relationship changes.

Grief and loss is a prevalent experience among grandparent caregivers. Sources of grief and loss often center around changing roles within the family, the timing of caregiving activities, and specific circumstances that brought about the transition to kinship caregiving. The type of grief and loss experienced by grandfamilies is distinctly different from the loss experienced by the death of a friend or loved one. Instead, many grandparent caregivers experience what is referred to as ambiguous loss. Ambiguous loss is the experience of loss that does not bring with it a sense of closure, and can create confusion and distress for those who are experiencing the loss. Boss (2010) outlines the two types of ambiguous loss that can be experienced. The first is a loss where there is physical absence but psychological presence of a loved one. This may occur when the adult child is incarcerated, staying in a residential treatment facility, or living out-of-state but still maintains some psychological presence in the family and stays connected to their parenting role.

The second type of ambiguous loss experienced in grandfamilies occurs when a loved one is physically present but psychologically absent. This type of loss is most common with families where addiction or mental illness has led to the kinship caregiving arrangements. Both grandchild and grandparent may feel the effects of these ambiguous losses. Ambiguous loss, because of its lack of closure and the confusion it brings to families, may lead to ambivalence surrounding the kinship caregiving arrangement. The key to managing ambiguous loss and resulting ambivalence is to provide an opportunity for caregivers to discuss their experiences, feelings, and conflict in a non-judgemental setting (Boss, 2010).

From a life course perspective, grandfamily arrangements may be seen as disrupting retirement and other life plans which will require coping strategies and retooling for the grandparent. As with grief and loss, there is no one right or wrong way that grandparents experience custodial grandparenting. While some grieve the loss of their retirement years others may enjoy the new focus and activities that the parenting arrangement brings to their lives. Supporting grandfamilies requires both a recognition of loss but also celebrating the positive aspects of such arrangements for children and caregivers. Along these lines, Servaty-Seib and Wilkins (2008) suggest a gains/loss framework when working with custodial grandparents. Using this perspective, grandparents can be encouraged to articulate the gains and losses they have experienced, aiming to increase the perception of gains while decreasing the perception of losses. This perspective allows for an individualized approach to assessment and intervention. For example, you may discuss the role of grandparent that is lost in the custodial grandparent arrangement but also the new role of parent/caregiver that is gained. A grandparent may lose their opportunity for traditional retirement activities but gain a new and deeper sense of purpose that comes with caring for their grandchild. This approach can help grandparents to more accurately assess their personal circumstances and intentionally focus on the positive aspects of caregiving.

Another important consideration is the circumstances that have led to the grandfamilies arrangement. With a significant portion of children in kinship foster care placements placed due to substance use disorders within their families, it is important to recognize that many grandfamilies are affected by substance abuse. This substance use reverberates throughout the whole family as it affects not only the adult child but the grandchild and ultimately the grandparent who assumes care. Children who have been raised in homes affected by substance abuse are more likely to have special cognitive and physical needs of their own, especially if they were exposed prenatally to drugs or alcohol. Children affected by substance abuse may have also experienced abuse and neglect or other family trauma related to their parent’s substance use disorder. These special considerations place additional stress on the grandparent caregiver and require services and education to support the grandparent. As such, grandparents parenting a child affected by substance abuse should be encouraged and supported to learn more about substance use and its effect on children to ultimately enhance the parenting they are able to provide to the children in their care and navigate the relationship with their adult child. Community support groups that are tailored to support families affected by substance abuse, like a Nar-Anon or Al-Anon family group, can be valuable sources of emotional support and education for grandparents caring for children affected by substance use.

Importance of Caregiver Self-Care and Setting Boundaries

The grandparents who are raising grandchildren face their own challenges with as many as 1 in 4 grandparents managing their own disability in addition to the needs of the children in their care. In addition, about a third of such caregivers live in poverty (Generations United, n.d.a). With 58% of grandparent caregivers filling the roles of both worker and caregiver, juggling time commitments is an additional challenge to be faced. Lozier (2015) suggests the following strategies for caregiver self-care which can help to combat the additional stressors and time commitments: 1) prioritize obligations and time commitments by learning to say “no” to non-essential tasks; 2) reduce or limit exposure to technology (computer screens, phones, televisions) to limit stress; 3) turn to faith-based endeavors if that is a source of comfort; 4) schedule free time in the day if even only for small increments of time; and 5) get organized using lists and tools that help you prioritize (Lozier, 2015).

As new roles are established, grandparents should be encouraged to develop practical strategies for managing the new relationship dynamics between themselves and their adult child. Proactively setting boundaries will help to facilitate the relationship between grandparent and adult child. These strategies include thinking through how they can allow adult children to be involved in some aspects of the parenting work, even if that involvement is limited. Grandparents should also be encouraged to identify manipulative behavior on behalf of the adult child and be prepared to address it proactively. Grandparents will also need to increase their comfort level in decision making for their grandchild when their adult child is not able to do so (Smith & Dannison, 2015).

Navigating Service Systems

Grandfamily familial arrangements include both families where children are placed into formal and informal kinship care arrangements. Formal kinship care is care provided by a relative that is arranged and formalized through a foster home licensure process facilitated by the state-level child welfare system. Informal kinship care, on the other hand, is care that is arranged when a grandparent or other relative steps in to provide care to a child without any formal child welfare involvement. Estimates suggest that for every child in a formal kinship placement there are 20 children who are being raised in informal kinship care arrangements (Generations United, 2016). This distinction is an important one for practitioners to recognize as informal kinship care families often lack access to the resources and support provided through state foster care systems. A first step to supporting grandparent caregivers is to identify their family arrangement and understand the potential service gaps that may exist for informal families.

Dolbin-MacNab and Targ (2002) developed a framework that professionals from any field can use to guide their practice with grandfamilies. Three of the tenets within this framework include being prepared to consider the multiple and complex issues that grandfamilies face, networking with other professionals to stay abreast of new programs and services available, and removing barriers that may keep grandparents from seeking and obtaining the help they need through advocacy. Using this framework, aging practitioners may find themselves with new and strange bedfellows such as child welfare service providers and those who work within educational and legal systems. Supporting grandfamilies will require new networks and connections be formed to address emerging needs faced by grandparent caregivers. To guide this work, Generations United (n.d.b) has created a taxonomy of needs presented by grandparent caregivers which crosses into areas beyond aging services and include the categories of housing, education, health, legal and financial challenges. Specific challenges faced by grandfamilies include:

    • Housing: residing in inadequate housing for children due to lack of space or housing configuration, living in senior housing that does not allow children to live with the grandparents, and a lack of household funding to handle extra housing and utility expenses related to having an additional child under your roof.
    • Education: barriers to enrolling children in school, especially when the grandparent does not have legal custody or guardianship; lack of familiarity with special education services that the child may need; lack of household funding to provide school supplies and necessities for the child.
    • Health: a caregiver’s own health challenges which may need to be met; lack of financial resources to cover additional medical expenses for themselves and/or their grandchild; lack of access to insurance when the grandparent does not have legal custody or guardianship; inability to make medical decisions on behalf of the child without appropriate legal arrangements; and lack of knowledge of health programs, such as Medicaid and Children’s Health Insurance Program (CHIP), that can assist in meeting medical needs.
    • Legal: Legal issues for grandfamilies tend to focus on issues related to formal custody and guardianship arrangements for the child. An ad-ditional legal consideration includes setting up a will and making other legal arrangements that can assist in providing care and support for the grandchild in the event that a caregiver dies or is no longer able to assume the role of kinship caregiver.
    • Financial: Financial supports needed by grandfamilies center on programs and services that can reduce financial burden for families. These include obtaining access to programs like child-only Temporary Assistance for Needy Families (TANF) benefits, Supplemental Nutrition Assistance Program (SNAP), Supplemental Security Income (SSI); obtaining subsidized guardianship, adoption payments, or other forms of child support; access to emergency food cupboards and clothing exchanges; connecting with heating assistance programs; and learning about and accessing local programs through churches and civic groups that provide individual assistance and support.
    • Additional needs: While the full range of needs is likely to vary from family to family, additional needs may include the need for learning or re-learning child development knowledge and parenting skills; staying connected socially with other kinship caregivers through support groups; finding relief from caregiving and an opportunity for self-care through the use of respite services; and obtaining special needs services for the children in their care

It is important to note that some states also have kinship navigator programs, programs that are specially designed to meet the service needs of kinship families. More information can be obtained about these programs and other resources for grandfamilies at www.grandfamilies.org

Continuing Education is Key for Practitioners

Research points to a need for practitioners who work with children and older adults to be educated about the special needs of grandfamilies (Fruhauf, Pevney, & Bundy-Fazioli, 2015). There are recent national programs developed to help retool practitioners for assisting these families, including the online Certificate Program in Grandfamilies Leadership facilitated by the UMaine Center on Aging (www.kinshipcert.org) which features online content tailored to a wide variety of professionals in the field. Additional resources that may be helpful to practitioners include Generations United (GU) (www.gu.org), a national organization that works to “improve the lives of children, youth, and older people through intergenerational collaboration.” GU offers policy and practice resources that can assist those who serve grandfamilies. The GrandFamilies journal, a publication from the National Research Center on Grandparents Raising Grandchildren, is a new open access publication in the field that features peer-reviewed research and practice articles specific to issues faced by grandfamilies.

In summary, assisting grandparents who are raising their grandchildren necessitates an individualized approach to meet the complex and ever changing needs of these families. Successfully engaging custodial grandparents requires a practitioner to understand the special needs of this population including family dynamics, grief and loss, coping strategies, and where families can turn for help. Aging Life Care Managers are encouraged to seek out continuing education and training and collaborate across disciplines on grandfamilies issues in order to connect with programs and services across aging, child welfare, education, and legal systems.

WORKS CITED


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