Kinship Care

A relative caregiver (commonly called a kinship caregiver) is rearing about 10 percent of children in the United States. While relative caregivers are typically a child’s grandparent, they can also be other relatives (e.g., aunts, uncles, siblings, cousins) or fictive kin (e.g., godparents). The most prevalent care arrangement is classified as informal, denoting an agreement voluntarily brokered between a child’s parent and relative caregivers. However, more commonly discussed in the literature is formal care, where a public child welfare entity has intervened in establishing safeguards for a child, resulting in court action that designates a child a ward of the state and authorizes placement with a relative caregiver. This dichotomous classification involves more nuanced typologies when considering the voluntary versus involuntary nature of agreements and the public versus private auspices under which they fall. For example, a child could be in an informal, private kinship care arrangement brokered by a public child welfare entity. Such distinctions are important not just for classification but because they are often associated with differential levels of support, financial provisions, public oversight, and outcomes (e.g., child well-being, permanency). While typologies vary, there are common reasons why children come to be reared by relatives, including child maltreatment, parental incarceration, physical or mental illness, addiction, death, or abandonment. For children removed from parental care for maltreatment, placement with kin tends to be preferred for most public child welfare agencies. Demographically, Black and Native children are most likely to be reared by kin. Caregivers tend to be women, unmarried, of color, and economically disadvantaged, with an average age of fifty. Kinship caregiver experiences differ, but most report satisfaction with the role and a sense of self-efficacy from ensuring that their relative’s child is safe, nurtured, feels loved, and remains connected to family. Although kinship care is considered a protective factor because children experience more favorable outcomes (e.g., stability) than their counterparts do, many caregivers report being under resourced and experiencing high stress levels. Likewise, many kinship caregivers lack knowledge and direction about legal issues, resources, and pathways to support. Safeguarding children and promoting their well-being is of paramount interest to those involved in kinship care. More recent research and state and federal laws recognize that to advance child well-being, financial provisions, services, and supports must be in place for children and caregivers. Despite significant gains in the past twenty years, the literature, well-supported programs and interventions, and policy related to kinship care remains inchoate.

Who Should Make Care Arrangement for Older Adults? Heteronormative Family Responsibility in Japan

In Japan, despite the greater availability of public care services upon implementation of national long-term care insurance, families are still considered as primarily responsible to make care arrangement for older adults. My aim in this study was to explore (hetero)normative ideas about families that underlie Japan’s institutionalized practices of elder care. In doing so, I focused on care managers, who are certified care practitioners helping families to make care arrangement, and whether they would count older adults’ same-sex partners as legitimate family members to participate in such arrangement. Data were collected from 1,580 care managers working for officially designated in-home care providers across the nation. Preliminary analysis revealed that although most care managers believed the voices of same-sex partners should be preferably reflected in the process of care arrangement, they also thought that these partners could not participate in such process without permission from older adult’s “blood relatives” (e.g., siblings).

Children’s Experiences of Stress in Joint Physical Custody

Background Joint physical custody is a parental care arrangement in which children live roughly an equal amount of time with each parent after family dissolution, residing alternately in each of the two parental households. Because joint physical custody is characterised by fathers’ continued involvement in their children’s lives, this care arrangement is believed to compensate for the negative effects of family dissolution, and to contribute to children’s well-being in post-separation families. Objective This study aims to investigate potential differences in the experiences of stress of children living in joint physical custody and sole physical custody arrangements, while considering both the proportion of time the children spend with each of their parents and the number of transitions the children make between the parental households. Methods Based on data from the Family Models in Germany (FAMOD) study, a national convenience sample, linear regression models were estimated for 297 children between the ages of 11 and 14. Results The statistical analysis suggests that there was no significant association between the physical custody type (sole physical custody vs. joint physical custody) and the children’s levels of stress. In addition, the results revealed that children’s experiences of stress did not depend on how often they moved between their parents’ households. Conclusions This study does not corroborate the assumption that joint physical custody has a protective effect on children, but instead suggests that different physical custody arrangements are associated with different stressors that lead to similar levels of stress in children living in different post-separation families.

Towards a middle-range theory of ‘Stability of home-based care arrangements for people living with dementia’ (SoCA-Dem): findings from a meta-study on mixed research

BackgroundMost people with dementia and their informal carers live at home and strive to create a stable care situation for as long as possible. This preference of dyads is consistent with the global policy of ageing in place. Therefore, we aimed to develop a middle-range theory of stability guided by two research questions: How is stability of home-based care arrangements for people living with dementia constituted? What are the essential factors influencing stability?MethodsWithin the 'Stability of home-based care arrangements for people living with dementia' project (SoCA project) at the German Center for Neurodegenerative Diseases (DZNE), we conducted a meta-study on mixed research. The analytical steps of meta-data analysis, meta-method and meta-theory are merged in an integrative synthesis. Eligible publications were identified through systematic database searches (MEDLINE, CINAHL and PsycINFO; last searched on 3 January 2017), backward/forward citation tracking and snowballing. All publications were screened against predefined inclusion criteria and evaluated through a quality appraisal. The analytical approach was thematic synthesis.Results99 publications were included. The middle-range theory conceptualises stability as a complex phenomenon comprising three components including eight concepts that are dynamically inter-related. The conceptual model visualises: (1) the trajectory of the dementia care arrangement, which involves a cyclic process of change and balancing over time; (2) the characteristics of the care arrangement, including needs, the carer role, the dyadic relationship and resources; and (3) the context, which is determined by society and culture and the respective healthcare system. The relevance of each concept in relation to stability changes over time. The forming of each concept is actively shaped by the informal carer.DiscussionThis middle-range theory provides a thorough understanding of the stability of home-based care arrangements for people living with dementia and can be used to guide future research and practice.OtherThis meta-study was funded by the DZNE and registered in PROSPERO (registration number CRD42016041727).

Uptake of Childcare Arrangements—Grandparental Availability and Availability of Formal Childcare

Grandparents constitute an important source of childcare to many parents. Focusing on the Belgian context, this paper improves our understanding of childcare decision-making by investigating how formal childcare availability and availability of grandparents affect childcare arrangements. By means of multinomial regression models we simultaneously model uptake of formal and informal childcare by parents. Combining linked microdata from the Belgian censuses with contextual data on childcare at the level of municipalities, we consider formal childcare availability at a local level, while including a wide array of characteristics which may affect grandparental availability. Results indicate that increasing formal care crowds-out informal care as the sole care arrangement, whereas combined use of formal and informal care becomes more prevalent. Characteristics indicating a lack of grandmaternal availability increase uptake of formal care and inhibit to a lesser extent the uptake of combined formal and informal care. While increasing formal care substitutes informal care use, the lack of availability of informal care by grandparents may be problematic, particularly for those families most prone to use informal care.

Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum

At some point in our lives, approximately 70% of us will need support to help with daily care. Without adequate assistance we may experience unmet care need consequences (UCNC) – such as skipping meals, going without clean clothes, or taking the wrong medication. This study examines the likelihood of experiencing UCNC related to gaps in assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) across long-term care arrangements: informal community care, paid community care, residential care, and nursing homes. We examine a sample of older adults receiving assistance in a care arrangement (N=2,499) from the nationally representative 2015 National Health and Aging Trends Study. Cross-sectional and longitudinal regression models, adjusting for differences in demographic and health/functioning characteristics, examine if type of care arrangement in 2015 is associated with UCNC in 2015 and change in UCNC by 2017. Holding all else constant, there were no significant differences in UCNC related to ADLs in 2015 across care arrangements. However, those receiving paid community care were more likely to experience UCNC related to IADLs (going without clean clothes, groceries, or a hot meal and making medication errors) compared to those receiving only informal care (OR=1.64, p<.05) or residential care (OR=2.19, p<.01). By 2017, paid care was also significantly associated with continued UCNC, but older adults in informal care arrangements were most likely to experience a new UCNC. Results suggest improving/expanding assistance with IADLs among community-dwelling older adults, and promoting equitable access to residential care, to reduce UCNC.