Grandparent Caregiver Wellbeing: A Strengths-Based Approach Utilizing the Positive Emotions, Engagement, Relationships, Meaning, and Accomplishment (PERMA) Framework

Grandparent caregivers experience a complex web of rewards and challenges as the primary source of support for their grandchildren. Consistent with the trend towards a more positive framing of grandparent caregiving, this paper explores the grandparent caregiver experience through a strengths-based approach and makes the case for Seligman's Wellbeing Theory, or PERMA model, being used to support research, programming, and policy. A scoping review of 16 current empirical articles relevant to grandparent caregiver wellbeing revealed the experience of grandparent caregivers aligns well with the five components of Seligman’s PERMA model: positive emotions, engagement, relationships, meaning, and accomplishment. Using this framework with grandparent caregivers, both in theory and in practice, can provide relevant stakeholders with a more comprehensive picture of the needs of this population, enabling them to more effectively support wellbeing for grandparent caregivers and positive developmental outcomes for the growing number of children in their care.

Process-Outcome Relationships and Solution-Based Goal-Setting Interventions With Grandparent Caregivers

The present study examines the impact of change processes on outcomes in a solution-based thinking and goal-setting intervention for grandparents raising their grandchildren. We found that across the 6 program sessions there was stability and/or increases in the salience of hypothesized change processes, i.e., hopefulness about the future, solution-based thinking, positive thoughts about one's grandchild, multiple indicators of decisional personal goal-setting regarding one's own well-being and grandchild relationship quality. Indicators of change processes were for the most part, related to both post-program outcomes as well as to pre-post program outcome difference scores. Regression analyses suggested that change processes in many cases partially mediated pre-post primary program outcome scores. These data suggest that how grandmother caregivers think about themselves and their grandchildren and their approach to setting personal goals are key change processes explaining the impact of a solution-based, goal-setting intervention on them.

The Daily Challenges of Caring for Grandchildren: A Daily Analysis of Emotional and Physical Reactivity to Stressors

Grandparents are increasingly providing extensive and custodial care for their grandchildren. Many factors have contributed to a societal rise in caregiving among grandparents, including addiction, incarceration, dual-income families, and the cost of childcare. Past work has highlighted positive effects of grandparenting (e.g. reduced dementia risk); however, research is limited that examines the day to day challenges grandparent caregivers experience. The goal of this research was to examine daily experiences of stressors, positive events, physical symptoms, and daily mood of grandparent caregivers. Participants (n=18 grandparent caregivers) filled out a diary survey for five consecutive days that measured daily stressors and positive events. A total of 90 diaries were completed. Stressors were reported on 97.6% of days. Multilevel analysis examining emotional and physical reactivity to daily events showed that, controlling for age and gender, on days when participants reported more stressors than average, they reported higher negative affect (p=.019), lower positive affect (p=.003) and more physical symptoms (p=.002). Positive events were not significantly associated with daily mood or daily physical symptoms. Overall, the findings supported the hypothesis that grandparent caregivers experience emotional and physical reactivity to the daily challenges they experience. Future research should examine resources and supports to reduce the impact of daily stressors, as well as the particular challenges among underrepresented groups, particularly Black and Latino grandparents, who provide disproportionate levels of care for their grandchildren. The current study highlights the potential vulnerability and daily needs for support among grandparents who provide regular and custodial care for their grandchildren.

Virtual Empowerment Training: Reaching Grandparent Caregivers During COVID19

COVID-19 has had a devastating impact on minority populations in the United States who have disproportionately been at risk of getting the virus, having severe illness, and dying from it, with these risks most pronounced for older adults. The impact has been particularly severe on the more than on the more than 2, 7 million grandparents raising their grandchildren in the United States. Covid-19 has added profound strains to these families as they struggle with resources and isolation, frequently without assistance as well as the challenge of helping children to navigate online learning. The Virtual Empowerment Training Project, developed as a 7 session pilot program for low income grandparent caregivers in New York includes classes that strengthen parenting, communication, coping with loss and grief, and community empowerment. Participants were given ipads and computer training prior to classes, all conducted through Zoom. Initial data from the 56 participants (M age = 62, Race/ethnicity=Black, 79%, Hispanic, 16%, Income annual 41%<$15,K ) indicate improvement, i.e. a lessening of Negative Affect regarding the grandchild (p < .01) in the quality of their relationships with their grandchildren while also experiencing a decline (p < .01) in their sense of parental efficacy, possibly reflecting their becoming more critical of their own parental skills. Participant evaluations of the course were overwhelmingly positive, with more than 90% finding it extremely helpful, valuable, and eager to share it with others and to become more involved in improving the lives of grandfamilies.

Support Needs as Perceived by Grandparent-Caregivers: A Qualitative Systematic Review

Caregiving can have adverse mental and physical health outcomes. Older grandparents who are primary caregivers for their grandchildren report multiple health conditions such as depression, anxiety, hypertension, cardiac disease and chronic fatigue, which are caused by or otherwise exacerbated by the caregiving demands. We conducted this qualitative systematic review to identify support needs that contribute to such poor health outcomes and as perceived by grandparent-caregivers for minor grandchildren. We searched relevant databases (PubMed, PyschINFO, CINAHL, and Social Work Abstracts) using terms such as: child rearing, parenting, child custody, grandparents, support needs, and caregiving. Studies were included for review if they were written in the English language; used only qualitative methods; and were published from January 1990 to January 2020. Included studies were critically appraised using the Critical Appraisal Skills Programme checklist. Data were extracted from these studies and synthesized using meta-ethnography. Of the 2828 studies identified, 58 studies from 12 countries met all inclusion criteria for review. Three main themes emerged from the review: 1) grandparent-caregivers’ personal needs, and 2) grandchildren needs. Both themes were further divided into subthemes of health (mental & physical), financial, social (interpersonal, cultural and environmental factors and services). Findings from this review have potential to: 1) inform design of comprehensive interventions and screening needed to address perceived support needs; and 2) identify gaps in and barriers to available support resources for older grandparent-caregivers. Further research is needed on comprehensive assessment of support needs and risk for poor health outcomes among grandparent-caregivers.

Connecting Grandparent Caregivers Through Telemental Health During COVID-19

Since the COVID-19 outbreak, children and their caregivers throughout the world are experiencing unprecedented long-term social isolation. For too many, especially grandparent-headed families, underrepresented minorities, and those living in poverty, this precipitates and exacerbates mental health conditions including anxiety and depression. Despite these families’ increased needs for mental health services during the pandemic, professionals often lack experience and expertise in telemental health, which is a safe and effective way to provide these services. In this symposium, we will present a telemental health model for working with grandparent-headed families that draws upon Solution-Focused Brief Therapy (SFBT), an evidence-based approach focusing on strengths. This SFBT-based telemental health training program prepares mental health professionals to implement this safe and innovative intervention, enabling them to effectively serve isolated and marginalized grandparent caregivers and their families when providing in-person services is not possible.

Predictors of Custodial Grandparents’ Perceived Barriers to the Use of Services

Getting timely access to help, information, and a variety of services is paramount among the challenges of raising a grandchild, and grandparents face a variety of internal and external barriers in getting such help. The present pilot exploratory study focused on caregiving-related and personal resource variables best predicting grandparent caregivers’ perceptions of barriers to receiving services. Fifty-two grandparents (M age = 59.1) raising their grandchildren completed measures assessing caregiver strain, social support, resilience, self-care, psychosocial adequacy, health, depression, and grandchild relationship quality. They also completed measures of the extent to which they faced personal and caregiving-related difficulties giving rise to the need for services (e.g. health, grandchild well-being, support from others) as well as the extent to which they had experienced barriers to service (health/financial limitations, isolation, transportation, respite care, lack of knowledge of services) in the past 3 months. Correlations (p < .05) suggested that psychosocial adequacy (r = -.32), depression (r = .27), caregiver strain (r = .42) and difficulties (r = .48) were all related to greater perceived barriers. Regression analyses (F7, 40 = 2.81, p < .02) indicated that caregiver strain (Beta = .33, p < .05) and difficulties giving rise to the need for services (Beta = .32, p < .04) emerged as most salient in predicting barriers. These findings underscore the fact that personal, caregiving-related, and interpersonal factors exacerbate the barriers associated with grandparents’ accessing needed services and reinforce such factors’ impact on grandparents as targets for overcoming impediments to accessing services among them.

The Moderation of Middle-Generation Support on the Relation of Stress and Depression in Coresident Grandparents

Consistent with Cohen & Wills’ Buffering Hypothesis, social support has been found to moderate the relation between stress and depressive symptoms but has yet to be examined among coresident grandparents (CGPs), a population at risk of increased stress and depression. The current study sought to extend the model to this highly prevalent, vulnerable population. Participants were 180 grandparents across the USA living with their grandchildren. Measures included depression, stress, and satisfaction with support provided by the middle generation (MG) parent of the grandchild. After controlling for age, gender, income, and household type (skipped or multi-gen), MG support moderated the relation between perceived stress and depressive symptoms, accounting for 49% of variance. For CGPs least satisfied with support provided by the MG, the more stress, the higher their depressive symptoms. These findings indicate that improving relationships with grandchildren’s parents is an important avenue for interventions focused on grandparent caregivers’ mental health.

Intensity of Grandparent Caregiving and Well-Being in a Cultural Context: A Systematic Review

With improved longevity and changes in family structure, grandparents are key resources in providing care for grandchildren. However, mixed findings indicate that multiple role engagement may enhance well-being or bring demands on grandparents raising grandchildren. Little is known about how the intensity of grandparent caregiving is associated with their well-being in different family contexts (i.e., structures, cultures/regions, and reasons of care). This systematic review examines the association between the intensity of grandparent caregiving and their well-being. Peer-reviewed articles published after 1990 were identified in five electronic databases. A keyword search was performed for keywords associated with: (a) grandparent caregivers raising grandchildren, and (2) well-being (i.e., physical, mental, cognitive, and life satisfaction). Only quantitative studies were included. Fifty-six articles from 28 countries/regions were included. Findings suggested that the well-being of grandparents is optimal when they provide caregiving of moderate intensity, with optimal amounts varying across sociocultural contexts. In Europe and Australia, providing supplementary care seems beneficial for grandparents’ well-being, especially supporting dual-earner families. In Asia, economic resources buffer the adverse effect of primary care on grandparents’ well-being. In the U.S., findings vary across ethnicity/race. White grandparents enjoy health benefits providing supplementary care with support from adult children. However, Hispanic grandparent caregivers in multigenerational households have better well-being than those in skipped-generation households, whereas Black custodial caregivers have better well-being than supplemental caregivers. Collectively, the intensity of grandparent caregiving and well-being is complicated by their roles in the family and cultural differences. This systematic review calls for culturally-tailored family interventions.

Domestic Generative Acts and Life Satisfaction among Supplementary Grandparent Caregivers in Urban China: Mediated by Social Support and Moderated by Hukou Status

Urban China is witnessing a growth of migrant grandparents apart from the prevalent local grandparent caregiving. However, the health consequences and influencing factors of grandparent caregiving remain largely unknown among migrant and local grandparent caregivers. This study examined informal and formal social support’s mediation roles between domestic generative acts and life satisfaction, as well as investigating Hukou’s (household registration system) moderation effect. Our sample compromised 1013 grandparent caregivers (Migrant = 508, Local = 505) from 12 kindergartens with a multistage clustered random sampling from Eastern China. Migrant grandparent caregivers had significant lower informal social support (M = 4.000, L = 4.355, p < 0.001), formal social support (M = 1.787, L = 2.111, p < 0.001), and life satisfaction (M = 3.323, L = 3.574, p < 0.001) than local ones. Structural equation modeling results indicated that domestic generative acts positively associated with life satisfaction (b = 0.085, p < 0.05), informal (b = 0.223, p < 0.001) and formal social support (b = 0.080, p < 0.05); informal (b = 0.379, p < 0.001) and formal social support (b = 0.138, p < 0.001) positively associated with life satisfaction. In addition, both informal (β = 0.084, CI [0.039, 0.101], p < 0.001) and formal social support (β = 0.011, CI [0.001, 0.018], p < 0.05) mediated the relationship between domestic generative acts and life satisfaction. Furthermore, Hukou status moderated the indirect path from domestic generative acts to life satisfaction via informal social support (p < 0.01), but not formal social support (p > 0.05). Migrant grandparent caregivers, with limited formal social support resources, were found to be more dependent on informal social support than locals. The findings revealed social support and wellbeing disparities among migrant and local grandparent caregivers in urban China. Theoretical contributions and practical implications are also discussed.