Exploring grandparents' psychosocial responses to childhood cancer: A qualitative study.

OBJECTIVE: A childhood cancer diagnosis is a traumatic experience for patients and their families. However, little is known about the effect on grandparents. We aimed to investigate the negative psychosocial impact, coping strategies, and positive outcomes of grandparents of childhood cancer patients in Switzerland. METHODS: We collected data using a semi-structured interview guide and applied qualitative content analysis. RESULTS: We conducted 20 interviews with 23 grandparents (57% female; mean age = 66.9 years; SD = 6.4; range = 57.0-82.4) of 13 affected children (69% female; mean age = 7.5 years; SD = 6.1; range = 1.0-18.9) between January 2022 and April 2023. The mean time since diagnosis was 1.0 years (SD = 0.5; range = 0.4-1.9). Grandparents were in shock and experienced strong feelings of fear and helplessness. They were particularly afraid of a relapse or late effects. The worst part for most was seeing their grandchild suffer. Many stated that their fear was always present which could lead to tension and sleep problems. To cope with these negative experiences, the grandparents used internal and external strategies, such as accepting the illness or talking to their spouse and friends. Some grandparents also reported positive outcomes, such as getting emotionally closer to family members and appreciating things that had previously been taken for granted. CONCLUSIONS: Grandparents suffer greatly when their grandchild is diagnosed with cancer. Encouragingly, most grandparents also reported coping strategies and positive outcomes despite the challenges. Promoting coping strategies and providing appropriate resources could reduce the psychological burden of grandparents and strengthen the whole family system.

Revisiting the association between grandparenting and mental health in China: New evidence from the harmonized CHARLS.

BACKGROUND: In the context of the global aging challenge, an increasing number of middle-aged and older adults (MAOAs) are engaging in grandparenting. However, the effect of grandparenting on the mental health of caregivers has shown inconsistent findings. To effectively promote healthy aging, it is imperative to adopt a comprehensive perspective and employ a rigorous approach to further investigate the relationship between these two social phenomena. METHODS: The data from the Harmonized China Health and Retirement Longitudinal Study were analyzed, focusing on MAOAs with at least one grandchild. Mental health assessments used the center for epidemiologic studies depression scale scale. The study employed a series of difference-in-differences (DID) models, especially complemented by propensity score matching, to evaluate the average treatment effect for the treated (ATT) on mental health of caregivers, considering covariates like personal and family characteristics. The intervention perspective includes both the provision and cessation of grandparenting. RESULTS: The study found that providing grandchildren care does not have a significant effect on the mental health of grandparents, in comparison to those who have never engaged in such care (ATT = -0.172, T = 0.65, p = 0.517 in the PSM-DID model). Furthermore, ceasing this care also appears to have no substantial effect on the mental health of the caregivers, relative to individuals who have consistently offered grandchildren care (ATT = 0.060, T = 0.26, p = 0.795 in the PSM-DID model). Furthermore, subsequent robustness analyses consistently supported these findings, even when considering data from different survey waves. CONCLUSIONS: In contrast to many prior studies that have reported either positive or negative effects, our research reveals that grandparenting exerts no significant effect on the mental health of MAOAs. Consequently, health practitioners and policymakers should carefully consider the diverse cultural context when tailoring interventions and support strategies.

Through the eyes of grandparents: an in-depth exploration of the nexus between grandchild caring and the psychological well-being of older grandparents.

BACKGROUND: Grandchild caring has positive as well as negative impact on the grandparents' psychological well-being and the findings are varied by culture and country. METHODS: Present study was intended to understand the relationship between caring for grandchildren and psychological well-being of grandparents living in skipped (SGH) and multi-generational households (MGH) in Indian demographical context. The present research involved In-depth Interviews (IDI) focusing on grandparents above 60 and grandchildren below 18, where the elder played a crucial role in caregiving. The study area was Malda, a district of West Bengal in India. Purposively 24 IDIs were selected. Psychological well-being was measured using open-ended questions. Thematic and content analyses were adopted to understand the perspective of grandparents. RESULTS: Most of the grandparents from SGH reported depression word frequently, while grandparents from MGH reported happy. In the content analysis, grandparents from SGH expressed tension, mental turmoil, and worry about grandchild's future. On the contrary, grandparents from MGH expressed happy, companionship, and worry about grandchild's future. Further, full time caring, compulsive reason behind grandchild caring, and working status were linked with living in SGH and grandchild caring, which were in turn connected with deteriorate psychological health. However, in MGH, a different scenario was observed, most grandparents were partially and non-compulsively engaged in grandchild caring and had expressed positive mental health. CONCLUSIONS: The Findings provide an intervention implication, particularly in the context of India's ageing population and their well-being by acknowledging the influence of household structure, caring intensity, motive behind grandchild caring, and working status on their psychological health. Understanding the importance of these key factors may help the policy maker and the individual to incorporate the most effective intervention to achieve sustainable development goal 3 and healthy ageing.

Being both a grandmother and a health worker: experiences of community-based health workers in addressing adolescents' sexual and reproductive health needs in rural Zambia.

INTRODUCTION: Community-based health workers (CBHWs) possess great potential to be the missing link between the community and the formal health system for improving adolescents' access to sexual and reproductive health and rights (SRHR) information and services. Yet, their role in addressing adolescents' SRHR within the context of the community-based health system has received very little attention. This paper analyses how CBHWs experience and perceive their role in addressing adolescents' SRHR needs in rural Zambia, including the possible barriers, dilemmas, and opportunities that emerge as CBHWs work with adolescents. METHODS: Between July and September 2019, we conducted 14 in-depth interviews with 14 community-based health workers recruited across 14 different communities in the central province of Zambia. The interviews were focused on eliciting their experiences and perceptions of providing sexual and reproductive health services to adolescents. Charmaz's grounded theory approach was used for the analysis. RESULTS: We present the core category "being both a grandmother and a CBHW", which builds upon four categories: being educators about sexual and reproductive health; being service providers and a link to SRHR services; being advocates for adolescents' SRHR; and reporting sexual violence. These categories show that CBHWs adopt a dual role of being part of the community (as a grandmother) and part of the health system (as a professional CBHW), in order to create/maximise opportunities and navigate challenges. CONCLUSION: Community-based health workers could be key actors providing context-specific comprehensive SRHR information and services that could span all the boundaries in the community-based health system. When addressing adolescents SRHR, playing dual roles of being both a grandmother and a professional CBHW were sometimes complimentary and at other times conflicting. Additional research is required to understand how to improve the role of CBHWs in addressing adolescents and young people's sexual and reproductive health.

Barriers and enablers to promoting grandchildren's physical activity and reducing screen time: a qualitative study with Australian grandparents.

BACKGROUND: With an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children's engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children's physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children's physical activity and reducing screen time. The present study sought to explore these perceptions. METHODS: Semi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis. RESULTS: Key reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents' age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children's fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view). CONCLUSIONS: Findings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents' age and health status, as well as any environmental barriers, are likely to be well-received.

Exploring the shift in newborn care practices among mothers and grandmothers in rural Odisha, India - a qualitative study.

BACKGROUND: This study delves into newborn care and infant-feeding practices in rural Odisha, specifically focusing on the rural KBK + region of Odisha (Kalahandi-Bolangir-Koraput region), inhabited predominantly by Schedule Tribes and Schedule Castes individuals. There has been an improvement in the health indicators in these areas in recent times. In the background of improved health indicators in these areas, this research explores the current and changing newborn care practices and attempts to gain insight into people's perceptions of the factors that brought about the changes. METHODS: This qualitative study was conducted between February and July 2023 at Christian Hospital, Bissamcuttack in Odisha. The methodology involved focused group discussions with mothers and grandmothers. RESULTS: Analysis revealed healthy practices like exclusive breastfeeding till six months of age, appropriate timing of the first bath, and prompt healthcare-seeking behavior for minor illnesses among the mothers. The use of cow ghee or breast milk in a baby's eyes, the application of ash on the umbilical cord, and the use of herbal medicines for minor illnesses were practiced more by the grandmothers in the past and were not as popular among the mothers. It is noteworthy that the cultural practices to ward off the 'evil eye' were practiced by both mothers and grandmothers alike. Despite the influence of traditional cultural practices on the beliefs and norms of the community, the study identified a shift in health-seeking behavior, with increased reliance on healthcare providers and safe healthcare practices. The study identifies the pivotal role of Accredited Social Health Activists (ASHAs) as a bridge between the rural communities and the healthcare system. CONCLUSIONS: This research provides valuable insights for healthcare providers aiming to enhance community-centric safe newborn care practices in rural settings. The emphasis is on the importance of understanding the current and changing local practices. This would help the healthcare providers to encourage healthy practices while eliminating the harmful practices related to newborn care through community workers like ASHA and Anganwadi workers.

The contributions of grandparents to preadolescent grandchildren's social skills in rural Malaysia.

This study aimed to generate localized knowledge by investigating the perceptions and experiences of preadolescent grandchildren and grandparents regarding grandparenting and intergenerational interactions and how these processes were related to the social skills of preadolescents from three ethnic groups in Malaysia. Using a concurrent quantitative-qualitative mixed method research design, Chinese, Malay, and Indian preadolescents (N = 465; ages 9-12 years old; M = 10.27 years; SD = 1.03) from rural areas in Malaysia completed a self-administered quantitative survey; furthermore, 25 grandparents participated in one-on-one interviews. Survey findings showed that preadolescent grandchildren who reported higher grandparental warmth and support had greater social skills, mediated by positive grandparent-grandchildren (GP-GC) relationships. The GP-GC relationship and preadolescent social skills association was stronger for skipped generation compared to three-generation households. Interview findings revealed that grandparents expressed unconditional love and autonomy support in their grandparenting roles by guiding and encouraging their preadolescent grandchildren to make decisions. The GP-GC interactions served as a dynamic force in promoting preadolescents' social skills. By employing a decolonized approach and drawing on the lived experiences of grandparents from three ethnic backgrounds in rural Malaysia, the study provided an understanding of grandparenting practices and their general implications across the three ethnic groups. The interview responses highlighted both commonalities and specificities in grandparenting practices and relationship dynamics shaped by religious, class, and sociocultural dimensions in rural Malaysia.

Psychometric Properties under EFA, CFA, Measurement Invariance, and IRT Models for Older Adults' First Aids Knowledge Scale among Iranian Grandparents: The Modified Scale.

This research aims to create and evaluate an assessment tool termed Older Adults' First Aid Knowledge Scale, which measures the knowledge and attitude of Iranian grandparents about first aid. In accordance with COSIM guidelines, 485 individuals in southern Iran completed the instrument as part of a psychometric investigation. Rasch partial credit model (PCM), exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and receiver operating characteristic (ROC) analysis were used to analyze the results. The final version of OFAKS consisted of 18 items that were validated through EFA, CFA, and item response theory (IRT) analysis. All items showed measurement invariance and consecutive response groupings in the predictable order, and the instrument had strong internal consistency. Although Rasch's analysis demonstrated the significance of OFAKS, further investigations and testing in different settings are required to confirm the validity of the tool.

Continuity in Socialization Styles: Typologies of Socialization in the Different Life Stages of Older People.

The purpose of this research was to identify the socialization styles of the older person (such as authoritative, indulgent, authoritarian, and negligent) in three different roles: (1) nowadays as a grandparent, (2) considering the style used to educate their own children in the past; and (3), considering the socialization style they received when they were children. The sample (317 people over 65 years old with at least one grandchild aged up to 16 years old participated) received the questionnaire on socialization styles in those roles. The results showed the predominance of the indulgent style in their role as grandparents. Almost 80% showed intergenerational continuity between at least two roles, with the exception of those with a neglectful style. Continuity in socialization style is crucial to understanding the dynamics within family relationships, which have highly durable intergenerational ties.

Intergenerational Caregiving Patterns and Cognitive Health among the Sandwich Generation Within Four-Generation Families.

This study aims to investigate whether generational differences in intergenerational caregiving patterns (caring for parents only, caring for grandchildren only, and caring for parents and grandchildren simultaneously) are associated with cognitive health disparities among the sandwich generation within four-generation families, drawing upon the theories of intergenerational solidarity and intergenerational stake. Moreover, this study seeks to identify mediators that help explain these disparities. A nationally representative sample of 8,065 respondents was drawn from the 2011 and 2018 waves of the China Health and Retirement Longitudinal Study. The findings reveal that the sandwich generation caring for grandchildren only, as well as those caring for grandchildren and parents simultaneously, exhibit better cognitive health. However, caregiving for parents only is not significantly related to their cognitive health. This study identifies the inability to reduce depressive symptoms as a mediator explaining the insignificant association between caregiving for parents only and the cognitive health of the sandwich generation. The findings underscore the importance of offering support to the sandwich generation within four-generation families to enhance their cognitive health. Moreover, it is imperative to distinguish between different intergenerational caregiving patterns based on generational differences among the sandwich generation, with a specific emphasis on allocating public resources aimed at promoting cognitive health for those engaged in caring for parents.

Latent profile analysis of depression and its influencing factors in older adults raising grandchildren in China.

OBJECTIVE: To explore the latent profile of depression in older adults raising grandchildren in China, and to analyze the differences in the characteristics of the different profiles of the population and the factors influencing them. METHODS: This study utilized the 2018 China Health and Retirement Longitudinal Study (CHARLS). Through a cross-sectional study, the latent profile analysis was used to analyze the potential classification of depression among older adults raising grandchildren, and using ordered multi-categorical logistic regression analyses to assess the effects of each factor on their different classifications. RESULTS: The 1271 older adults raising grandchildren with depression symptoms were divided into three categories: low-level depression (55.4%), moderate-level depression (31.2%), and high-level depression (13.4%). Ordered multi-categorical Logistic results showed: Gender, marital status, pension insurance, physical health status, life satisfaction, and IADL were predictors of latent profile classification of depression symptoms in older adults raising grandchildren (P < 0.05). CONCLUSIONS: In the future of primary care, it will be more meaningful to provide targeted interventions for different subgroups of depression in older adults raising grandchildren.

Grandparent Caregivers Lived Experiences and Resource Needs/Use During the COVID-19 Pandemic.

This project examined the impacts of the COVID-19 pandemic on grandparent caregivers, grandchildren, family dynamics, and resources to mitigate and navigate crises. Phone interviews were conducted with 24 grandparent caregivers using a semi-structured interview guide. Caregivers explained that the pandemic had impacted them and their grandchildren by increasing emotional distress, social isolation, financial difficulties, and challenges with education. Helpful resources consisted of financial support, respite care, and support for grandchildren. Thus, there is a need to provide grandparent caregivers with the same resources that foster care providers receive - particularly when faced with challenges such as the COVID-19 pandemic.

Grandparenting during pandemic times: pros and cons for mental health.

BACKGROUND: The COVID-19 pandemic and associated lockdown measures posed an unprecedented challenge to the crucial role of grandparenting in family-oriented cultures, such as Italy. Reduced contact with grandchildren during this period potentially threatened grandparents' mental health and well-being. METHODS: We analysed data from the LOckdown and lifeSTyles in Lombardia cross-sectional study conducted in November 2020. The study included a representative sample of 4400 older adults from Lombardy, Italy, of which 1289 provided childcare to their grandchildren. RESULTS: A decrease in self-reported grandparenting was associated with an increased likelihood of experiencing depressive symptoms among grandparents (OR 1.50, 95% CI 1.01-2.24). Conversely, an increase in grandparenting was linked to poorer sleep quality (OR 11.67, 95% CI 5.88-23.17) and reduced sleep quantity (OR 2.53, 95% CI 1.45-4.41). CONCLUSIONS: Despite the barriers posed by the pandemic, grandparenting played a beneficial role in maintaining the mental health and well-being of older adults. However, it is crucial to recognise specific vulnerabilities, such as gender, feelings of hopelessness and overcrowding, which can have detrimental effects during and beyond emergency situations. Careful attention to these factors is essential for developing targeted support systems and interventions aimed at safeguarding the mental health of older adults and enhancing their resilience in crises.

Impacts of grandparenting on older Chinese adults' mental health: a cross-sectional study.

BACKGROUND: The practice of grandparenting has been growing in popularity worldwide, particularly in Asian societies. Nevertheless, there is a lack of thorough studies investigating the mental health effects of grandchild care on grandparents, particularly within the family context. The present study aimed to explore the impact of grandparenting on depressive symptoms in older Chinese adults, taking into account the functional role of intergenerational support. METHODS: Using the China Longitudinal Aging Social Survey (CLASS, 2014 and 2018, N = 9,486), we employed the Pooled Ordinary Least Square method (POLS) to explore the association between depressive symptoms and grandparenting intensity as well as include the interaction terms to investigate the role of intergenerational support among grandparents aged from 60 to 80. RESULTS: After adjusting for control variables, both non-intensive (-0.17; 95% CI: -0.30, -0.03) and intensive (-0.69; 95% CI: -0.95, -0.43) childcare, as well as giving financial support to adult children (-0.06; 95% CI: -0.08, -0.04) and emotional closeness with them (-0.94; 95% CI: -1.15, -0.72), were found to have a positive impact on the mental health of grandparents. Giving financial support (non-intensive: -0.04, 95% CI: -0.07, -0.01; intensive: -0.06, 95% CI: -0.13, -0.01) and providing instrumental support to adult children (non-intensive: -0.12, 95% CI: -0.24, -0.01; intensive: -0.19, 95% CI: -0.37, -0.02) moderated the association between grandparenting and the mental health of older adults, regardless of care intensity. However, the moderating role of receiving financial support (-0.07; 95% CI: -0.12, -0.02) only existed when non-intensive childcare was provided. CONCLUSION: Grandchild care predicted better mental health in grandparents, mainly when they engaged in intensive grandparenting. Emotional closeness and providing financial support to adult children brought mental health benefits to grandparents involved in childcare. Giving financial support and providing instrumental support to adult children moderated the association between grandparenting and the mental health of older adults. However, the moderating role of receiving financial support from adult children only existed when non-intensive childcare was provided.

Grandparenting and life satisfaction among Chinese elderlies: a study of possible mechanisms.

OBJECTIVE: This study examines the impact of caregiving on older people's life satisfaction, focusing on the role of caring for grandchildren. The study considers individual characteristics (aging attitudes) and situational factors (intergenerational support) and aims to identify the mediating roles of aging attitudes and intergenerational support in the relationship between caregiving and life satisfaction. METHOD: The study analyzed data from the 2014 China Longitudinal Aging Social Survey (CLASS), focusing on 5363 grandparents who reported providing care for their grandchildren in the 12 months before the survey. Life satisfaction was subjectively measured. The data was analyzed using multiple linear regression, propensity score matching, and mediation analysis. RESULT: The study found that grandparents who cared for their grandchildren have higher levels of life satisfaction. Self-aging attitudes, general aging attitudes, intergenerational economic support, intergenerational instrumental support, and intergenerational emotional support fully mediated the relationship between grandchild care and life satisfaction. CONCLUSION: This study demonstrates that caring for grandchildren is a vital activity for older people that helps them develop positive aging attitudes and strengthens intergenerational support, thereby improving their quality of life. Hence, the government, society, families, and communities should provide more social support to older adults caring for grandchildren. This would not only benefit the health of the older people themselves but also promote intergenerational harmony and family development.

Attitudes toward mental health and mental health care among custodial grandparents.

Objective: Two-hundred thirty-nine grandparents who were raising their grandchildren were surveyed regarding their attitudes toward mental health and mental health care as well as their use of mental health services, each twice over a one-year time frame.Methods: Mental health attitudes were assessed utilizing self-report scales assessing openness to seeking help, biases regarding mental health and mental health professionals, and breadth regarding beliefs about the origins of mental/emotional distress.Results: Findings suggested that grandparent caregivers were generally positive regarding their willingness to seek mental health care, biases regarding mental health professionals, and beliefs about the origins of emotional distress. Factors that predicted mental health attitudes reflected grandparent personal characteristics, aspects of caregiving, and sample demographics. There was a relationship between attitudes toward mental health and the use of mental health-related services, and having sought help was associated with mental health attitudes and emotional distress at both occasions of measurement and over the one-year timeframe. Some modest evidence was found for the role of openness to seeking help in partially mediating relationships between emotional/caregiving-related distress and mental health care use.Conclusion: These findings are important in understanding not only grandparent caregivers' attitudes toward mental health, but also can serve as a basis for enhancing their use of mental health care services.

Intergenerational exploration of traditional practices affecting child health: A phenomenological study.

BACKGROUND: All over the world, various traditional practices affect child health. The aim of our research was to explore the changes in traditional practices that affect child health between generations and to investigate the life experiences of generations in depth. METHODS: Using a phenomenological design, this study was conducted with semi-structured interviews with families of both generations (mothers and daughters). The study was written based on the COREQ checklist. FINDINGS: Four themes (traditional practices and intergenerational differences, beliefs/emotions related to traditional practices, influence factors in traditional practices, traditional methods in child care) and fourteen sub-themes (change in practices between generations, intergenerational transmission of traditional practices, beliefs in perceived benefits, skepticism and disbelief attitude, emotional reactions and perceiving as unnecessary, mother/mother in-law, traditional knowledge from mothers and grandmothers, family elders, the role of the internet and social media, spiritual practices, use of herbal products, alternative applications to medicines, relaxing applications, health consequences of traditional practices) were generated from the data. DISCUSSION: According to the findings, some harmless traditional practices are still relevant across generations, while harmful practices are mostly abandoned by new generations. The level of education and access to information has led the new generation to question traditional practices and show more interest in scientific knowledge-based methods. APPLICATION TO PRACTICE: This research can contribute to advances in child health by helping us understand beliefs, feelings, and influencing factors related to traditional practices. Maternal education and community awareness-raising campaigns can be used to reduce harmful traditional practices.

"Who is going to take care of these grandkids if I go?": End-of-life planning by caregivers in grandparent-headed households.

This qualitative study applied thematic analysis to semi-structured interviews with 15 key informants who self-identified as primary caregivers to at least one grandchild. Using Family Systems Theory and Theory of Planned Behavior as guiding frameworks, this study reports grandparent caregivers' end-of-life planning behaviors while illuminating factors influencing these behaviors. The analysis revealed two themes related to grandparents' communicative behaviors surrounding end-of-life planning (formal and informal behaviors) and four themes related to factors that influence grandparents' end-of-life planning (emotional paradoxes, legal/custodial conundrums, concerns about child wellbeing, and resources needed to plan). Findings extend end-of-life planning literature to often overlooked nontraditional family populations.

Respect Your Elders: Generativity and Life Satisfaction in Caregiving Grandparents.

Erikson's theory of psychosocial development defines generativity as the drive to benefit future generations and leave a legacy. Generativity has been shown to predict life satisfaction, but generative concern and action can be impacted by factors such as perceived respect from younger generations. This study utilized caregiving grandparents aged 40 and older to assess the extent to which perceived respect mediated the relation between generativity and life satisfaction. Perceived respect from a grandchild mediated the relation between generative concern expressed by caregiving grandparents and life satisfaction after controlling for demographic variables that have been shown to influence heterogeneity and overall well-being in caregiving grandparent samples. These findings suggest that the relation between life satisfaction and generativity in grandparents may depend, in part, on perceived respect from grandchildren, intimating that the implications of generativity may be influenced by the perceived appreciation of its recipients.

Early and continuing grandparental care and middle school students' educational and mental health outcomes in China.

Several recent studies have examined the relationship between grandparents and grandchildren, but few have examined the effects of early and continuing grandparental care on children's development in China. Using data from the China Education Panel Survey, this study examines the effects of early and continuing care, in which grandparents serve as primary caregivers on middle school students' educational (measured by academic performance and cognitive scores) and mental health (depression score) outcomes. Using multilevel analyses and robustness tests, the results show that for urban and rural students, students cared for by their grandparents showed no disadvantages in their educational outcomes. For rural students who received grandparental care in early childhood or adolescence academically outperformed those who received only parental care. Urban and rural students who received only grandparental care in early childhood and adolescence show worse mental health outcomes. These results challenge the prevailing belief that grandparent caregiving can harm grandchildren's school preparation and cognitive abilities.