[Perceived social support of people over 60 years who care for their grandchildren]. / Apoyo social percibido de personas mayores de 60 años que cuidan de sus nietos.

OBJECTIVE: The role of older people in today's society is important in supporting work-life balance and well-being. The aim of the study was to analyze the perception of the support they receive and the psychosocial well-being of people over 60years of age who take care of their grandchildren. METHODOLOGY: Cross-sectional descriptive observational study. A sample of people over 60years of age, who attended the pediatrics service in three health centers accompanying their grandchildren, during the first four-month period of 2018. They were administered the Duke-UNC questionnaire, with measures of social support and involvement in the care of their grandchildren. RESULTS: The majority cared for their grandchildren between 5 and 14hours per week, performing recreational and maintenance activities. The participants reported a significant relationship of the caregiver's role in their quality of life and well-being; 88% of the subjects perceived a high level of social support. Involvement in weekly caregiving hours did not correlate with worse perceived support. CONCLUSIONS: Older adults who care for their grandchildren and attend the primary care pediatrics service with them perceive an adequate level of social support, regardless of the number of hours spent doing so.

Experiences of primary health care nurses regarding the promotion of sexual reproductive health communication with grandparents in Tshwane District, Gauteng Province.

A qualitative, descriptive contextual design study was conducted to explore and describe the experiences of primary health care nurses regarding the promotion of sexual reproductive health communication with grandparents in Tshwane District, Gauteng Province. A non-probability, purposive sampling was used to select 12 Primary Health care nurses based in the Primary health care facilities within Tshwane District. An in-depth interview was used to collect data and Giorgio's five (5) steps were followed during data analysis. Ethical consideration was adhered to by ensuring confidentiality, anonymity, and privacy. All participants signed the consent form to indicate their willingness to participate in the study. Findings of the study revealed the following themes: Primary health care nurses (PHCNs) experiences of sexual and reproductive health communication, and PHCNs experiences of factors facilitating sexual reproductive health (SRH) communication. From the findings it can then be concluded that PHCNs understand facilitating factors to promote open communication with grandparents regarding SRH.

Une étude contextuelle qualitative et descriptive a été menée pour explorer et décrire les expériences des infirmières de soins de santé primaires concernant la promotion de la communication sur la santé sexuelle et reproductive avec les grands-parents dans le district de Tshwane, province de Gauteng. Un échantillonnage non probabiliste et raisonné a été utilisé pour sélectionner 12 infirmières de soins de santé primaires basées dans les établissements de soins de santé primaires du district de Tshwane. Un entretien approfondi a été utilisé pour collecter les données et les cinq (5) étapes de Giorgio ont été suivies lors de l'analyse des données. Des considérations éthiques ont été respectées en garantissant la confidentialité, l'anonymat et la vie privée. Tous les participants ont signé le formulaire de consentement pour indiquer leur volonté de participer à l'étude. Les résultats de l'étude ont révélé les thèmes suivants : les expériences des infirmières de soins de santé primaires (PHCN) en matière de communication sur la santé sexuelle et reproductive, et les expériences des PHCN sur les facteurs facilitant la communication sur la santé sexuelle et reproductive (SSR). À partir des résultats, on peut alors conclure que les PHCN comprennent les facteurs facilitant la promotion d'une communication ouverte avec les grands-parents concernant la SSR.

A scoping review of multigenerational impacts of grandparental exposures on mental health in grandchildren.

PURPOSE OF REVIEW: The multigenerational effects of grandparental exposures on their grandchildren's mental health and neurodevelopment are gaining research attention. We conducted a scoping review to summarize the current epidemiological studies investigating pregnancy-related and environmental factors that affected grandparental pregnancies and mental health outcomes in their grandchildren. We also identified methodological challenges that affect these multigenerational health studies and discuss opportunities for future research. RECENT FINDINGS: We performed a literature search using PubMed and Embase and included 18 articles for this review. The most investigated grandparental pregnancy-related factors were the grandparental age of pregnancy (N = 6), smoking during pregnancy (N = 4), and medication intake (N = 3). The most frequently examined grandchild outcomes were autism spectrum disorder (N = 6) and attention-deficit/hyperactivity disorder (N = 4). Among these studies, grandparental smoking and the use of diethylstilbestrol were more consistently reported to be associated with neurodevelopmental disorders, while the findings for grandparental age vary across the maternal or paternal line. Grandmaternal weight, adverse delivery outcomes, and other spatial-temporal markers of physical and social environmental stressors require further scrutiny. The current body of literature has suggested that mental and neurodevelopmental disorders may be outcomes of unfavorable exposures originating from the grandparental generation during their pregnancies. To advance the field, we recommend research efforts into setting up multigenerational studies with prospectively collected data that span through at least three generations, incorporating spatial, environmental, and biological markers for exposure assessment, expanding the outcome phenotypes evaluated, and developing a causal analytical framework including mediation analyses specific for multigenerational research.

Socioemotional and Behavioral Problems of Grandchildren Raised by Grandparents: The Role of Grandparent-Grandchild Relational Closeness and Conflict.

This study examined the associations of grandparent-grandchild relational closeness and conflict with grandchildren's socioemotional and behavioral problems, including emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. We analyzed primary cross-sectional survey data collected from custodial grandparents in the United States using logistic regression models. The results indicated that grandparent-grandchild relational closeness was significantly associated with lower odds of custodial grandchildren having emotional symptoms, conduct problems, peer problems, and abnormal prosocial behaviors, whereas grandparent-grandchild relational conflict was significantly associated with higher odds of emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. Implications for increasing grandparent-grandchild relational closeness and decreasing relational conflicts among grandparent-headed families are discussed, which might improve grandchildren's socioemotional and behavioral well-being.

Determinants of caregiving grandparents' physical activity and sedentary behavior: a qualitative study using focus group discussions.

BACKGROUND: Evidence on the factors influencing physical activity (PA) and sedentary behavior (SB) in middle-aged and older adults taking care of their grandchild(ren) is limited, even though this knowledge seems imperative when considering the unique relationship between grandparents and their grandchild(ren) as well as the rising popularity of intergenerational interventions targeting these energy-expenditure related behaviors. Therefore, this explorative qualitative study aimed to identify the determinants of PA and SB levels among Flemish caregiving grandparents in the presence of their grandchild(ren) aged between 0-5 years. METHODS: Six online focus group discussions were conducted via Microsoft Teams, all of which were audio- and videotaped with permission granted by the participating grandparents. In total, nine caregiving grandfathers and 28 caregiving grandmothers (overall mean age = 60.9 ± 4.1y) participated in this study. An inductive content analysis approach was used to derive subcategories, categories and themes from the verbatim transcribed data using NVivo R1. RESULTS: Caregiving grandparents' levels of PA and SB were both influenced by personal determinants (e.g., physical health, grandparental perceptions and responsibilities), interpersonal determinants (e.g., characteristics of the grandchild(ren), such as age-related physical/motor development and family interaction), and environmental determinants (e.g., weather and seasonal circumstances). PA levels of caregiving grandparents were further affected by additional personal determinants (e.g., age of the grandparent, planning and location) and interpersonal determinants (e.g., characteristics of the grandchild(ren), such as new experiences of the grandchild(ren)). Additionally, some personal determinants (e.g., perception of educational value) and interpersonal determinants (e.g., characteristics of the grandchild(ren), such as age-related cognitive development and health of the grandchild(ren)) were strictly mentioned to influence caregiving grandparents' SB. CONCLUSIONS: Acknowledging the unique relationship between grandparents and their grandchild(ren), the current study identified specific factors determining grandparents' PA and SB levels during the provision of grandchild care. Besides, it turned out of importance to take the interplay between the different determinants into account. Especially, for those grandparents with older grandchild(ren), within the studied 0-5 years age range, more attention should be paid to grandchild characteristics as part of the interpersonal determinants when setting up interventions to improve levels of PA and SB in caregiving grandparents.

The impact of retirement on body mass index in China: An empirical study based on regression discontinuity design.

An aging population is an important trend of social development, and it will be China's basic national condition for a long time. However, the pressure on domestic pension payments and economic operations will increase daily. The delayed retirement policy is gradually implemented as a critical initiative to improve capital and labor force allocation. The impact of retirement on residents' Body Mass Index (BMI) and weight has become a focus issue. This paper investigates the mechanism of the impact of retirement on residents' BMI using microdata from the China Family Panel Studies (CFPS) 2018, combined with a fuzzy regression discontinuity design to measure the potential health impact of China's current retirement policy on residents. The study finds that: (1) Retirement has a significant negative effect on BMI for women, with retirement leading to a significantly increased risk of deviation from normal BMI levels and significantly increasing the weight of retired women. However, retirement does not have a significant effect on men. (2) Retirement policies affect residents' BMI to different degrees depending on their family size, with the negative effect on women being more pronounced in smaller family sizes. (3) Female residents who retire to help their children with intergenerational care are more likely to maintain normal BMI levels, significantly positively affecting their potential health. (4) Retirement negatively affects BMI through channels such as significantly reducing exercise frequency among female residents. The study demonstrates that retirement policy impacts the BMI and weight of female residents, so the formulation and implementation of delayed retirement policy should be flexible, and family factors such as family sizes and intergenerational care should be considered appropriately.

The Profile of Stress and Coping Related to Successful Aging among Chinese Migrant and Non-migrant Grandparents.

BACKGROUND AND OBJECTIVES: Around eight million older adults have internally migrated to take care of grandchildren in China. This study aimed to explore how Chinese migrant and non-migrant grandparents perceived successful aging and how they coped with challenges to successful aging. RESEARCH DESIGN AND METHODS: Based on ecological systems theory, semi-structured interviews were conducted among 21 grandparents (12 migrants, median age = 59 years old) from urban areas in China who provided noncustodial grandchild care. Deductive content analysis was employed to examine the data pertaining to the definition of successful aging, the stressors encountered, and coping strategies employed by both groups. RESULTS: Findings revealed that both migrant and non-migrant grandparents placed a higher emphasis on family prosperity than their own physical health, in their definitions of successful aging. While both groups experienced common stressors in the microsystem (e.g., intergenerational conflicts), migrant grandparents uniquely encountered stressors in the mesosystem (e.g., hardships in their close relationships), and in the macrosystem (e.g., uncertainty in aging preparation). In terms of coping, migrant grandparents exhibited a distinctive pattern of utilizing avoidant coping strategies when navigating intergenerational conflicts and planning for their later life, compared to non-migrant grandparents. DISCUSSION AND IMPLICATIONS: Our findings suggested that although migration was not associated with grandparents' definition of successful aging, migrant grandparents encountered specific challenges in achieving successful aging. This highlights the necessity of providing more support to grandparents through the family, community, or state for grandparents, particularly to those who are migrants.

The Influence of Grandparents on Children's Dietary Health: A Narrative Review.

PURPOSE OF REVIEW: To examine and synthesise recent evidence on the role of grandparents in shaping children's dietary health. RECENT FINDINGS: The influence of grandparents on children's dietary health was evident across studies. Grandparents frequently provide their grandchildren with meals and snacks, and engage in many of the same feeding practices used by parents. Although grandparents report providing their grandchildren with healthy foods, the provision of treat foods high in sugar or fat was a common finding. This provision led to family conflict, with the indulgent behaviours of grandparents seen by parents as a barrier to healthy eating. Grandparents are exerting significant influence on child dietary health. Efforts are needed to ensure these care providers are considered key stakeholders in the promotion of healthy eating and are targeted in policies and programs addressing children's diets. Research that determines how to best support grandparents to foster healthy behaviours in children is critical.

The Twelve Ds: An Update to Edwards and Benson's Reasons for Non-Parental Caregiving.

This qualitative study examined the prevalence of the "Nine Ds," a framework developed by Edwards and Benson for understanding the heterogeneity of reasons for which grandparents assume care of grandchildren (i.e., death, disease, detention, divorce, departure, drugs, desertion, delivery, deployment) in a contemporary sample. Using a nationwide sample of custodial grandparents (N = 322) and foster parents (N = 105), caregivers were asked their reason for assuming care of the grandchild or foster child within their care. The results of the study suggest that the Nine Ds are a useful framework, but accounted for only 21.74% of responses, indicating the Nine Ds fail to capture many of the reasons for assuming care. Three new themes-dollars, duty, and daily grind-were identified using semantic thematic analysis and are applicable to both grandfamilies and foster families. These themes represent different motivations for assuming care and provide insight into the social structures that may act as barriers to family formation. This study provides a foundation for future research examining the impact of assumed care by non-parental attachment figures on the health and well-being of both grandchildren and foster children.

Grandparental co-residence and grandchild survival: the role of resource competition in a pre-industrial population.

Although grandparents are and have been important alloparents to their grandchildren, they are not necessarily only beneficial but can also compete with grandchildren over limited resources. Competition over parental care or other resources may exist especially if grandparents live in the same household with grandchildren and it can be dependent on grandchild age. By utilizing demographic data collected from historic population registers in Finland between 1761 and 1895 (study sample n = 4041) we investigate whether grandparents living in the same household with grandchildren are detrimental or beneficial for grandchild survival. Having a living but not co-residing grandmother or grandfather were both associated with better survival whereas having a co-resident grandfather was associated with lower chance to survive for infants (age < 1 year). Separating the effect between maternal and paternal grandparents and grandmothers and grandfathers revealed no differences in the effects between lineages. Negative effect of having a co-residing grandfather was not significant when grandfathers were separated for lineage specific models. These results implicate that accounting for the co-residence status and child's age, grandparents were mostly beneficial when not co-residing with very young children and that having a co-residing grandfather at that age could be associated with lower chances to survive. Predictions made by grandmother hypothesis and resource competition both received support. The results presented here also offered comparison points to preindustrial and contemporary three-generational families.

Grandchildren of grandparents with Alzheimer's disease: Exploratory study of the impact of the disease on their relationships.

The aim of this study was to describe the perception of changes that Alzheimer's disease in grandparents has made to the relationship with their grandchildren of between 6 and 13. Qualitative methodology was used. Semi-structured interviews were carried out with 25 grandchildren living in Catalonia, Spain. Participants reported a change in roles from being the care receiver to being the caregiver, changes in the activities that they did together and a positive impact on the grandparent's emotional wellbeing. In the physical sphere, sleeping problems were reported in grandchildren that cohabited with their grandparents. The feelings they described include fear of not being recognized by their grandparents and sadness, as well as satisfaction resulting from their affection and participating in caring. These findings suggest the need to provide information and resources for grandchildren and their families to enable them to deal with the disease.

Association between caring for grandchildren based on living arrangements and cognitive function among Chinese middle-aged and older adults: The mediating roles of social activities and depressive symptoms.

Introduction: In the context of an aging population and age-related conditions increasing, the increasing number of middle-aged and older adults are involved in grandchildren care. This study aimed to 1) explore the association between caring for grandchildren based on living arrangements and cognitive function among Chinese middle-aged and older adults; and 2) investigate the mediating roles of social activities and depressive symptoms in the aforementioned association. Methods: This study selected 5490 Chinese people (≥45 years old) from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Participants answered questions related to socio-demographics, the Mini-mental State Examination, the intensity of grandchildren care, the Center for Epidemiological Studies Depression Scale, and social activity. Results: The results showed that caring for grandchildren and cohabiting with a spouse was positively associated with cognitive function among Chinese middle-aged and older adults (B = 0.829, p < 0.001). Furthermore, there was a positive association between providing intensive or no-intensive grandchildren care and cognitive function. In contrast, caring for grandchildren but not cohabiting with a spouse was negatively associated with cognitive function (B = -0.545, p < 0.05). Moreover, directly and indirectly, caring for grandchildren was significantly associated with cognitive function among Chinese middle-aged and older adults, as mediated by social activities and depressive symptoms. Discussion: The findings emphasize that living arrangements, social engagement, and psychological health could be considered when encouraging grandparent care as formal care.

Actividad física intergeneracional y bienestar en la infancia / Intergenerational physical activities and well-being in childhood

El objetivo de este trabajo fue examinar si la práctica de la actividad física de ocio compartida entre abuelos y nietos se asocia con un mayor bienestar psicológico y físico en la infancia. Participaron en esta investigación 1080 niños y niñas de entre 6 y 12 años, 53,61% mujeres y 46,38% hombres, de la zona norte de España. Un 32,4% de niños practicaban actividad física de ocio con sus abuelos y opinaron que el ocio compartido con sus mayores les aportaba bienestar psicológico y físico. La práctica de actividad física compartida entre abuelos y nietos se asoció positivamente con un mayor bienestar físico y psicológico de los nietos. Las políticas de intervención social y familiar deben dirigirse a favorecer entornos de práctica de actividad física familiar intergeneracional por su contribución a la adherencia físico-deportiva de los menores y al incremento de su bienestar físico y psicológico. (AU)

The objective of this work was to examine whether the practice of physical activity shared by grandparents and grandchildren is associated with increased psychological and physical well-being in childhood. In this research, participants were 1080 children aged 6 to 12 (53.61% female and 46.38% male) from northern Spain. Concerning leisure, 32.4% of the children practiced physical leisure activity with their grandparents and considered that sharing leisure with their grandparents contributed to their psychological and physical well-being. The practice of physical activity shared by grandparents and grandchildren was positively associated with the grandchildren’s greater perception of physical and psychological well-being. Social and family intervention policies should be aimed at fostering intergenerational settings for family physical activity because of their contribution to children's physical-sports adherence and to the increase in children’s physical and psychological well-being. (AU)

Exploring grandparents' receptivity to and preferences for a grandchild nutrition-focused intervention: A qualitative study.

OBJECTIVE: Interventions promoting healthy eating in children typically overlook the critical role of grandparent caregivers. Utilising a co-design approach, this study (i) assessed the receptiveness of grandparents to a nutrition-focused resource aimed at promoting healthy eating in their grandchildren and (ii) explored grandparents' preferences for resource delivery and dissemination. METHODS: Seventy-nine grandparents (58% female; mean age=69.37 years) who were secondary carers to a grandchild aged 3-12 years participated in one of 10 focus groups. Focus group transcripts were imported into NVivo for coding and semantic thematic analysis. RESULTS: The vast majority of focus groups (n=9) were receptive to receiving a nutrition-focused resource. Participants indicated that such a resource should contain strategies that help grandparents promote healthy eating in their grandchildren rather than outline what grandchildren should be fed. A range of delivery (pamphlets, seminars and fridge magnets) and dissemination (online, email) methods were suggested. CONCLUSIONS: A nutrition resource that equips grandparents with the strategies they need to promote healthy eating in their grandchildren would likely be welcomed. IMPLICATIONS FOR PUBLIC HEALTH: Results provide program developers with the preliminary information required to tailor childhood lifestyle interventions to the needs of grandparents, thus helping increase acceptability and uptake.

Intensity of Grandparent Caregiving, Health, and Well-Being in Cultural Context: A Systematic Review.

BACKGROUND AND OBJECTIVES: Grandparents are key resources in grandchildren care globally. However, mixed findings indicated that multiple role engagement may enhance well-being and bring demands on grandparent caregivers in different contexts. This systematic review examines the association between the intensity of grandparent caregiving and their health and well-being (i.e., physical, mental, cognitive, and life satisfaction) by continent and country/region. RESEARCH DESIGN AND METHODS: Systematic searches were conducted in 4 databases. Peer-reviewed articles with quantitative designs published between 1990 and November 2021 were identified. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The studies were critically appraised, and their results were narratively synthesized. RESULTS: Sixty-five articles from 29 countries/regions were included. Findings suggested a concave curvilinear relationship between the intensity of grandparent caregiving and their health and well-being, with the optimal caregiving intensity varying across sociocultural contexts. In Europe, Oceania, the Middle East, and South America, providing supplementary or occasional care seems beneficial for grandparents' health and well-being, especially supporting dual-earner families. In East Asia, economic resources appear to buffer the adverse effect of primary care on grandparents' well-being. In the United States, findings vary across ethnicity/race. DISCUSSION AND IMPLICATIONS: Collectively, the intensity of grandparent caregiving, health, and well-being is complicated by grandparents' roles in the family and cultural differences. Acknowledging the bidirectional relationship between well-being and grandparents' capacity for providing care, the well-being as outcome is a limitation. Despite so, this systematic review calls for culturally-tailored family programs to support grandparent caregiving.

Grandchildren as Caregivers: Adding a New Layer to the Sandwich Generation.

Although 10% of family caregivers are grandchildren, only a few studies have examined the experience of grandchildren who provide care to grandparents. The current study examined the caregiving processes and outcomes of grandchild caregivers to grandparents. Participants were (N = 5,778) adults identified as a caregiver, including 311 adult grandchildren. Analyses showed that although caregivers to grandparents did not differ significantly from other family caregivers in terms of depression, grandchildren did differ on a variety of demographic and caregiving context variables. A hierarchical binary logistic regression showed that providing personal care and helping with household tasks contribute to the equation, however, grandchild status did not uniquely contribute to the equation after other elements of the caregiving and personal contexts were entered. Post-hoc analyses identified additional predictors within the group of grandchild caregivers. The current study is an important starting point in understanding the experiences of grandchildren caregivers.

Who cares? The grandmother kinship carers shouldering the burden within a gendered care economy.

It is estimated that around half of all kinship carers in the UK are grandparents. International studies show that when broken down by gender, these carers are predominantly grandmothers. However, there is little research exploring the gender dimensions of kinship carers' experiences. Drawing on data from qualitative interviews with 27 grandparent kinship carers, this article highlights the gendered context in which the grandparents we spoke to found themselves. The grandparents - the majority of whom were grandmothers - described lives filled with multiple unpaid caring commitments and demands. We discuss the ways that gender norms, roles and stereotypes, alongside economic models and policies that invisiblise women's care work, shaped the experiences of the grandmothers who took part in our research. We argue that, despite their undeniable determination and commitment to love, nurture and care for their grandchildren in very difficult circumstances, and the money they are saving the state in doing so, grandmother kinship carers are penalized in multiple ways. Economically, emotionally, socially, physically and practically, grandmother kinship carers are unsupported and undervalued. We need a social, economic and cultural shift around the value of care and a redistribution of care work across genders. The situations of grandmother kinship carers need to be part of this shift, so that grandmothers who care for their grandchildren are no longer penalized, and all kinship carers are properly supported and valued.

Stepping Up and Stepping In: Exploring the Role of Nurses in Supporting Grandparents Raising Grandchildren.

This study focused on the experiences of grandparents raising grandchildren in rural, Prince Edward Island, Canada. Termed grand-families, there are numerous reasons why grandparents must step up and step in to care for their grandchildren. Often these reasons are related to their adult children's struggles with mental illness and substance use disorders. Adopting Clandinin and Connelly's approach to narrative inquiry, we present findings from the conversational interviews conducted with 12 grandparents raising their grandchildren. Interview data were analyzed through the narrative dimensions of time, place, and relationship. Findings are presented as rich narratives which illuminate the evolution and storied experiences of grand-families. Particularly revealing are the challenges grandparents face as they navigate various systems, including health care, that do not acknowledge the uniqueness of their family form. Nurses work with grand-families across varied clinical settings. Grounded within the philosophy of Patient and Family Centered Care and family nursing theory, this article offers recommendations for supportive interventions that nurses can implement when caring for grand-families across clinical settings. This study has the potential to facilitate the development of evidence-based supports and services, which are responsive to the needs, realities, and complexities of grand-families.

Needs of Grandparents Raising Grandchildren: A Qualitative Study.

This study identified custodial grandparents' perception of sources of stress that may affect their health and better understand their needs. Findings from this qualitative study are based on thematic analysis of interviews with 10 custodial grandparents. The following themes emerged: 1) grandparents' stress from perceived lack of readiness to care for grandchildren; 2) need for effective communication between and among family members; 3) sufficiency of financial and legal resources; 4) access to community resources, and 5) raising grandchildren reenergizes and revitalizes grandparents' physical and mental health. These findings provide insight into the stressful aspects of the role of raising grandchildren. Understanding stressors affecting custodial grandparents and their grandchildren will help school nurses, social workers, teachers, school administrators and other professionals collaborate to address their challenges.