It is 5:30 a.m., and the housing projects of Brooklyn form a dim silhouette against the breaking day. The lights have been on in Mrs. S.'s apartment for half an hour, illuminating her strong, tender hands as they bathe and dress her 7-year-old granddaughter, who has cerebral palsy. The ritual is second nature; the child has been with Mrs. S. since birth. The routine is carefully timed, for two other grandchildren, ages 10 and 12, need to get to school, and a six-month old infant will soon wake.
Mrs. S. is special, but she is not alone. In 1980, the Bureau of the Census estimated that 2.0 million children lived with a grandparent (U.S. Bureau of the Census, 1991). In 1990, 3.4 million children 5% percent of all children under age 18-lived with a grandparent (U.S. Bureau of the Census, 1991).
This upward trend is due to a combination of structural changes in multigenerational families, such as longer lifespans and fewer children per generation; the outbreak of tragic social health problems, notably the crack: cocaine and HIV/AIDS epidemics; and the changing sociocultural norms and public policies that govern familial responsibility (Burnette, forthcoming).
Previous studies show that caregiving grandparents are at increased risk for emotional and physical health problems, social isolation, family conflict, and legal and financial obstacles. In a study of 74 African-American grandmothers canny for young kin due to the crack addiction of adult children in Oakland, California, Minkler and Roe (1992) found extraordinary dedication to childrearing commitments, but at enormous personal costs such as anger, despair and frustration. In a study of 60 grandparent caregivers in two urban African-American communities, Burton (1992) found that parenting grandchildren was emotionally rewarding, but at considerable psychological, physical and economic costs.
Family assistance for grandparents in their role as surrogate parents was sparse in both of these studies--only 3% of Burton's respondents reported having consistent familial support. Johnson and Barer (1990) found that older African-Americans in San Francisco who lacked adequate kin support tended to generate "fictive kin" (distant or nonfamilial support) to fill this gap.
Issues of private versus public responsibility for family welfare are complex, emotional and highly politicized. Empirical data on informal and formal support needs of grandparent caregivers and the efficacy of programmatic responses to these needs are limited. More research is needed to provide useful data, and more attention must be paid to the types of assistance that exist to fulfill the multifaceted needs associated with parenting grandchildren.
Support groups are the most common intervention for helping these grandparents cope with multiple life stresses. These rapidly proliferating groups are now tracked by a National Grandparent Information Center funded by the American Association of Retired Persons and the Brookdale Foundation Group. The content, format and usefulness of these groups appear to be quite variable. Only a few specific examples are documented in the literature. Vardi and Buchhok (1994) described a year- long psychotherapy group for eight grandmothers in which a psychoanalytic developmental orientation was employed.
Consistent with this approach to intervention and the need to conduct research and evaluation in this area, CUSSW Assistant Professor Denise Burnette and a group of JBFCS staff launched a structured, time-limited group intervention and a study to assess its efficacy in 1994. Partial funding for the development of the gmap and the study was provided by the Willma and Albert Musher Fund (see Musher Professorship Announced, page 5). Although it was originally designed as a quasi- experimental pretest-posttest study with a wait-list comparison group, time constraints prohibited recruitment of a comparison group. Outreach was targeted to all grandparent caregivers of children at a New York: City elementary school through its JBFCS on-site mental health program.
Eleven grandparents were selected. Group members, 10 African-American grandmothers and one Latino grandfather, were found to be similar to the "typical" profile of previous studies. Mean age was 57 and over half were widowed. Three- fourths reported that they were "doing okay" financially while the others were "barely getting by" Group members were canny for 2.67 grandchildren on average (range 1-5). About one-third of children had special physical, social, emotional and/or educational needs. Reasons given for caregiving were substance abuse, HIV/AIDS, incarceration and/or death of grandchildren's parents.
The nine sessions that comprised intervention were based on principles of psychoeducation and mutual aid. Educational material on designated topics were combined with discussion of the members' own experiences. Session topics included: 1. introductions/overview; 2. sodal supports: family friends and community; 3. stress and coping; 4. interpersonal family issues; 5. parent skills training; 6. Iegal and social services: rights, responsibilities, and entitlements; and 7. community-based initiatives.
Standardized instruments were used to gather data on venous dimensions of the group members' physical and mental health, well being, stress and coping, and social support. Pretest data suggest that group members were functioning quite well despite many challenges. Scores on the General Health Questionnaire (Goldberg & Hillier, 1979) were in the "nominal" range with none above the clinical cutting score. On the subscales, members showed highest scores for "anxiety and insomnia," "social dysfunction," and "somatic symptoms." Scores on "severe depression" were extremely low.
Randy Tanzer, CSW (JBFCS) Group Leader and Grandparents Group
The Ways of Coping (revised) instrument (Folkman et al., 1986) was used to assess the relative use of eight styles of coping with problems in caregiving. Group members used positive reappraisal most often, followed by (in descending order): seeking social support, problem solving, distancing, confrontation, accepting responsibility, and escape-avoidance.
The Social Support Behaviors (SS-B) Scale (Vaux, Riedel, & Stewart, 1987) was used to assess support from family and friends. Members' scores were generally very high. On a scale of 1-4, support from friends averaged 3.7, from family 3.9. With respect to specific dimensions of support, highest ratings from family were on emotional support, followed by financial, practical, advice, and socializing types of support. Emotional support also ranked highest for friends, with practical, advice, socializing, and financial support following. Knowledge of and need for 14 different types of services also were assessed. Members expressed both lack of knowledge about the special needs of their grandchildren, and the need for such services. Other services needed by at least half of group members were education/counseling for special emotional needs of children, counseling for self, respite childcare services, stress management techniques and education about social problems. Posttest measures of the standardized scales are being analyzed to determine if specific areas of knowledge and/or functioning improved with group sessions.
Qualitative data will be examined to further assess group outcomes. Audiotapes of the nine sessions will be analyzed for content and process. During the last group meeting, members convened congenially about the flow of everyday lifeólooking back, forward and living today As they prepared to disband for the summer, Mrs. S. was networking among members to seek support for her work during the next school year as President of the Parent Teacher Association. Clearly, much repetition exists in this cycle of life that revolves around child-rearing for three, four, even five decades. Yet, continual learning and growth also are possible, as evidenced in this group.
Principal Investigator: Denise Burnette, PhD, MSSW (CUSSW) Group Leader and Project Facilitator: Randy Tanzer, CSW aBFCS) Project Facilitators: Jennifer Crumpley, CSW; Jonathan Katz, CSW; Vickie Rosenstreich, ACSW and Ruby Thompson, CA (JBFCS)
1. Burnette, D. (forthcoming). One more time with (mixed) feelings: Grandmothers parenting grandchildren. In B.L. Simon PH. Mayhew (Eds.). Single women in America since 1945. New York: Greenwood Press.
2. Burton, L.M. (1992). Black grandparents rearing children of drug- addicted parents: Stressors, outcomes, and social service needs. The Gerontologist, 32 (6), 744-751.
3. Folkman, S., Lazarus, R.S., DunkelSchetter, C., DeLongis, A. & Gruen, RJ. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. J Personality and Social Psychol, 50 (5), 992-1003.
4. Goldberg, D.P & Hillier, VF (1979). A scaled version of the General Health Questionnaire. Psychological Med, 9, 139-145.
5. Johnson' C.L. & Barer, B. (1990). Families and networks among older inner city blacks. Gerontologist, 30 (6), 726-733. . Minkler, M. & Roe, K. (1992). Forgotten Caregivers: Grandmothers Raising the Children of the Crack Cocaine Epidemic. Newbury Park, CA: Sage.
7. U.S. Bureau of the Census (1991). Current population reports: Mental status and living arrangements: March 1990. (Series P-20 No. 450). Washington, DC: U.S. Government Printing Office.
8. Vaux, A, Riedel, S. & Stewart, D. (1987). Modes of social support: The Social Support Behaviors (SS-B) Scale. Am J Comm Psychol, 15 (2), 209-237.