Concerns and supports of grandfamilies using formal services: Do they have the help they need?

The objective of this study was to discover the functional and psychosocial concerns of grandfamilies already receiving support services in their community, and to ask if they had the help they needed. Data were gathered from a convenience sample of 16 grandparents who were raising their grandchildren and were involved with a grandfamily support group or workshop. Results indicated that these grandparents experienced psychosocial concerns (i.e., child’s emotional problems) and functional concerns (i.e., financial strain). Suggestions are included for further development of this measure as derived from the literature, service provider observation, and grandfamily perspectives. GrandFamilies Vol. 3(1) 2 Introduction Recognition that more grandparents have the primary responsibility for their grandchildren today has resulted in many community agencies and organizations providing programs and resources, such as support groups, informational websites, and educational workshops (Fruhauf & Hayslip, 2013). Despite some success in providing support, public policies and programs such as financial or medical care (e.g., Temporary Assistance for Needy Families [TANF]; Medicaid for children) have availability or eligibility requirements that do not adequately meet all needs. As of 2012, 10% of children in the United States lived with a grandparent or grandparents, in either a threegeneration household, or in mostly informal arrangements with one or two grandparents (Dunifon, Ziol-Guest & Kopko, 2014). Dunifon et al. report that this figure represents an increase in grandfamilies during the years of the Great Recession, beginning in about 2008. As Backhouse and Graham (2012) also point out, the number of grandparent-headed households is increasing, particularly those in which grandparents may be the only adults responsible for the children in the home on a day-today basis. A possible reason for the difficulty some grandparents have in obtaining the specific support they may need is that recognizing grandparents raising grandchildren as a normative family structure is not yet accomplished in the United States. Thus, there is a cultural lag in developing resources that include grandparents who have primary responsibility for their grandchildren, especially if the living arrangement is not formalized by custody, guardianship or allocation of parental rights (Van GrandFamilies Vol. 3(1) 3 Etten, & Guatan, 2012). Although grandparents report that they love their grandchildren, they do not want them taken away from the family, and are committed to stepping in to raise them when needed, being full-time parents again can result in concerns about raising and providing for children, even when grandparents participate in community support services. This paper is a report on the findings of an exploratory needs assessment of grandparents who were already involved in some form of community support. Although this is a population well-studied in the literature (e.g., Hayslip, 2000; Kolomer, McCallion, & Overeynder, 2003; Monahan, 1994), we found that grandfamilies in our communities were still facing difficulties, despite support groups, workshops, and task force engagement with grandparents among various agencies and organizations. In particular, the purpose of this research was to discover the ongoing concerns grandparents had about raising their grandchildren, even though they were already attending support groups or informational events designed specifically for them. For this article, the term “grandfamilies” is used to define grandparents or other older relatives who are head of households and have the primary responsibility for a relative’s minor children. Based on prior research and our experience with grandfamilies in our communities, we wanted to discover the nature of any unmet needs or concerns, despite formal affiliation. Issues of interest for this study included reasons that grandparents take over care (Backhouse & Graham, 2012; Sands & Goldberg-Glen, 2000; Templeton, 2012), psychosocial difficulties for grandparents (Bundy-Fazioli, Fruhauf, & Miller, 2013; Sands, Goldberg-Glen, & Thornton, 2005) and the grandchildren (Edwards, 2006; GrandFamilies Vol. 3(1) 4 Hayslip & Kaminski, 2005a; Keller & Stricker, 2003), family dynamics involving the child’s parent or parents (Gladstone, Brown, & Fitzgerald, 2009; Strong, Bean, & Feinauer, 2010), service use and unmet needs of grandparents (Yancura, 2013), outcomes based on whether the grandparent has formal custody or informal charge of grandchildren (Kolomer, 2008), and the challenges often associated with parenting and working with school systems (Edwards & Sweeney, 2007), including pediatric health care, and other day-to-day needs in the lives of minor children (Baird, 2003). Despite the recent body of literature, grandparents' responsibility for grandchildren is not entirely new, especially among populations that include grandparents as part of an extended family in which day-today contact and child care among all adult members is normative (Chen, Liu, & Mair, 2011; Mollborn, Formby, & Dennis, 2011; Settles, Zhao, et al., 2009). Theoretical Perspective A theoretical framework that guided this research, and is particularly relevant for studying the grandfamily experience, is the bioecological approach (Bronfenbrenner, 2005). In particular, previous versions of Bronfenbrenner's (1979, 1989) ecological approach can “address the multiple needs of grandparent caregivers” (Cox, 2003, p. 133) because of its emphasis on the complex, inseparable interaction of the individual with his or her environment. Bronfenbrenner's (2005) last contribution before his death addresses the bioecological framework and includes describing a proximal process of individual/environment interaction and the roles and behaviors of the individual in his/her environment over time (Bronfenbrenner, 1994). This interaction influences the individual not only in his or GrandFamilies Vol. 3(1) 5 her near environment (e.g., the amount and quality of interaction among individuals living in a grandfamily household), but in the context of wider cultural norms, social norms, and institutions (e.g., whether or not it is acceptable for grandparents to live with and/or raise grandchildren in one’s culture; the social expectation that retired older adults will enjoy leisure without the task of child rearing; lack of recognition of informal grandfamilies by schools, such that grandparents cannot access information about the student, etc.). For a more specific description of the components of this model, see Bronfenbrenner (e.g., 1979, 1989, 1994, 2005). In the context of the current study, the proximal/environment interaction takes place within each unique grandparent/grandchild family situation, but those grandfamilies are also functioning within the communities in which they live, work, go to school, and carry out the individual roles of each family member. Although Bronfenbrenner’s work focused mostly on child development, additional study on adult development over a lifetime (e.g. Baltes & Schaie, 1973) suggests that an ecological approach is also relevant for adult experiences. In the United States, child rearing is considered to be the role of a parent or parents, and despite some culturally based exceptions, situations in which other relatives take on this responsibility are traditionally seen as outside the norm (Bengston, 2001; Gerstel, 2011). Grandfamilies may be especially vulnerable to the disruption of proximal process, not only because full responsibility of grandchildren by grandparents is not normative at the macro level (because society generally dictates that children should be raised by their own parents), but also because of micro level experiences. For example, grandparents are often retired, GrandFamilies Vol. 3(1) 6 are older than parents of the grandchild’s peers, and believed they had finished being the primary caregiver for children. Whatever individuals consider to be their role as grandparents, the necessity of functioning as a full-time parent can result in stress and other psychosocial difficulties due to multiple roles and/or role conflict (Landry-Meyer & Newman, 2004). Finally, grandparents report that they were caught off guard, with no time to prepare for this major shift in daily life (McGowan & Ladd, 2006). Concerns about the adjustments, knowledge, and parenting tasks needed may add difficulty to the grandfamily situation. Review of the Literature Formal Intervention and Support Formal community-based support intended specifically for grandparents has been implemented through various means (Fruhauf & Hayslip, 2013). Some communities are able to maximize a portion of funding from the Older Americans Act National Family Caregivers Support Program to implement a community task force or coalition for grandfamilies (Fruhauf, Bundy-Fazioli, & Miller, 2012). Other resources have begun informally, with grandparents themselves creating local support groups that in some cases grew into national organizations with country-wide membership. For example, Grandfamilies of America (GAP) was created due to the efforts of grandparents who had formed a support group in Maryland (Jackson, 2011). Services offered through formal means in some communities include cost-free grandparents raising grandchildren support groups and access to information GrandFamilies Vol. 3(1) 7 about services in the community, such as the single entry point information and referral services of Area Agencies on Aging (AAA). Information may include eligibility requirements and application procedures for TANF or Medicaid coverage for grandchildren. A local AAA may also be involved in providing support for coalitions or task forces specifically focused on providing information and programs for grandfamilies (Cox, 2009; Fruhauf et al., 2012). Many of today’s grandparents do not qualify to obtain formal support services. In some cases, this is due to the grandparent not being the parent or legal guardian. As a result, grandparents are not eligible for financial or legal assistance through formal children and family services (Kolomer, 2008). Even when grandparents establish formal custody, become foster parents, assume allocation of parental rights, or adopt grandchildren, there are restrictions on formal supports such as TANF, the Supplemental Nutrition Assistance Program (SNAP), and Old-Age, Survivors, and Disability Insurance (OASDI) that prevent them from qualifying for services (Mills, GomezSmith, & De Leon, 2005). These programs often depend on characteristics of the grandchildren, such as the grandchild having special needs, or being orphaned (Cox, 2009; Ehrle & Clark, 2001), not on a grandparent’s need for assistance. The situation for grandfamilies not quite financially eligible for adult subsidies does not fit into most current formal financial support programs. For example, TANF requires not only low income eligibility for single parents but the ability to work or seek further education. While this may be useful for younger grandfamilies who can work if they have child care, older adults raising grandchildren may not GrandFamilies Vol. 3(1) 8 have the physical health status or child care options to fulfill TANF work requirements. Another financial barrier for grandparents is that they may not yet be old enough to obtain age-based resources such as Social Security retirement benefits or Medicare (Fruhauf, Pevney, & Bundy-Fazioli, 2015; Hayslip & Shore, 2000). In addition, younger grandparents without legal custody are not only ineligible for many of the resources available, but also may not have the financial resources needed to raise children (Gladstone et al., 2009), especially if doing so requires that grandparents exit their employment to provide care (Silva & Clark, 2006). Formal support also includes private-pay services, such as mental health care, legal advice, and babysitting, which is something that many grandfamilies cannot afford. During the recent Great Recession beginning in 2008, there was an increase in multi-generational and grandfamily households, which placed even more financial burden on these families, especially households consisting only of one grandparent and the child or children (Dunifon at al., 2014). One type of support that is generally available to all grandfamilies, without financial consideration or an age eligibility requirement, is grandparents raising grandchildren support groups (Kolomer, 2008). These may be facilitated by professionals and paraprofessionals connected to private entities, such as churches, or through formal community organizations, such as AAA, Catholic Charities/Lutheran Family Services, or Cooperative Extension Programs. Researchers have reported the efficacy of such groups for reducing feelings of isolation and depression (Kolomer, McCallion, & Overeynder, 2003; Leder, Grinstead, & Torres, 2007), learning about other resources in the community that could be helpful GrandFamilies Vol. 3(1) 9 (Monahan, 1994), and providing a place to feel appreciated and understood (Strom & Strom, 2000). Most of the research on grandparents raising grandchildren has been conducted among grandparents who were already affiliated with some form of formal support, particularly support groups. While this has been cited as a limitation to understanding a broader range of grandfamily experiences who may not attend such groups (e.g., DolbinMacNab, 2006), it has also been noted that there is often merely a sharing of helplessness and defeat during group meetings (Strom & Strom, 2000) as well as a lack of rigorous attention to evaluating in what ways such networks are actually providing useful support (Smith, 2003). Purpose of This Study The purpose of this exploratory research was to determine if grandfamilies, already affiliated with formal support in the community perceived they were getting the help and support they needed, and to test a measure specifically developed for these individuals. The literature base (see Baird, 2003; Backhouse & Graham, 2012; Gladstone et al., 2009; Goodman, Potts, & Pasztor, 2007; Kolomer, 2008) provided an understanding of common functional and psychosocial concerns of grandfamilies. Functional and psychosocial concerns were of interest because all three authors have direct involvement with grandparents raising grandchildren support services in their respective communities. It was through their affiliations with service providers and grandparents that they discovered that needs described in the literature by grandparents were still concerns for those individuals using support services. GrandFamilies Vol. 3(1) 10 For the present study, the authors explored concerns perceived by grandfamilies already affiliated in some way with formal support services in order to determine if expressed challenges represented a pattern of continuing need that would help service providers address such needs. This research study was the logical next step from our previous qualitative work exploring grandparents’ health and self-care practices as it relates to receiving support services (Bundy-Fazioli, Fruhauf, & Miller, 2013; Fruhauf & Bundy-Fazioli, 2013). The research questions guiding this study were: (1) What are the serious concerns perceived by grandfamilies who are already affiliated with formal support? (2) Are serious concerns related to whether or not grandfamilies perceive that they have help and support?