Sandwiched Grandparents and Biological Health Risks in China

This study examined the cross-sectional associations between intergenerational caregiving and health risks among sandwiched Chinese grandparents who provide care to grandchildren, great-grandparents, or both. Drawing on biomarker data from the 2011 wave of the China Health and Retirement Longitudinal Study (N range = 2,189–3,035), we measured age-related biological health risks of hypertension, diabetes, inflammation, and allostatic load. We found that health risks did not necessarily increase with the intensity of intergenerational caregiving. Providing care to grandchildren and great-grandparents simultaneously was not as detrimental to health as reported in earlier studies from the United States. Sandwiched grandparents could benefit from providing care to grandchildren or great-grandparents only. These unexpected findings might be related to the cultural mandates of filial piety and family solidarity in China. Grandfathers and grandmothers experienced different associations between varying types of intergenerational caregiving and health risks.

Italian Adolescent Young Caregivers of Grandparents: Difficulties Experienced and Support Needed in Intergenerational Care-Giving: Qualitative Findings from a European Union Funded Project

The article aims to describe the experiences of 87 Italian adolescent young caregivers (AYCs) of grandparents (GrPs), with reference to the caregiving stress appraisal model (CSA) that provides a theoretical lens to explore the difficulties encountered and support needed in their caring role. Qualitative data were drawn from an online survey conducted within an EU Horizon 2020 funded project. An inductive thematic analysis was carried out, and the findings were critically interpreted within the conceptual framework of the CSA model. The analysis highlighted three categories of difficulties: material, communication and emotional/psychological. The most common material difficulty was the physical strain associated with moving “uncooperative” disabled older adults. The types of support needed concerned both emotional and material support. The study provides a deeper understanding of the under-studied experiences of AYCs of GrPs. Based on these findings, policies and support measures targeted at AYCs of GrPs should include early needs detection, emotional support and training on intergenerational caring in order to mitigate the stress drivers. Moreover, the study advances the conceptualisation of the CSA model by considering the above-mentioned aspects related to intergenerational caregiving.

Intergenerational Caregiving Patterns, Living Arrangements, and Life Satisfaction of Adults in Mid and Later Life in China

While the health implications of intergenerational caregiving have been broadly investigated in the aging literature, less is known about caregivers in four-generation families and their living arrangements. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study ( N = 12,914 obs.), we document enhanced life satisfaction of grandchild caregivers and sandwich caregivers caring for both grandchildren and parents than non-caregivers. When further taking living arrangements into consideration, we find that parent caregivers also benefit from care provision when not living with their parents and sandwich caregivers only have an advantage when co-residing with care recipients with adult children present in households. By contrast, grandchild caregivers living with grandchildren show substantially higher life satisfaction no matter adult children are present or not. The subgroup comparison suggests that females and rural residents enjoy psychological advantages over their male counterparts and urban counterparts in grandparenting within skipped-generation households and sandwich caregiving.

Diverse Needs of Grandparents Raising Grandchildren: Qualitative Research in Malawi, South Korea, and the United States

Despite custodial grandparents’ significant contributions to their grandchildren’s healthy development, unique needs of older adults often remain unmet with a limited cultural understanding of intergenerational caregiving. Using a phenomenological approach, interviews and focus groups were conducted with 75 custodial grandparents in Malawi (n=29), South Korea (n=23), and the U.S. (n=23). Malawian grandparents presented financial and physical hardships; however, they experienced strong support from community. Korean grandparents reported similar needs as Malawian grandparents while additionally experiencing cultural biases toward grandparent-headed families (maternal grandparenting and adult child’s divorce). The U.S. grandparents disclosed increased needs for social support as well as family trauma with intergenerational impacts. The increase in custodial grandparent population across the world and findings from this comparative transnational research highlight the need for development of a model for culturally responsive practice with grandparent-headed families in a global context. Part of a symposium sponsored by the Grandparents as Caregivers Interest Group.

Intergenerational Caregiving Patterns, BMI, and Gender Gaps Among the Sandwich Generation in China

Existing literatures yield established evidence about the heightened stress brought by multiple roles and potential role overload across work-family context, but little is known about the BMI levels of the “sandwich” caregivers within families and the associated gender inequalities. Indeed, the Chinese pivotal generations are exposed to unshared stress and higher health risks considering that intergenerational support still predominates the caregiving patterns for the oldest old and dependent children under current socioeconomic backgrounds. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study (CHARLS, N = 12186), we examine associations of BMI and intergenerational caregiving patterns among the “sandwich generation” aged 45 to 69. We find that the sandwich generation with at least one parent alive and one grandchild under 16 have higher BMI (24.2, within obesity range) than their counterparts (23.7, within normal range). A higher proportion of females act as caregivers and especially high-intensity caregivers than males, and they also score one-unit higher in BMI than males (23.4). Fixed effect regression results indicate that simultaneous caregiving to both parents and young grandchildren significantly advances individuals’ BMI levels, while no evidence shows similar negative effect of providing care to one generation. Moreover, high-intensity caregiving (1000 hours and above during the past year) is associated with elevated BMI for females but not for males. The gendered caregiving patterns and health implications inform the physical and psychological vulnerability of the pivotal generation and the necessities of gender-specific intervention in middle and later life.

Needs of and Services for Grandparents Raising Grandchildren: Regional, National, and International Perspectives

Grandparents raising grandchildren build strong foundations for their grandchildren. Despite grandparents’ significant contributions to their grandchildren’s future and society in general, there is a limited understanding of the unique needs and service utilization of grandparents raising grandchildren in various contexts. This symposium is focused on the needs of and services for the grandparent population at the regional, national, and international levels. Stucki will present findings from an examination of types and locally available services for grandparents raising grandchildren in Appalachia by sub-region. Musil and colleagues will discuss the service need utilization and unmet service needs of a nationwide sample of 284 grandmothers living with/ raising grandchildren and the relationships between service use/need and resilience, resourcefulness, perceived stress, reward, and appraisals of their current living environment for themselves and their grandchildren. Lastly, Lee will describe research findings from her comparative transnational research on needs and experiences of grandparents raising grandchildren in Malawi (n=29), South Korea (n=23), and the U.S. (n=23). Unique needs and cultural interpretation of intergenerational caregiving in each country will be presented. The symposium discussion will address diverse needs of grandparents raising grandchildren and strategies to meet those needs at regional, national, and international levels. Grandparents as Caregivers Interest Group Sponsored Symposium.

Perspective-Taking Interventions for Intergenerational Caregivers of Alzheimer’s Diseases: A Randomized Controlled Trial

Purpose: The present study examined the effects of perspective-taking (PT) intervention in the context of intergenerational caregiving. Method: Seventy-two adult child caregivers of persons living with Alzheimer’s disease (AD) were randomized into two 8-week interventions: (1) connecting through caregiving (CTC: 37 participants) with intergenerational PT reappraisals and (2) basic skill building (BSB: 35 participants). The CTC intervention focused on PT reappraisals aiming to promote balance between self-care and caring of others: (1) connecting with self through enhancing self-awareness, (2) connecting with the care recipient through empathetic understanding, and (3) connecting with others who can help. Results: As compared to the BSB group, the CTC group reported significantly higher increase in the level of life satisfaction and also greater reductions in depressive symptoms and burden. PT was found to mediate between intervention effects and change in life satisfaction. Discussion: The results provided evidence for the efficacy of the CTC program in enhancing the well-being of AD caregivers.

“Everybody Takes Care of Everybody”: Care Circulation and Care Relations in Three-Generation Cohabitation

Demographic changes in Western societies have enabled long-term relationships between more generations and have significantly affected the structure and dynamic of family lives and contemporary families. This article presents a case study of three-generation cohabitation, the situation in which three generations live together in the same place at the same time. Drawing on in-depth interviews with three generations—grandparents, parents, and adult grandchildren—the article illuminates the characteristics of intergenerational caregiving and care-receiving. It uses the concept of care circulation to explore the everyday repeated exchanges of care among all family members and the caregiving constellations, arrangements, and distributions across the generations. We argue that the care is not unidimensional and unidirectional; rather, the care circulates among the family members cohabiting in three-generation households who are at the same time both caregivers and care-receivers.

International Perspectives on Grandparents Raising Grandchildren: Contextual Considerations for Advancing Global Discourse

Globally, it is common for grandparents to serve as surrogate parents to their grandchildren, often in response to family crises and other challenges such as poverty, disease epidemics, and migration. Despite the global nature of this intergenerational caregiving arrangement, there have been few contextually focused examinations of how grandparents’ surrogate parenting roles are enacted across countries and cultures. This analytic review addresses this issue by exploring demographic and cultural contexts, needs and experiences, and formal and informal supports for grandparents raising grandchildren in four diverse countries: China, New Zealand, Romania, and South Africa. We conclude our analysis by discussing key contextual factors, and their associated interrelationships, from which future research may elucidate how cultural, historical, and sociopolitical factors uniquely shape grandparents’ experiences. We also make recommendations for contextually informed policies and practice.