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.

Presence at a distance: Video chat supports intergenerational sensitivity and positive infant affect during COVID-19.

COVID-19 disrupted infant contact with people beyond the immediate family. Because grandparents faced higher COVID-19 risks due to age, many used video chat instead of interacting with their infant grandchildren in person. We conducted a semi-naturalistic, longitudinal study with 48 families, each of whom submitted a series of video chats and surveys, and most (n = 40) also submitted a video of an in-person interaction. Families were mostly highly-educated, White/Caucasian, and lived between 1 and 2700 miles apart. We used multilevel models to examine grandparents' and parents' sensitivity during video chat across time (centered at February 1, 2021, the approximate date of vaccine availability). Grandparent video chat sensitivity changed as a function of date and parent sensitivity. Parent sensitivity changed as a function of date, grandparent sensitivity, and geographic distance. We then modeled infants' affective valence during video chat and in-person interactions with their grandparents, which was only predicted by grandparent sensitivity, not modality or other factors. This study demonstrates that caregivers were sensitive toward infants during video chat interactions despite fluctuations in family stress and reduced in-person contact during COVID-19 and that grandparent sensitivity predicted positive infant affect during both video chat and in-person interactions.

Difficulties and Needs of Adolescent Young Caregivers of Grandparents in Italy and Slovenia: A Concurrent Mixed-Methods Study.

Many adolescent young caregivers (AYCs) care for a grandparent (GrP) with chronic disease, especially in countries with no or low developed long-term care systems and/or level of awareness of and policy responses to young caregivers. This mixed-methods study aimed at shedding light on the needs and difficulties faced by a sample of 162 adolescents aged 15-17, caring for GrPs, living in Italy (87) and Slovenia (75), respectively. A multiple linear regression model was built for the quantitative data. Qualitative data were content analysed using an open coding process. Italian and Slovenian respondents reported a moderate amount of caring activity and relatively high positive caregiving outcomes. Nevertheless, one out of three AYCs reported health problems due to their caring responsibilities. Compared to their Italian counterparts, Slovenian respondents were supported to a lesser extent by public services. Italian respondents faced communicative and practical problems; Slovenian AYCs experienced mainly emotional discomfort. AYCs from both countries requested emotional and practical support from formal services and family networks. Further, Slovenian AYCs requested emotional support and a personalized learning plan from schoolteachers. Support measures aimed at training AYCs of GrPs on geriatric care are recommended to address specific issues related to ageing and long-term care needs.

Using a Virtual Platform for Conducting Grandfamily Research.

BACKGROUND: Because of the COVID-19 pandemic, our research team quickly pivoted from planned face-to-face interaction with participants to virtual interactions. During this transition, we discovered invaluable new practices for conducting research remotely, including collecting physiological data. OBJECTIVE: Our objective was to describe the methodological challenges we encountered when conducting this research virtually with grandparent-grandchild dyads and describe the strategies we developed to overcome those challenges. Of primary focus were procedures for finger-stick blood sample collection. Of secondary focus were procedures for conducting virtual-based research with older adults and across multiple generations. METHODS: During an observational study utilizing a virtual platform with 11 grandparent-grandchild dyads (mean age: 64.2 ± 5.0 years for grandparents and 9.3 ± 1.9 years for grandchildren), we documented lessons learned (based on the discussion within our team and feedback we have received from participants) that could be applicable for other, similar research endeavors. RESULTS: We found several challenges in collecting blood samples, including staff were unfamiliar with providing online instruction and participants needed to develop familiarity with the blood sample collection process (without having in-person assistance), and we had to develop methods for delivering blood sample collection kits to participants safely. We also found that it took longer than expected to run procedures-a challenge that might be encountered when conducting any type of dyadic research utilizing a virtual platform-particularly involving older adults and across multiple generations. In addition, it was challenging to keep child participants engaged in the virtual interactions. We document how we employed targeted strategies to overcome those obstacles. Recommendations for strategies from our team include to provide comprehensive and clear instruction/materials on blood sampling procedure, offer generous support throughout the blood collection process, be prepared to divide study visits into more than one session as needed, proactively anticipate potential roadblocks, and carefully consider the participants' developmental stages and attention span. DISCUSSION: The insights we gained will help inform future research with grandparent-grandchild dyads in remote or rural populations utilizing virtual platforms.

Grandparents' Mental Health and Lived Experiences while Raising Their Grandchildren at the Forefront of COVID-19 in Saudi Arabia.

Understanding grandparents' lived experiences and healthy aging is essential to designing efficient, effective, and safe services to support a family structure in which grandparents care for their grandchildren. However, no study to date has explored this concept in an Arab and Muslim country during a pandemic. The purpose of this study was to examine grandparents' experiences raising their grandchildren to provide recommendations for needed mental health interventions during and after COVID-19. We used a phenomenological approach to gain a detailed and in-depth understanding of the lived experiences of 15 grandparents caring for their grandchildren. This study shows the need for support service interventions (support groups, health professional support, and respite care) for grandparents in Saudi Arabia, especially during global crises like COVID-19, that enhance social distance and social isolation. Raising grandchildren affects the physical, mental, and social wellbeing of the grandparents.

Grandparents' and Grandchildren's Shared Festive Leisure.

Festive leisure provides experiences that can generate intergenerational well-being. The study aimed to examine the festive leisure activities shared by grandparents and grandchildren, and the link with times, spaces, motives, and well-being that these activities bring to both generations. A cross-sectional telematic survey was carried out with 357 grandparents living in the northern part of Spain, who had grandchildren aged between 6 and 12 years. Both a descriptive and inferential analysis was performed. A high proportion of grandparents and grandchildren share festive activities, which occur on weekends and holiday periods. Private spaces, such as bars, cafeterias, and restaurants are the ones chosen for going out to eat or drink, and open public spaces like parks, squares, and streets are dedicated to traditional festivals, and are excellent scenarios for coexistence and intergenerational social interaction. The reasons that drive this practice are associated with the strengthening of emotional ties and family intimacy. Grandparents consider the practice of shared festive leisure to be beneficial for their personal development because they perceive that, thanks to this leisure, they improve their creativity, physical condition, their happiness and fun, the relationship with their grandchildren, and develop new manual and technical skills.

Material hardship and child neglect risk amidst COVID-19 in grandparent-headed kinship families: The role of financial assistance.

BACKGROUND: COVID-19 has exacerbated material hardship among grandparent-headed kinship families. Grandparent-headed kinship families receive financial assistance, which may mitigate material hardship and reduce child neglect risk. OBJECTIVE: This study aims to examine (1) the association between material hardship and child neglect risk; and (2) whether financial assistance moderates this association in a sample of kinship grandparent-headed families during COVID-19. PARTICIPANTS AND SETTING: Cross-sectional survey data were collected from a convenience sample of grandparent-headed kinship families (not necessarily child welfare involved) (N = 362) in the United States via Qualtrics Panels online survey. METHODS: Descriptive, bivariate, and negative binomial regression were conducted using STATA 15.0. RESULTS: Experiencing material hardship was found to be associated with an increased risk of child neglect, and receiving financial assistance was associated with a decreased risk of child neglect in the full sample and a subsample with household income > $30,000. Receiving financial assistance buffered the negative effect of material hardship on child neglect risk across analytic samples, and receiving SNAP was a significant moderator in the full sample. Among families with a household income ≤ $30,000, receiving SNAP and foster care payments was associated with a decreased risk of child neglect, while receiving TANF and unemployment insurance was associated with an increased risk of child neglect. Among families with household income > $30,000, only receiving SNAP was associated with a decreased risk of child neglect. CONCLUSIONS: This study suggests the potential importance of providing concrete financial assistance, particularly SNAP and foster care payments, to grandparent-headed kinship families in efforts to decrease child neglect risk during COVID-19.

A 29-Year-Old Man with COVID-19 Pneumonia, Heart Failure-Reduced Ejection Fraction, and Atrial Fibrillation with a Father and 2 Grandparents Who Were Positive for SARS-CoV-2 Infection.

BACKGROUND We report 4 family members, a 29-year-old son, 54-year-old father, 79-year-old grandmother, and 84-year-old grandfather, with COVID-19 pneumonia. Only the son had heart failure, with reduced ejection fraction and atrial fibrillation. This report aims to show that age and baseline comorbidities are not always predictors of severe COVID-19 disease. CASE REPORT Case 1: The son, a 29-year-old man, presented with dyspnea and palpitation. His nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He required high-flow nasal cannula oxygen therapy and had new-onset atrial fibrillation and reduced ejection fraction. Case 2: The father, a 54-year-old man, presented with dyspnea. Nasopharyngeal swab was positive for SARS-CoV-2. He required regular nasal cannula oxygen therapy. Electrocardiogram showed sinus rhythm. Echocardiogram showed normal ejection fraction. Case 3: The grandfather, an 84-year-old man with a history of atrial flutter, chronic kidney disease, and hypertension, presented with dyspnea and fever. Nasopharyngeal swab was positive for SARS-CoV-2. He required regular nasal cannula oxygen therapy. Electrocardiogram showed sinus rhythm. Echocardiogram showed normal ejection fraction. Case 4: The grandmother, a 79-year-old woman with a history of hypertension, presented with dyspnea. Nasopharyngeal swab was positive for SARS-CoV-2. She required regular nasal cannula oxygen therapy. Electrocardiogram showed sinus rhythm. CONCLUSIONS COVID-19 caused by SARS-CoV-2 is recognized to affect family members and can involve the heart, causing heart failure and cardiac arrhythmia like atrial fibrillation. This report highlights the importance of cardiac monitoring and consideration of cardiac damage, even without previous risk factors, in all hospitalized patients with COVID-19.

Custodial Grandparent's Job Loss During the COVID-19 Pandemic and Its Relationship With Parenting Stress and Mental Health.

Involuntary job loss during the COVID-19 pandemic adds challenges, especially for custodial grandparents that are taking care of grandchildren. Grandparents are relatively vulnerable, and they need more attention and support when facing the negative impacts of COVID-19. This study analyzed cross-sectional survey data collected from 234 custodial grandparents via Qualtrics Panels in June 2020 in the United States. After using the propensity score weighting adjustment, results from logistic and ordinary least squares regression showed that compared with grandparents that did not lose their job during the pandemic, grandparents that did had more parenting stress and worse mental health. Moderation analysis also showed that social support was a significant moderator of the relationship between job loss and mental health, but not the relationship between job loss and parenting stress. The findings and implications are discussed.

Positive and Negative Impacts of Caring among Adolescents Caring for Grandparents. Results from an Online Survey in Six European Countries and Implications for Future Research, Policy and Practice.

Although up to 8% of European youngsters carry out high-intensity care for a family member, adolescent young carers (AYCs), especially those caring for their grandparents (GrPs), remain an under-researched group. This study aimed at addressing the current knowledge gap by carrying out an online survey in Italy, the Netherlands, Slovenia, Sweden, Switzerland, and the United Kingdom. The analysis included a final sample of 817 AYCs aged 15-17 years old. AYCs of grandparents (GrPs) were compared to AYCs of other care recipients (OCRs), in order to identify any difference in positive and negative caregiving outcomes and exposure factors between the two groups. Linear or logistic regression models were built, and multivariate analyses were repeated, including a fixed effect on the country variable. AYCs of GrPs experienced more positive caregiving outcomes than AYCs of OCRs across all six countries. Being female or non-binary, and having a migration background, were associated with more negative outcomes, regardless of the relationship with the care recipient. Further research on intergenerational caregiving outcomes is recommended for shaping measures and policies, which preserve the intergenerational emotional bonds, whilst protecting AYCs from inappropriate responsibilities, undermining their mental health and well-being.

Material hardship and parenting stress among grandparent kinship providers during the COVID-19 pandemic: The mediating role of grandparents' mental health.

BACKGROUND: The COVID-19 pandemic has exposed the vulnerability of many families, including grandparent kinship families, to deal with a health/economic crisis. The fear of COVID-19 plus stay-at-home orders have increased individuals' psychological distress. Moreover, school closures and homeschooling further increased parenting stress among caregivers. OBJECTIVES: This study examined the relationship between material hardship and parenting stress among grandparent kinship providers, and assessed grandparents' mental health as a potential mediator to this relationship during the COVID-19 pandemic in the United States. PARTICIPANTS AND SETTING: Grandparent kinship providers (N = 362) that took primary care of their grandchildren participated in a cross-sectional survey via Qualtrics Panels in June 2020 in the United States. METHODS: Descriptive and bivariate analyses, binary logistic regression, and mediation analyses were conducted using STATA 15.0. RESULTS: Suffering material hardship was significantly associated with higher odds of experiencing parenting stress among grandparent kinship providers, and grandparents' mental health partially mediated this association. CONCLUSIONS: Addressing material and mental health needs among grandparent kinship providers is critical to decreasing their parenting stress.