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PubMed2006

Elderly African Americans as intragenerational caregivers.

A growing number of older Americans serve as caregiving resources for their elderly spouses, partners, relatives, and/or friends. Yet, little research has addressed the impact and implications of this trend among African Americans. This article describes the results of a qualitative study examining the intragenerational caregiving experiences and perspectives of two cohorts of African Americans (urban and rural, N = 129) between the ages of 58 and 89. Its findings reveal important differences and commonalities associated with elderly African American caregivers and their care giving in urban and rural settings. Additionally, the study suggests that volunteer caregivers can often fill the void left by partners and relatives who predecease or fail to assume responsibility for the care of their elderly relatives. Their efforts do not displace those of friends and family members, but rather address unmet needs in available care. The discussion focuses on the implications of the study findings for public policy and practice.

Adaptation, Psychological↗

PubMed2000

African American grandmothers' perceptions of caregiver concerns associated with rearing adolescent grandchildren.

In 1996, grandparents were the sole providers of care for 269,000 grandchildren. Research findings indicate that grandmothers are usually the primary caretakers of grandchildren. Previous issues associated with raising grandchildren vary, but usually relate to the grandparents' health, financial concerns, or lack of social support. This qualitative descriptive study was designed to describe African American grandmothers' perceptions about the burdens of raising adolescent grandchildren. Using this approach, the researchers were able to study the richness and diversity of the grandmothers' perceptions. Data were collected from 35 grandmothers through a focus group (n = 7) and during a 4-day intervention research study (n = 28) entitled "Grandmother-Grandchild Health Promotion Program." Numerous concerns were voiced by both groups, but those stated most frequently were associated with the well-being of grandchildren (grandchildren's sexual behavior, potential drug use, and potential risk of encountering violence) and relational conflicts with adult children. Unexpected findings were the absence of stated concerns associated with the grandmothers' financial situation or health. Recommendations for intervention, clinical practice, and research are discussed.

Adolescent↗

PubMed2001

Social support exchange among elderly Chinese people and their family members in Hong Kong: a longitudinal study.

This study examines the pattern of social support exchange between the elderly and their family members, focusing on financial aid and household care (both instrumental and emotional). The second objective of this study is to identify resource capacity factors (including education, physical health, and size of social network) that generate differences in the exchange of financial aid and household care between elderly people and their family members. The respondents were 213 people who had family members living in Hong Kong aged 70-years-old or older from a longitudinal study of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, we found that the elderly subjects who received more household care from their family members were likely to provide more household care to their family members three years later, even after controlling for the impact of resource capacities; and the elderly subjects who provided more household care to their family members were more likely to receive more household care from their family members three years later. In assessing the impact of the resource variables on support exchange, functional disability and the number of close relatives were significantly associated with the amount of household care the old people provided, whereas the number of close family members were significantly associated with the amount of household care the old people received. Policy implications of the findings in this study were discussed.

Aged↗

PubMed2004

The economic consequences for parents of losing an adult child to AIDS: evidence from Thailand.

An examination of the economic consequences for older-age parents of losing an adult child to AIDS in Thailand based on quantitative data derived from a key informant study and a direct interview survey with parents yielded the following main findings: (1) parents frequently paid for their children's care and treatment, but government health insurance and to a lesser extent welfare measures helped alleviate these expenses; (2) parental caregiving often disrupted economic activity, although the resulting opportunity costs were limited by the typically short duration of caregiving; (3) parents commonly paid for funeral costs but benefited from funeral society memberships and customary contributions from those attending; (4) only a minority of parents supported AIDS orphans although orphaned grandchildren often ended up with their grandparents; (5) most deceased children had contributed financially to the parental household but only a minority were main providers. Poorer parents, however, were most likely to lose a main provider and experience severe financial hardship; and (6) although poorer parents spent much less on expenses related to the illness and death of their children, they were much more likely than better-off parents to be seriously burdened by these expenses. Programs are needed to address the plight of AIDS parents but should target those who are most susceptible to resulting economic hardship.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Interdependencies, values and the reshaping of difference: gender and generation at the birth of twentieth-century modernity.

The paper explores the mutuality of values, claims and social relations in the process of social change. Values are not separable from social relations but are embedded in the shaping and reshaping of social difference and interdependence. The paper focuses on developments around the turn of the twentieth century, and analyses changes in the relative social positioning of children and adults, and women and men, shifting patterns of interdependence, and linked values and ideas about difference. The reconfiguring of generational and gender relations was integral to the first fertility decline, to transformation in family life and societal divisions of labour, and to the embedding of particular values and claims regarding gendered difference, identities and gender appropriate roles. Analysis of these developments reveals the mutuality of 'cultural' and 'material' processes and holds lessons for interpreting social change today.

Adult↗

PubMed2000

Decision making and depressive symptoms in black and white multigenerational teen-parent families.

This study investigated correlates of depressive symptoms among 56 (30 Black and 26 White) low-income, coresiding teenage mothers and their mothers (referred to as grandmothers). Racial differences in teenage mothers' and grandmothers' reports of decision making and depressive symptoms and in the association of decision making with depressive symptoms were explored. Racial differences in levels of depressive symptoms emerged for grandmothers but not for teens. There were no significant differences in levels of decision making; however, the relation of decision making to depressive symptoms differed by racial group. Among White families, greater teen participation in decision making was negatively associated with teenage mothers' depressive symptoms. Among Black families, the opposite was found. A similar pattern of effects was observed for grandmothers.

Adolescent↗

PubMed2003

Partnering in the cultivation of the next generation of ethnic minority nurse scientists: responding to a compelling national agenda.

Health disparities continue to exist between communities of color and the poor and the health of the nation as a whole. Highly competent and culturally sensitive nurse researchers are needed to contribute to the elimination of disparities. There is however, an inadequate supply of nurse researchers of color and an insufficient number of students in the pipeline aspiring to careers as nurse researchers. The purpose of this article is to analyze a partnership model between nursing programs in a Historically Black Colleges/Universities (HBCU) with an evolving research presence and an Ivy League university with an research extensive environment. After four years of collaborating, minority undergraduate students have an increased interest in nursing research and the problems of health disparities, conduct original pilot studies, produce and deliver scholarly papers based on their pilots, publish in referred journals with their mentors, engage in networking with accomplished nurse researchers and leaders, and demonstrate increased enrollment and interest in graduate study. Faculties at both institutions exhibit enhanced competencies in the design and conduct of research related to eliminating disparities and in strengthening their respective research environments. The model demonstrates that the career trajectory of minority nursing students and the research capacity of faculty can be influenced through the deliberate application of elements of the model.

Black or African American↗

PubMed1995

"To grandmother's house we go": health and school adjustment of children raised solely by grandparents.

This study uses data from the 1988 National Children's Health Supplement (N = 17,110) to the National Health Interview Survey to examine the health and school adjustment of children raised solely by grandparents. We find that these children fare quite well relative to children in families with one biological parent present, a category which includes both single-parent and blended families. Furthermore, children raised solely by grandparents are not significantly different, except for academic performance, from children raised in traditional families where two biological parents are present.

Adult↗

PubMed1994

Family-embedded vs. family-deprived oldest-old: a study of contrasts.

Most of the white oldest-old in San Francisco have at least one surviving relative, but only one-half have relatives available to them if they need help. The primary family resources are children, especially for women. They are closer to children than to grandchildren or other relatives. The respondents themselves are more passive and unemotional family members, however, rather than being active kinkeepers. They also seem to derive satisfaction from thinking about relatives now dead--men usually about their dead wives and women about their mothers and siblings. There is a sharp contrast in life style and feelings between those who are most embedded in their families and those at the other extreme, the "family deprived," with the embedded being much better off.

Activities of Daily Living↗

PubMed1995

Posttraumatic stress disorder across two generations of Cambodian refugees.

OBJECTIVE: To examine the expression of war-related trauma as manifested by DSM-III-R rates of posttraumatic stress disorder (PTSD) and major depressive disorder in two generations of Cambodian refugees living in the western United States. METHOD: A probability sample of 209 Khmer adolescents and one of their parents were interviewed using portions of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version and the PTSD section of the Diagnostic Interview for Children and Adolescents. Interviews were conducted in English by a master's-level clinician with a Khmer interpreter. RESULTS: PTSD was found to be significantly related across parent-child generations. A nonsignificant generational trend was also found for depressive disorders. A number of environmental variables measured in the study (amount of reported war trauma, loss, living arrangements, treatment received, socioeconomic status) were not related to these findings. Parents were more likely to report an earlier onset of PTSD symptoms. CONCLUSIONS: This study suggests that PTSD in refugees may cluster in families. Whether this phenomenon is caused by a genetic susceptibility to trauma awaits further research. PTSD and depressive disorders in refugee populations, while often comorbid, appear to follow different courses over time.

Adolescent↗

PubMed1995

The meaning of grandparents as viewed by adolescent grandchildren: an empirical study in Belgium.

Why do adolescents value their grandparents? This was the leading question of an investigation among 563 adolescents and young adults in Flanders (Belgium). The Grandparent Meaning Scale which probes eleven a priori dimensions of meaning, was completed by 147 early adolescents (M = 12.5 years), 175 middle adolescents (M = 15.7 years), and 241 late adolescents (M = 18.9 years). Results show that adolescents generally find their grandparents important and feel close to them. Grandparents are valued primarily because they provide affection, reassurance of worth, and reliable alliance. Relational-affective and caregiving meanings were assigned more often to grandmothers whereas advising, teaching, and narrative roles were ascribed more frequently to grandfathers. Maternal grandparents were generally perceived as more important and closer than paternal grandparents. Early adolescents assigned more importance and meaning to their grandparents than middle and late adolescents. There were no differences between grandsons and granddaughters.

Adolescent↗

PubMed2003

Imminent concerns of filial caregivers reporting recent experiences of crisis.

The purpose of this descriptive study was to generate information about imminent concerns of adult children that could serve as initial context for development of a meaningful framework for coping with an ongoing parent care situation. Ninety-two adult children pre-selected for self-reports of crisis were interviewed about their concerns and goals for caregiving and asked to discuss experiences of crisis in the previous six months of caregiving. Key issues pertaining to their experiences were extracted from notes of the interviews and classified according to their common properties. Cohen's kappa for interrater reliability of the classifications was .79 while percentage agreement was 98 percent. The results of the study point to the presence of multiple issues pertaining to significant life and death events, relational burdens, early experiences with the family of origin, and focal patterns of distress and coping. Synthesis of the findings reveals overriding concerns for making improvements in one's family of origin, created family of adulthood, and middle-aged self. Findings have implications for experiential adult education in the area of filial maturity and caregiving.

Activities of Daily Living↗

PubMedDate not supplied

Factors influencing women's decisions about timing of motherhood.

OBJECTIVE: To examine the factors that influence women's decisions about the timing of motherhood from a life span perspective. DESIGN: Qualitative. SETTING: Large Western Canadian city with a high rate of infants born to women aged 35 years and older. PARTICIPANTS: 45 Canadian women aged 20 to 48 years. RESULTS: Independence, a stable relationship, and declining fertility influenced women's decisions about the timing of motherhood. Women integrated child developmental transitions into a projected life plan as they considered the timing of motherhood. Partner readiness and family of origin influences played a lesser role. Delayed childbearing has become more socially acceptable, with subsequent negative connotations associated with younger motherhood. Parental benefits have limited influence on the timing of motherhood. CONCLUSIONS: Recognition by nurses of the various and complex factors that influence women's decisions about the timing of motherhood may flag the importance of pregnancy-related counseling for woman across the fertility life span. Policy decision makers must be cognizant of the need for additional high-risk obstetric and neonatal health services when societal norms encourage women to delay childbearing in favor of completing education and establishing a career.

Adult↗

PubMed2002

Age and ethnicity differences in storytelling to young children: emotionality, relationality, and socialization.

Research has shown that age and ethnicity are associated with individuals' motivations for emotional regulation and social interaction. The authors proposed that these age and ethnicity-related motives would be reflected in storytelling. Women representing 2 age and 2 ethnic groups (young adulthood, oldage, African American, European American) told stories to young girls. Stories were coded for emotional, relational, and socialization focus. They predicted that older adults would selectively emphasize positive over negative emotions and would direct more utterances toward their interaction with their listener. The authors expected that African Americans would be more likely to emphasize socialization themes. Results suggest that older adults positively modulate emotional content while storytelling; qualified support was found for hypotheses concerning socialization and interrelational emphasis.

Adult↗

PubMed1999

Transmission of risk factors across three generations.

The present study examined the association between the parent-grandmother relationship, the parenting of toddlers, and toddlers' anger. Parent-grandmother relations were assessed when the parents were adolescents. Patient-toddler relations were examined when the toddlers were two years of age. The sample consists of 185 2-yr-old toddlers, one of the parents of each toddler, and the corresponding grandmother of each toddler. The findings support our hypothesis that there would be an indirect effect of the grandmothers' personalities and child-rearing practices on their grandchildren through the influence of the grandmothers on the parents. The influence of both the grandmothers' and the parents' smoking behaviors on the toddlers' anger was mediated by their child-rearing practices. The significance of the findings from a multigenerational study are discussed with reference to incorporating them into prevention programs. The findings are consistent with the notion of the intergenerational transmission of risk factors--from grandparents to parents to toddlers.

Adolescent↗

PubMed2003

Review of research on the health of caregiving grandparents.

AIM: To provide a critical review of research literature on the health of grandparents raising grandchildren, and identify directions for future research. METHODS: Approaches used to access the research studies for this review included a comprehensive search using relevant electronic databases and a thorough examination of the references in each published study. FINDINGS: All studies but one were published after 1990. Samples consisted primarily of African-American and Caucasian grandmothers in the United States of America. Earlier studies tended to describe health and other related concepts while more recent studies began to examine relationships between concepts. Most of the studies had a cross-sectional design and only one evaluated interventions. Inconsistencies in the results of these studies were prevalent. CONCLUSIONS: Evaluation studies, longitudinal designs, and more varied study samples including cross-cultural comparisons are needed to advance knowledge about grandparent caregivers' health.

Caregivers↗

PubMedDate not supplied

Afrocentric treatment in residential substance abuse care. The Iwo San.

Alcohol and other drug treatment programs continue to report relatively low success rates among African-American participants. We propose that there is a need to consider treatment approaches that are more culturally competent. An Afrocentric paradigm is suggested and instituted as the central theme of a residential drug treatment program. Elements of an Afrocentric orientation and how these principles are used to guide the development of a treatment philosophy are discussed.

Black or African American↗

PubMed1999

The multigenerational treatment setting for the chemically dependent adolescent; impact on cost, quality and treatment outcomes.

The treatment outcome from homogeneous age group substance abuse treatment centers, whose clientele consist of adolescent chemical dependents, has never clearly been demonstrated to be superior to heterogeneous age group treatment. An analysis of research in several disciplines concerning outcome studies related to adolescent chemical dependency and mental health treatment, demonstrates that heterogeneous (multigenerational) treatment settings may be superior to homogeneous age group treatment. Other adolescent issues in the family and society that directly affect treatment philosophies in centers directed toward youth are compared to the treatment philosophies of adult centers. It is suggested that multigenerational treatment facilities cost less, require less staff, are better received by the client, and produce higher abstinence rates than adolescent-specific centers.

Adolescent↗