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Caregiver burden, Grandmother caregiver, High-risk grandchildren, Physical health



  1. Dowdell, Elizabeth Burgess PhD, CRNP, RN


Purpose: To describe the experience of grandmothers who are parenting their grandchildren, and determine the amount of caregiver burden felt by the grandmothers.


Study Design and Methods: This descriptive correlational study had a sample of 104 grandmothers, reporting on 249 custodial grandchildren. Grandmothers completed the Caregiver Reactions Assessment to determine perceived physical health, family support, financial status, and caregiver burden.


Results: Overall, grandmothers perceived the health of their grandchildren as excellent. Of the grandchildren who had been born prematurely (30%), the primary health problems were hyperactivity and asthma. Parental drug use was reported as the reason for child placement with the grandmother in 80% of the cases. The range of time grandchildren had been living with the grandmother was 6 months to 15 years. Low ratings of grandchild physical health correlated with low ratings of grandmother physical health, which correlated strongly with low levels of self-esteem, a strong perception of poor family support, and poor financial status, all of which represent measures of caregiver burden.


Clinical Implications: This study demonstrated that the well being of the grandmother and grandchild are both linked to good physical health. Thus, indicators of poor health for both grandchild and grandmother must be identified early. Grandmothers in this study were surprised at how much had changed in every aspect of child health since they had raised their own children. Nurses working with grandmothers who have custody of grandchildren should understand the dynamics of the relationship, the possibility of caregiver burden, provide anticipatory guidance about the changes in child care and child healthcare in the 21st century, and help link grandmothers who have little support to community programs.