The Need for Mental Health Support for Caregiving Grandparents

In 2015, Tessy Chu immigrated to America with her two youngest children, then 10 and 14. Her mother had immigrated the previous year, so when Chu, who moved to California, began working as a registered nurse, her mother moved in to help look after her grandchildren.

Chu often worked long days, including weekends and nights, so her mother spent much time raising the children, and this arrangement would continue for several years. 

While research has shown that many grandparents, like Chu's mother, are caregivers, their mental health is often neglected. But a new study from the Journal of Aging and Mental Health emphasizes that the mental well-being of grandparent caregivers is a critical but ignored issue.

Nationwide, 2.7 million grandparents are raising grandchildren, and according to census figures, about one-fifth have incomes below the poverty line. In addition, many of these grandparents live on a fixed income and manage chronic illnesses or a disability. 

This number will only continue to grow due to an increase in the older population. Addressing their emotional and mental health needs is essential for reducing caregiver burnout and helping them manage their quality of life.

According to the Journal of Aging and Mental Health, the study surveyed grandparent caregivers' attitudes toward mental health and using mental health services. 

Grandparent carers were generally optimistic about their willingness to seek emotional health care. They were also open to seeking help and using health-related services, despite a bias about mental health and professionals working in the field. 

But having bias largely depended on their personal characteristics and aspects of caregiving. For example, grandparents who lacked awareness of mental health services or overlooked their emotional health needs were not likely to access help. 

In minority communities, this is especially evident because the family is considered the primary support system, and sometimes caregivers do not consider their limitations. Therefore, creating supportive environments and empowering minority communities to share their experiences can help reduce negative bias and barriers to mental health. 

Most grandparents do not expect to take on the role of caregiver for their grandchildren — and they usually fill this role longer than expected, according to a guide by the University of Missouri extension. "About half of the grandparents who care for their grandchildren do it for two years or less, while about 40% fill this role for five years or more." 

There are many reasons why grandparents become caregivers, ranging from caring for orphaned grandchildren to military deployment, the opiate epidemic, and the growth in the number of women who are incarcerated. 

My personal experience includes my grandmother caring for my siblings for a few years during my mother's crazy work schedule, including when she moved to a different city for work. I cannot recall a discussion around what it meant for my grandmother, or how it might affect her mental health, but in my grandmother's own words, "It was the only solution for your mother to provide for all of us, and I would do it again." 

While my siblings helped make their day-to-day life easier, I am confident that caring for school-age children was challenging for my grandmother. Nor is it a problem limited to my immediate family: My mother and her sister lived with their parents for a time as children. 

I also have friends whose families have had a similar arrangement, including grandparents moving in to care for their grandchildren. But being an effective caregiver, whether primary or secondary, involves having awareness about reducing mental distress. It includes learning beliefs and strategies about caregiving and emotional stress. 

In his book "The Problem of Pain," author C.S. Lewis states, "Mental pain is less dramatic than physical pain, but it is more common and harder to bear." 

The frequent attempt to conceal mental pain increases the burden: it is easier to say, "My tooth is aching" than to say "My heart is broken."

Like any family caregiver, grandparents can quickly become overwhelmed when they first take on raising their grandchildren full-time. In addition, studies have shown the effects of caregiving on mental health, which include higher-than-normal rates of depression, sleeplessness, and emotional problems. 

These stressors can heighten the pressure put upon grandparents who assume the role of primary caregiver. However, since the mental health space is seemingly saturated with younger people, we must not ignore older people who are also making strides, particularly older women. 

Recent data shows that more older women are using telehealth, a digital innovation designed to get behavioral health care at home. With 64% of grandparents living with grandchildren identifying as women in 2019, telehealth can be an easy and effective way for this demographic to receive mental health care. 

Another approach to managing emotional health is caregiver support groups, where grandparents can seek encouragement, comfort and advice about caregiving and health concerns related to aging. Now, grandparent support groups exist in the U.S. and beyond. 

In Australia, for example, organizations like Raising Children Network and Wanslea are leading the way in launching support groups for grandparent carers.

Lastly, self-care is always essential for enhancing mental resilience. But what is equally needed is community care. As the number of grandparent carers increases, ensuring that systems and communities are designed to enable healthy lifestyles is paramount to reducing the negative impacts of caregiving. These include YMCA respite care programs, more counseling centers, food banks and visiting nurses, making the transition and readiness easier and more effective. 

Emphasizing our need for community is critical to promoting and protecting mental health. Just as we need a discussion of strategies at the organizational- and system level to support millennial carers or children as caregivers, we cannot ignore the plight of older caregivers, especially when dealing with mental health and self-care. 

Understanding the attitudes of grandparent carers toward emotional health can serve as a basis for encouraging this demographic to use mental health care services. 

Being open to seeking help also helps to improve family relationships and avoid caregiver burnout. Ultimately, emphasizing the need for better mental health can improve the quality of life of older adults working as carers.

Editor’s note: This story is part of Caregiving in America: The 24/7 Caregiver, a Next Avenue initiative with support from The John A. Hartford Foundation.