The Doctor Will See You Now – A Special Kind of Family on the Rise

By Dr. Gilberto Heredia, Family Physician, Optum New Mexico

For most grandparents, busy mornings getting children off to school, arranging for after-school activities, and checking homework at the end of the day are responsibilities of the past. However, this is not the case for the heads of grandfamilies, also called “kinship” families.

About 2.4 million children in the U.S. are being raised by grandparents, older relatives, or close family friends without either parent present. Nearly half of the people heading up these households are age 60 or older. Here in New Mexico, eight percent of our children are being raised in grandfamilies – the highest percentage in the U.S.

There are dozens of reasons parents may be unable to raise their children – nearly all of them tragic. They may involve parental neglect, physical abuse, or substance use disorders, or other mental health problems. The vast majority of grandfamilies serve to keep children out of foster care.

While grandparents and others are doing the selfless work of giving children stability and a sense of cultural and community belonging, stepping into the role comes with physical, financial, and emotional consequences, impacting their ability to manage their own health and well-being needs.

Common challenges

Grandfamilies can be shining examples of love and resilience – but their unique circumstances mean both children and care givers need support. Chronic caregiver stress isn’t unusual, and because of how these children end up in grandfamilies, they are at risk for mental health challenges as well. They often come into grandfamilies with heavy emotional burdens. Past trauma and abuse can lead to learning difficulties, social, behavioral and health problems, and even PTSD.

The good news is that when these children grow up with a grandparent or other relative, they do much better than children being raised by non-relatives in the foster care system –including improved emotional and behavioral health outcomes.  When their caregivers have the mental health support they need, there can be a trickle-down effect.

Care for caregivers

For the heads of kinship and grandfamilies, managing their own health and wellness needs along with those of the children in their care can be a difficult balancing act. It may be the last thing that occurs to them, but meeting their own needs has to be prioritized just as much as meeting the needs of those in their care. No one can share from an empty cup.

Caregivers should discuss with their doctors or primary care physicians the lifestyle changes that come with the new role. Simple self-care habits like get enough rest, take time for physical activity, and connect with friends and family can all help.

Support for grandfamilies

For families experiencing financial hardship, the added cost of raising a child can exacerbate an already difficult situation – a very real struggle when 18 percent of grandfamilies live below the poverty line.

In 2018, the Supporting Grandparents Raising Grandchildren Act was enacted, creating a federal advisory council to develop support and make help available and accessible. Committees were formed to address a range of needs, from health care, housing, and behavioral care to financial or legal assistance and more. Training and community-based services are also available.

Stronger families make for stronger communities. When grandfamilies have access to the help and support they need, including for the mental health challenges of both care giver and child, these families can flourish.

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