Ruth Marquis

Drug Addiction is a Scourge on the Earth and my Grandchildren are its Victims: the Tough Love and Resilient Growth Exhibited by Grandparents Raising the Children of Drug-Dependent Mothers

Parental drug-usage is a risk factor for child neglect. Maternal drug-dependency, in particular, has far reaching implications for the mother, her children, and the grandparents who are left to rear the children when the mother’s drug-dependency prohibits her from doing so. Thus, drug-related maternal incapacity to adequately parent her child/ren places a tri-generational burden on society. This study aimed to broaden understanding of this burden. In this regard, forty-nine custodial grandparent interviews were subjected to thematic analysis. Grandparents typically revealed their daughter’s marijuana usage began in early-mid adolescence, progressed to heavy drugs, and led to an early exit from the family home. A teen-aged pregnancy commonly followed. Grandparents when becoming aware of their grandchild/ren’s mother’s continued drug use and repeated instances of child neglect issued the the children’s mother with a ‘go-into-rehab-or-lose-your-custodial-care-of-your-child/ren’ ultimatum. Drug-dependent mothers were often unable to meet this ultimatum and grandparents then transferred their energies into caring for their grandchild/ren. The implications of this grandparent investiture shift are discussed, and future policy considerations are tabled.

Understanding the Occupational Issues Faced by Custodial Grandparents Endeavoring to Improve Scholastic Outcomes for Their Grandchildren

The Model of Human Occupation (MOHO) is an evidenced-based model of practice that occupational therapists employ to discuss and reflect on the occupational needs of clients. Custodial grandparents are one cohort of potential clients who experience considerable difficulty in adapting to the occupational challenges of their grandchild-rearing role, particularly in relation to schooling. Hence, this study aims to broaden current understanding of the volition, habituation, and performance processes that custodial grandparents work through in their daily drive to meet their grandchildren’s educational needs. Thematic analysis was conducted on 49 custodial grandparent interviews. Critical intervention points exist during the custodial care-giving role, at which juncture grandcarers experience feelings of stress overload and self-doubt. It is at these junctures that custodial grandparents would benefit from occupational therapy (OT), but such OT intervention is difficult to initiate among the hard-to-reach grandcarer age-cohort. To reach grandcarers and meet their occupational needs it is recommended that OTs conduct a family unit strengths, resources, and needs assessment for each student referred to them for age-inappropriate behavioral issues. In conducting a detailed family background assessment, grandcarers by extension can be reached and their occupational needs can be met.

Understanding the Mental Health Travails of Custodial Grandparents

ABSTRACT Grandcarers are at-risk of poor mental health outcomes. Current knowledge of the support needs of grandcarers is fragmented. To help fill this knowledge gap qualitative analysis was undertaken on 49 interviews conducted with custodial grandparents. The findings reveal that conflicted occupational roles coupled with the complexity of the stressors facing grandcarers both contribute to their social isolation and to their self-doubts about their ability to adequately attend to their grandchildren’s needs. Greater awareness among occupational therapists (OTs) of custodial grandparents’ mental health travails and an increased understanding of key occupational therapy (OT) practice initiatives are central to addressing grandcarers’ mental health travails.

Occupational Therapy and Occupational Participation in Community Dwelling Older Adults: A Review of the Evidence

Abstract Aims: To review recent occupational therapy literature to establish the current level of evidence on how occupation may influence participation and may prevent or reduce social isolation in community dwelling older adults aged 60 years and over. Methods: Pertinent electronic databases were comprehensively searched using a guiding search strategy and inclusion criteria. Data extraction and quality assessment was conducted on included studies. Results: 14 studies were included in the review. The occupational domains within the studies that contributed to social participation or social isolation included instrumental activities of daily living, education, leisure, work and social participation. Conclusions: Evidence is emerging within recent literature to support a positive relationship between occupations, social participation and the prevention of social isolation in community dwelling older adults aged 60 years and over. Evidence supports the highly relevant and valuable role of occupational therapy in facilitating healthy aging through supporting social participation and addressing social isolation for the increasingly aging global population.

Identifying the enablers and barriers to community participation amongst older adults

Introduction The proportion of older adults throughout the world has increased significantly over the last decade and continues to rise. Such substantial growth highlights the importance of facilitating older people’s wellbeing. This research aimed to identify enablers and barriers to participation in community-based activities experienced by active older adults. Method This qualitative study employed the evidence-based paradigm of occupation and Model of Human Occupation to underpin protocol and discussion. Ten participants (females = 9, males = 1) who were aged 64–83 years and actively engaged in their community took part in semi-structured interviews. Participants reported mixed health levels including chronic/terminal illnesses and normal degenerative changes. Interview transcripts were analysed using thematic analysis. Findings Analysis identified four themes of enablers and barriers to community participation. These were: relationships; interests; personal knowledge and awareness towards health and wellbeing; and resources and the environment. Conclusion Intrinsic factors such as developing or maintaining strong relationships and developing interests were identified as enabling community participation. Barriers identified within this study included unappealing group cultures or structures, such as having limited opportunity to develop friendships or explicitly targeting ‘seniors aged 60+ years’ and accessibility limitations. Recommendations were established to inform the development of programmes to increase community participation among this group.

Issues affecting Australian grandparents who are primary caregivers of grandchildren: a review

ABSTRACT The aim of this review was to identify current issues affecting grandparents who are raising their grandchildren in Australia. The study systematically reviewed 12 studies that evaluated supports for grandparents. The Checklist Analysis of Research for Systematic Review and the Quantitative and Qualitative Checklist were used to evaluate the studies. Five support issues affecting grandparent-headed families were evidenced in the literature as being of priority. These include stress, intergenerational conflict, community support, legal and financial aspects, policies and service frameworks. The paucity of research implies that further funding for large-scale research is required. Implications for informal primary carers of grandchildren are that the lack of legal status and the sustained burden of care will continue to negatively impact upon the grandparents’ well-being. Further research to identify priorities and develop intervention strategies supported by policy development is required to enhance the health and well-being of grandparent carers and their grandchildren.

Substance misuse-related parental child maltreatment: Intergenerational implications for grandparents, parents, and grandchildren relationships

In Australia, children removed from the parental home because substance use–related child maltreatment issues are commonly placed in grandparent custodial care; however, the longer term relational costs of this approach have yet to be determined. Conventional, summative, and directive content analyses were conducted on data extracted from 88 Australian custodial grandparent completed Grandcarer Needs, Wellbeing and Health Surveys. Conventional analysis revealed the most common reason grandparents gave for their assumption of custodial care was drug use–related acts of parental child maltreatment. Summative analysis revealed antidepressants, marijuana, Valium, ice, and amphetamines were the most commonly used parental drugs and that these drugs were frequently used in combination with dexamphetamine, antipsychotics, heroin, ecstasy, and cocaine. Directed analysis contextualized the strain that drug use–related custodial caregiving places on grandparents’ financial resources, and how this strain is burdensome when the grandparents’ annual income is less than Aus

The Role of Adult Day Services in Supporting the Occupational Participation of People with Dementia and Their Carers: An Integrative Review

80,000. It also contextualizes the need for future research to explore family reunification desires/barriers.

The Enjoyment Rewards of Fulfilling a Custodial Grandparenting Role in the Lives of Grandchildren Removed from their Parents’ Care

The increasing numbers of people with dementia places considerable stress on health and aged care services and has resulted in the development of community adult day services. Aim: The aim of this integrative review is to determine the extent to which these services support the occupational participation of people with dementia, and how they impact their primary carers. Method: The mixed-methods appraisal tool (MMAT) was used to identify relevant studies in the period 2011–2016. Results: Nine databases were searched and yielded 16 articles with a variety of research designs for inclusion in the review. Conclusions: Findings indicate that adult day services use a range of approaches to support attendees and their carers. In spite of these efforts, there appears to be a lack of interest in utilizing these services while a person is in the early stages of dementia. This suggests that policies in aged care, such as aging-in-place, need to consider the pressure and stress they exert on carer’s quality of life. Another consideration is to better promote the benefits of participating in adult day services in the early stages of dementia for both the attendees and their carers, thereby delaying the tendency towards early institutionalization.

The physical health dilemmas facing custodial grandparent caregivers: Policy considerations

ABSTRACT Custodial grandparenting (i.e. raising grandchildren on a full-time basis) is a global phenomenon. Despite the hardships associated with 24/7 custodial care, grandparents continue to invest in their grandchildren. Why they do so is a matter of much conjecture. For example, it has been posited that grandparents assume custodial care of their grandchildren for reasons of necessity, altruism, aged-care reciprocity, or cultural continuity. This study examines the often overlooked issue of grandparent enjoyment as a motivating force behind custodial grandparenting caregiving investment. The results of our analysis of 88 completed Grandparent Needs, Wellbeing and Health Surveys determined that custodial grandparents’ investiture in their grandchildren is influenced by three types of enjoyment, namely those derived from engagement in the child-centred nurturance of an at-risk grandchild, dyadic engagement in shared activities with their grandchild, and the personal grandparent-centred pleasure benefits to be had from fulfilling a grandcarer role. This study additionally reveals that informal custodial grandparents experience lower levels of closeness to their grandchild/ren, satisfaction with their grandparenting role, and assessment of their state of health than do formal (legal) custodial grandparents. The need to educate custodial grandparents of the potential health benefits to be had from investiture in their grandchildren is discussed.