Grandparents in Shreveport, Louisiana face challenges caring for their grandchildren. The document summarizes interviews with 15 grandparent caregivers who access services at a local health center. Most have low incomes and lack health insurance. Common reasons for taking in grandchildren include parental substance abuse or death. Grandparents desire resources to help with basic needs like food, clothing, bills and legal advice. A majority were unaware of existing support services and groups and expressed interest in informational materials and a resource center.

1. GRANDPARENTS RAISING GRANDCHILDREN IN
SHREVEPORT, LA: CHALLENGES AND RESOURCES
LISH’A BOND

2. FROM THE PRACTICUM
 Literature search concerning grandparents raising their grandchildren
 Literature review concerning grandparents raising their grandchildren
 Developed a matrix for collecting and analyzing data
 Searched MLK Health Center data base to determine which patients are grandparent caregivers
 Identified resources for health and well-being available currently to grandparent caregivers in Shreveport,
Louisiana
 Created a matrix for the community resources identified
 Listened to and read the transcripts of 11 of Dr. Clottey’s previous interviews of grandparents raising
grandchildren
 Read selective chapters from Siedman’s book on qualitative interviewing
 Read Designing Qualitative Research
 Constructed appropriate qualitative interview questions with faculty supervisor and practicum supervisor
 Piloted four interviews

3. PROBLEM
 United States
 2.9 million grandparents raising grandchildren in 2009
 5% of all children
 Louisiana 2010 census
 11.5% (128,600) of children lived with grandparent householders
 72,555 cared for primarily by the grandparent
 26,708 had no parent present
 68,668 grandparents raising grandchildren in their home
 46% have no parent present
 27% live in poverty
 In Shreveport, LA 2,593 grandparents “are the householders and responsible for their grandchildren living with
them.”

4. SIGNIFICANCE
 Circumstances leading to grandparent caregivers
 Substance abuse
 Death
 Child abuse, neglect, or abandonment
 Divorce
 Teen pregnancy
 Unemployment
 HIV/AIDS
 Incarceration
 Physical/mental/developmental illness
 Financial or emotional hardship

5. SIGNIFICANCE
 Grandchildren's increased health risks
 Developmental delay
 Emotional issues
 Psychological and behavioral problems
 Poor physical health
 Asthma, weakened immune system, physical disabilities, poor sleeping patterns, sinuses, allergies, chronic bronchitis, poor
eating habits, and diabetes.

6. SIGNIFICANCE
 Grandparent’s increased health risks
 Mental health
 Stress, depression, psychological distress, anxiety, and stigma related to the grandchildren’s parents
 Social health
 Role functioning, social isolation, role conflicts, marital distress, dysfunctional parenting, role restructuring, social functioning,
and family dysfunction
 Physical health
 Diabetes, hypertension, heart disease, insomnia, overweight or obesity, activity limitation, body pain, decreased physical
functioning, and suppressed immune function
 Other concerns
 Quality of life, caregiver burden, poverty, legal issues, and adequate resources and services

7. QUALITY OF LIFE
 Negative
 Decreased mental and physical health
 Positive
 Provides a second chance and new opportunities
 Predictors of quality of life
 Education level
 Number of grandchildren being cared for
 Grandchildren’s health problems

8. CAREGIVER BURDEN AND SERVICES
 “Burden uniquely predicted needs for information about services, needs for service, and service use.”
 Awareness of a need for services and what services are available is vital to help support grandparents raising
grandchildren.
 Reasons for being unaware of services
 Lack of access
 Distrust of the services
 Greater family resources
 Depression
 Recommendations made by the study
 Utilizing faith-based organizations
 Support groups
 Reducing barriers

9. METHOD
 Qualitative Research
 Exploratory or descriptive
 Stresses importance of context, setting, and subjects’ frame of reference
 Preserve right to modify aspects of research design as research proceeds
 Pilot study may be important
 Qualitative procedures criteria
 Informational adequacy
 Efficiency
 Ethical considerations

10. METHOD
 Site of Study: Martin Luther King Health Center
 The mission is to serve at no cost to uninsured patients with chronic illness who would forgo routine medical care
because of a lack of resources to reduce health costs by lowering the number of unnecessary hospital emergency
department visits.
 Patient eligibility
 Age:18-64
 Uninsured
 Not above 200% poverty
 One or more chronic illnesses
 Entry
 Dr. Dennis Wissing
 History of MLK and the MPH program

11. METHOD
 Participant Population
 Charts for each clinic were viewed to determine if the clients had minors in the household
 If so, they were approached and asked if they were a grandparent raising their grandchild
 If so, they were asked to participate in the interview
 Clients who did not have minors in the household on their charts were approached, asked if they were a
grandparents caring for their grandchild, and then asked if they were willing to participate in the interview
 If the client agreed they were brought to a private conference room to conduct the interview in a confidential
manner

12. METHOD
 Data Collection
 Primary
 In-depth interviews recorded audibly
 Supplemental
 Unobtrusive client chart reviews

13. INTERVIEW QUESTIONS
Practicum Interview Questions Lish’a Bond
Interview Questions (10-20 mins):
1. May I ask why you are here today?
2. How old are the grandchildren you care for?
3. How long have you been caring for them?
4. Do your grandchildren have health insurance?
5. Do your grandchildren see a doctor? If so, would you mind telling me about
that?
6. Are you aware of services in the area for grandparents raising grandchildren?
7. What services or resources do you currently receive to help raise them?
8. Are you aware of any groups in the area for grandparents raising grandchildren?
If so, do you belong to a social support group for grandparents raising
grandchildren? If not, would you find a support group helpful for you?
9. What happened for you to take responsibility for your grandchildren’s care?
10. Do you have legal custody of your grandchildren?
11. What are the difficulties or frustrations you face with raising your
grandchildren?
12. What is the most fulfilling about raising your grandchildren, or what do you get
out of it that is good?
13. What resources do you think would be helpful in raising your grandchildren?
14. Would a resource information pamphlet or booklet, with information on who
provides, where they are located, and how to receive the resources, be helpful to
you?
15. Would a resource center for grandparents raising grandchildren be useful to
you?

14. DEMOGRAPHIC AND OTHER DATA COLLECTED
 Age
 Sex
 Race
 Marital status
 Health conditions
 Health insurance
 Educational level
 Employment status
 Yearly income
 Source of income

15. ETHICAL CONSIDERATIONS
 Data from chart reviews labeled with a coded number prohibiting identification of subjects’ name
 One-on-one interviews audibly recorded with no mention of names
 Recordings and transcriptions coded as well to prevent participant identification

16. DATA ANALYSIS
 Interviews
 Themes and coding
 Descriptive analysis
 Chart Reviews
 Descriptive analysis

17. RESULTS
 Data on 15 participants extracted from their MLK patient charts
 One recruit declined participation
 Ages of the participants ranged from 42-70 and the mean age was 57
 Participants were primarily female, black, married or divorced, and had completed 12th grade

18. RESULTS
 Most Common Health Conditions
 High blood pressure
 Arthritis
 High cholesterol
 Diabetes
 Other common health conditions: stroke, asthma, and depression
 Most participants had no health insurance
 No health insurance and denied by Medicaid

19. RESULTS
 Yearly household income ranged from $864 to $31,536 with a mean of $16,637
 Most common sources of income were wages and disability
 Many had more than one source of income
 Wages and a household members’ disability
 Wages and a household members’ social security
 Social security and pension

20. RESULTS
 15 participant interviews
 One participant spoke Spanish only
 Daughter-in-law answered the questions she knew and translated the ones she did not

21. RESULTS
 24 total grandchildren of the 15 grandparent caregivers
 Grandchildren’s age ranged from 1 to 18 years with an average age of 9 years
 Grandparent caregivers cared for 2 grandchildren on average with range from 1 to 4
 10 of the 15 grandparents caregivers had been caring for them since they were born
 Average time was 7 years with a range of 1 to 18 years

22. RESULTS
 Health Status
 70% stated no ongoing health issues
 Health Insurance Status
 >70% yes with 66% having Medicaid
 Some participants said the grandchild did not have any yet followed with sating they have Medicaid
 Others said the grandchild had Medicare, but corrected to Medicaid

23. RESULTS
 Most Common Reasons
 Mother working
 Mother deceased
 Drugs/alcohol
 DCFS/CPS
 Legal Custody
 67% did not have full custody
 13% had full custody
 Joint, guardianship, and unsure

24. RESULTS
 Most Common Challenges
 Difference in activity level
 Behavioral issues
 Financial and lack of resources
 Most Common Fulfilling
 Everything, happiness
 Knowing the child was learning, safe, and being
raised right

25. RESULTS
Aware Frequency Percentage
No 12 80%
Yes
Food pantry 1 6.7%
Unable to identify 2 13.3%
Services Received Frequency Percentage
No 7 46.7%
Yes
Food stamps 6 40%
Food pantry 1 6.7%
Social Security from
deceased parent 1 6.7%
Check for autism 1 6.7%

26. RESULTS
 Resources Needed/Wanted
 Money/finance
 Food
 Clothes
 Utility bills
 Medicaid
 Home improvement
 Support group
 Legal resource
 Housing
 Transportation

27. RESULTS
 Aware of Groups
 93% were not
 Would Join Support Group
 Yes = 53%
 No = 13%
 Maybe = 33%
 Reasons
 Time constraints
 Poor health

28. RESULTS
Response Frequency Percentage
Information Pamphlet
Yes 12 80%
Uncertain 2 13.3%
In Spanish 1 6.7%
Resource Center
Yes 13 86.7%
No 1 6.7%
Maybe 1 6.7%

29. RESULTS
 Suggestions
 Information Pamphlets
 Partial payments (home improvements)
 Utility bills help
 Part-time jobs
 Legal help
 Clothes
 Food
 Information on handling changes in today’s teenagers
 Spanish version
 Website

30. RESULTS
 Suggestions
 Resource Center
 Located in Shreveport
 Activities for parents with kids
 Grandparents get together and do activities with grandchildren
 Support groups for the grandchildren
 Open weekends (Saturday mornings)

31. LIMITATIONS
 Small sample size
 Convenience sampling
 Lacked control group
 Single informant

32. BIAS
 Positive response
 Social desirability
 Interviewer

33. RESOURCE INFORMATION
 Directory
 Director of MLK
 Director of MPH program
 Pamphlets
 Participants, through MLK
 Electronic version provided to the staff of MLK to be provided to their other clients as needed

34. COMMUNITY RESOURCES
 Academics
 Application centers
 Behavioral health
 Bills
 Cash assistance
 Child support enforcement
 Clothing
 Counseling
 Dental care
 Disaster services
 Education
 Employment training
 Family planning
 Financial assistance
 Food
 HIV/STI testing
 Home improvement
 Housing
 Immunizations
 Information and referral

35. COMMUNITY RESOURCES
 Job placement
 Legal
 Medical care
 Medical equipment
 Optometry
 Pharmacy
 Prescription assistance
 Rehabilitation and therapy
 Screenings
 Support groups
 Transportation
 Vital records
 WIC
 Other: phones, medical alert program,
mentoring and support, sports and recreation,
Haven Houses and Friendship Houses

36. FURTHER RESEARCH
 More expansive and further in-depth research needed in Shreveport, LA to include:
 Interviews with the organizations identified as community resources
 Quantitative data
 Support groups
 Literature review found support groups are beneficial to grandparents raising grandchildren
 Participants responded that they would be interested in joining a support group
 Website
 Collaboration and partnerships within and between community resources
 Resource center
 One-stop-shop to provide information, referrals, and help navigate the system of resources available