The physical health dilemmas facing custodial grandparent caregivers: Policy considerations

Figures & data

Table 1. Custodial grandparent interview questions

Q. No.	Question
1	How old are you?
2	Are you the maternal or paternal grandparent of the grandchild you are raising?
3	How old is your grandchild?
4	Is your grandchild male or female?
5	Are the parents of your grandchild alive?
6	If the parents are a live how far (approximately) do they live from your house?
7	How old were you when you took on the responsibility of raising your grandchild?
8	Do you have legal custody of your grandchild?
9	How did you become the custodial carer of your grandchild?
10	What changes have you made to your lifestyle since becoming the carer of your grandchild?
11	How did you feel at the time you became the carer of your grandchild and how you have coped since?
12	What aspect of raising your grandchild have you found particularly challenging?
13	Have you been able to maintain your social and family relationships since taking on the care of your grandchild?
14	Have you made any new relationships through your grandchild? (e.g. through their playgroup, school or sporting activities)
15	Has the extra responsibility of caring for your grandchild affected your health either positively or negatively?
16	Do you have any concerns about your own health and how this might impact on your future ability to care for your grandchild?
17	Do you know of or use any community services or grandparent carer support services in your area?
18	What support services do you think grandparents need to help them raise their grandchild?

Figure 1. Six stage analytic process.

Table 2. Themes and subthemes

Themes		Subthemes
Theme I	Age-related health issues	Subtheme 1	It’s a knee operation here and a prolapse there
		Subtheme 2	Health is a big thing at our age so I’ve just got to make sure I look after myself
		Subtheme 3	Your health is a daily concern not only to yourself, but also to your grandchild
Theme II	Respite care needs and uptake dilemmas	Subtheme 4	Respite care gives us grandparents a break
		Subtheme 5	Respite, I probably wouldn’t use it as much as I’d want to
Theme III	Government healthcare financial assistance	Subtheme 6	It’s been a struggle right from the start to get anything from Centrelink
		Subtheme 7	I chase up all the help we need because nobody’s going to come in and help!

Table 3. Example of grandparents’ recounted age-related physical health issues

Health issue	Examples
Muscular-skeletal	I’m now dealing with pretty sore hands from years of hard work
	I have osteoarthritis
	I have rheumatoid arthritis
	I suffer from severe arthritis … My arthritis is shocking and I had to have cortisone
	I’ve got aches and pains all over
	My partner’s had a shoulder operation … and a knee replacement. These things you know, have stopped his mobility
	I’ve constant shoulder and back pain. I’m not sure if this is just the age or the lifting
	I’ve got an ongoing arthritis problem and I’ve got spurs on the vertebrae in my neck, had growing onto my neck and I’m having a lot of trouble with those at the moment because I can’t move my head very well
	I’ve always been quite fit … but I can’t exercise like I used to anymore because my back’s too bad and my joints too
Vision	I’ve got cataracts that are creating confusion
Weight gain/loss	I eat too much. I’ve put on weight, I’m now a type two diabetic
	I have put on weight. Whereas before if I wasn’t hungry I could please myself but now I think it’s important to sit down with my grandson at meal times
	I’ve put on approximately 20kgs in the 3 years I’ve looked after my grandson
	My wife’s lost at least five kilograms … and she’ll never put it back on while she is in the situation she is in because she worries too much
Cardiovascular	I have high blood pressure, I’m medicated for it but it’s still high at times
	I’ve got hypotension
	My partner had a stroke
	I’ve got a tachycardia problem with my heart, it just means that when it suits itself it beats too bloody fast and it just buckles my knees under me … I’ve got to take tablets for my heart they don’t do any good, it still bangs away when it wants to
	My wife she’s got four stents in her heart and sees the cardiologist every year
Chronic conditions	I’m asthmatic
	I’ve had kidney stones
	My partner’s has every complication of diabetes
	My husband’s had a kidney transplant
	My husband’s been a diabetic he had advanced kidney failure and he’d been on dialysis. He had a kidney transplant almost at the time we got the children
	Because I smoked I’ve had a cancer of the bladder removed
	I can add myself to the list of grandmothers having a prolapse operation
	My partner, he’s had a bad back injury and emergency surgery and spent time in hospital and, when that happened, is when I got breast cancer
	He’s got shingles. The worst case the doctor said he had ever seen
Stress and fatigue	I suffer from chronic fatigue
	I don’t sleep you see, because I’ve got the worry
	I’m physically tired, whether that’s actual or mental because of the extra workload I don’t know
	I notice that my energy is fairly depleted at times
	I got cancer, had my bladder removed and about three months after I was out of hospital my wife’s sitting in the chair and she said: I think I’m having a heart attack. It was all brought on by stress
	I’ve got a few guts-aches
	I’ve notice my energy levels are certainly different