Abstract
To understand the challenges arising from the context within which diabetic African-American caregiving grandmothers self-manage their diabetes we used the Adaptive Leadership Framework. Additionally, challenges to retaining this population in a longitudinal study were examined. In this exploratory, longitudinal, qualitative pilot study, data were collected at five time-points over 18 months. We coded the data using content analysis and conducted the within-case and cross-case analyses using data matrices. Lack of awareness of available resources, represented a technical challenge within the life context of these grandmothers and the remaining three themes: family upheaval; priority setting (with subthemes of difficulty meeting basic needs and competing demands); and self-silencing and self-sacrifice represented adaptive challenges. The context of African-American grandmothers’ lives created primarily adaptive challenges that were complex and without immediate solutions. Research is needed to develop culturally and contextually appropriate interventions to help this vulnerable group develop capacity for adaptive work.
Highlights
As of 2010, an estimated 2.7 million grandparents were raising grandchildren in the United States (USA); 24% were African-American with women overwhelmingly assuming this role [1]
Feelings of resentment toward the biological parent, which brought about family upheaval, was noted in the findings of del Bene’s 2010 [24] study of caregiving grandmothers in which they caregiving grandmothers “consistently expressed intense feelings of anger toward the biological parents”
It is evident that adaptive challenges are overwhelming for these women and that the type of adaptive work they must do has not been addressed in traditional educational interventions for diabetes self-management
Summary
As of 2010, an estimated 2.7 million grandparents were raising grandchildren in the United States (USA); 24% were African-American with women overwhelmingly assuming this role [1]. Adding care of grandchildren creates financial burdens for many African-American caregiving grandmothers who already live under severe financial constraints [2]. The biological parent may receive benefits for the child from the state, these benefits may not filter to the grandmother. Often the grandmother does not have legal custody of the grandchild, she is not be entitled to welfare benefits, food stamps, etc. This means the grandmothers must delve into their own limited benefits or retirement savings to provide for the needs of their grandchildren as well as themselves. In addition to the financial obligations, as the primary caregiver the grandmother is responsible for child rearing, driving them around to activities, attending school functions etc
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