Grand Children Research Articles

Communication between grandparents and young grandchildren over distance: Establishing contact with constitutive nonhumans

Physical items are often taken for granted in mediated communication between grandparents (GP) and young grandchildren (GC). This article puts “constitutive nonhumans” at the center of inquiry to understand the potential of physical items and communication technologies to communicate over distance. The notion of phaticity operationalizes the role of constitutive nonhumans to establish and maintain contact over distance, which might have pleasurable or unpleasurable outcomes. A relational view on agency supports the entanglement of humans and nonhumans when they cooperate to communicate over distance. The article reports on a two-phase qualitative study that was conducted in two European countries with 10 GP (aged 60–75 years) and 10 GC (aged 6–11 years). The results identify how the entanglement between constitutive nonhumans conflates emotional connection and contact. Furthermore, the results suggest that the condition of familiarity can direct contact to pleasant or unpleasant outcomes that might differ across mediated and co-located communication.

MODERATION OF CUSTODIAL GRANDPARENT’S WELLNESS AND GRANDCHILD'S BEHAVIOR BY RELATIONSHIP QUALITY

Abstract A growing number of grandparents are assuming care of their grandchildren, and both grandparents and children report higher levels of stress than their peers, although the source of this stress remains largely unexplored. In Conger & Donnellan’s Family Stress Model, a parent’s distress can impact the levels of distress experienced by their child, and previous research indicates that parent/child relationship quality impacts children’s mental health. This study extended this to custodial grandfamilies, by investigating whether the relationship quality of custodial grandparents (GP) and grandchildren (GC) would moderate the relation between the health of GC and the wellness of their GP. Participants include 322 custodial grandparents within the United States recruited via Qualtrics Research Panel Survey (m age = 55.66 yr., 86.1% female). Measures included the Achenbach Child Behavior Checklist, Kivnick’s Grandparent Meaning Scale, and grandparents’ wellness. Moderation of relationship quality on the relation between the GP’s wellness and internalizing behaviors of the GC was tested using SPSS’ Process macro. A significant interaction was found (t = 2.31, p = .02) wherein GP’s wellness was not predictive of changes in GC’s behavior for the group with high relationship quality, but greater GP wellness was associated with less GC internalizing behaviors when relationship quality was low (p < .001). These findings indicate that when a GP feels that they have a more positive relationship with their GC, there is a greater likelihood that they will report fewer health concerns and fewer GC’s internalizing behavior symptoms.

IMPACT OF AN ONLINE SOCIAL INTELLIGENCE TRAINING PROGRAM ON CUSTODIAL GRANDMOTHERS’ WELL-BEING

Abstract Despite widespread evidence that the circumstances leading to care, combined with the stress of full-time parenting, have profound effects on psychological, physical, and social functioning of custodial grandmothers (CGM) and their adolescent grandchildren (GC), evidence-based interventions for these families are scarce. To address this gap, we conducted a randomized clinical trial (RCT) with 349 nationally recruited CGMs which compared an online social intelligence training intervention (SIT; n=185) to an attention-control (AC; n=164) condition. The SIT focused on enhancing CGMs’ capacity to develop and sustain positive social ties; an important goal since working models of attachment and caregiving are challenged and re-shaped by the off-time and demanding nature of parenting a GC. To investigate initial impact of SIT, we conducted multi-domain latent difference score models (Mplus 8) on a full intent-to-treat basis comparing the two RCT conditions on changes across key outcomes from baseline to immediate post-intervention. In comparison to AC, SIT yielded statistically significant improvement in CGMs’ depressed affect, self-esteem, relationship quality with the GC, and attachment avoidance and attachment anxiety with GC. Contrary to expectations, no significant differences were found between the two conditions on outcomes indicative of social competence (e.g., perspective taking, social awareness, social information processing, social self-monitoring). We conclude that CGMs may have applied information obtained from the SIT primarily to their relationship with GC. Our findings point to the potential benefits of the self-guided SIT, given that it can be delivered online and therefore has widespread reach to a vulnerable population. [Funded by R01AG054571]

GRANDPARENT-PARENT RELATIONSHIP, CAREGIVING MEANING AND FAMILY WELLBEING: AN APIM STUDY OF 200 DYADS

Abstract While many older persons contribute to their families by providing care to their grandchildren (GC), the role transition could bring challenges to both grandparents (GP) and parents (P) especially for those who evenly share caregiving duties. Despite growing research on grandparenthood, a knowledge gap remains in the study of GP-P partnership; it is essential to examine GP and P as a unit and learn how the dyadic relationship influences their family. The purpose of this study is to gain a further understanding of GP-P relationship, meaning of caregiving, and family well-being (FWB). Data from 200 GP-P dyads in China were collected by a questionnaire survey. The study participants were chosen from families with one GC aged 0–8 who is cared for by GP and P together, and identified by the GC’s teachers. The actor-partner interdependence model (APIM) was adopted in data analysis. Results showed that for co-(grand)parenting relationship and FWB, the actor effect was statistically significant for both GP and P; so was the partner effect from P to GP. Likewise, for meaning of caregiving and FWB, the actor effect was statistically significant for both GP and P; so was the partner effect from GP to P. The results advance knowledge about GP-P partnership and how feelings and actions could impact the overall family well-being. The findings can also guide the development of practices and services that enhance the function of GP-P collaboration and their family well-being.

Allogeneic Blood or Marrow Transplantation (alloBMT) Using Haploidentical Grandchildren Donors and Post-Transplant Cyclophosphamide (PTCy) -Based Gvhd Prophylaxis

Background: High dose PT-Cy allows the safe and effective use of haploidentical relatives as an allograft source. This platform increased the pool of related donors to include haploidentical siblings, parents, and children; more recently, second-and third-degree relatives have also been shown to be safe allograft donors. There is no consensus on the ideal donor; our standard practice is to prioritize young relatives such as siblings, children, or rarely parents- is safe and feasible. AlloBMT using nonmyeloablative (NMA) conditioning is safe and feasible in select patients aged 70 and above, a large group with hematologic malignancies. An increasing number of older patients have been treated with allogeneic blood or marrow transplantation (alloBMT) using related haploidentical donors. Older patients are more likely to have older siblings and children, and recent reports associated older donor age with worse outcomes. Therefore, we report the safety and utility of grandchildren (GC) as haploidentical donors and compare outcomes to patients with children donors. Methods: We reviewed records of patients at Johns Hopkins Hospital who received T-cell replete related allogeneic haploidentical donor blood or marrow grafts. We identified eight hundred and seven consecutive adults (≥18 years) between May 1, 2016, to October 1, 2021. Patients with aggressive myeloid and lymphoid malignancies were included. Only the first transplant was included for patients who received more than one transplant. All patients received NMA conditioning consisting of fludarabine, cyclophosphamide, and total body irradiation at 200 or 400 cGy. GVHD prophylaxis consisted of PT-Cy on days 3 and 4, followed by mycophenolate mofetil and either tacrolimus or sirolimus starting on day 5. Statistical analysis was performed using t-test, Wilcoxon rank sum test, or Chi-square test. Overall survival (OS), progression-free survival (PFS), relapse and non-relapse mortality (NRM) were estimated using Kaplan-Meier methods. Additionally, propensity score matching analysis (PSMA) for patient's age, BMT year, and graft source was performed. Results: Analysis was done on four hundred and sixty patients who received grafts from children donors and twenty-nine grandchildren donors. The median follow-up for patients was 28.8 (range 0.2 - 70.8) and 30 (range 0.8-50.4) months in children and GC, respectively. The most common diagnosis in both groups was acute leukemia compromising about a third of the patients, followed by myelodysplastic syndrome/ myeloproliferative disorders and Non-Hodgkin's (Table 1). Median age of patients in the GC group was 11 years older, 73 years (range 57-78) compared to 62 years (range 36 - 78) in the children group. The median age of children donors was 30 years (range 12-52), and 21 years (range 14-34) in the GC group. Patients in the GC group had higher comorbidities compared to patients in the children group, with a median hematopoietic cell transplantation comorbidity index (HCT-CI) of 2 (range 1-5) and 1 (range 0-7) respectively, (P=0.001). There was almost twice as many patients with HCT-CI of ≥3 in the GC compared to the children group, 38% and 21% respectively. The use of marrow vs PBSC as the graft source was not significantly different between the two groups (table 1). The two-year cumulative incidence of NRM was statistically significant higher for the GC group at 27% compared to 12% in the children group (P= 0.02). Since NRM is more likely in older patients, and older patients were more likely to be in GC group, we performed a PSMA. When matched for age, BMT-year and HCT-CI, PSMA did not show significant differences in NRM (HR 1.49, 95% 0.7-3.4, P=0.35). Similarly, OS, relapse and PFS did not show differences before or after PSMA. The two-year OS was 58% and 64% for children and GC, respectively (HR 0.82, 95% CI 0.36-1.88, P=0.63). Two-year relapse cumulative incidence was 24% and 7% for children and grandchildren, respectively (HR 0.45, 95% CI 0.15-1.34, P=0.15). Two-year PFS was comparable 52% and 56% for children and GC groups, respectively (HR 0.93, 95% CI 0.5-1.73, P=0.82) (fig. 1). Conclusions: Despite older age and comorbidities, the outcomes of alloBMT from grandchildren were at least as good as those from children, with 2-year OS of 64% and 58%, respectively. Choosing grandchildren as donors was associated with promising outcomes and should be examined further. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Belief on Witchcraft and Killing of People with Albinism in Lack Victoria Zone, Tanzania

Killing of people with albinism and old people has been featuring in Tanzania mass media and worldwide. The main cause of killing old people and people with albinism is witchcraft beliefs. Old women are reported to be killing grand children; whereas people with albinism were believed their part of the body when added with other potent traditional remedies brings fortune and prosperous. Witchcraft cannot be denied in indigenous African communities; however there might be other factors unexplored that lead to killing old people and people with albinism. The aim of this paper is to explore other factors that contribute to killing old people and people with albinism.
 Methodology: The study was carried in Lake Victoria zone, Tanzania using qualitative research methods. The main focus were to explore factors that lead to killing old people and people with albinism in addition to current belief of witchcraft. The collected information were analyzed using qualitatively techniques
 Results: The findings have shown any health problems including death need explanations that were sought through ramli. The ramli showed old people especially old women were noted to be killing grand children by witchcraft means. Other factors like wealth acquisition, jealous, misunderstanding in the day to day activities were also repotted. Whereas killing of people with albinism were due to the belief of that part of their body when added with potent traditional remedies brought fortune and prosperous to one requested. In addition it was noted that people with albinism were seen as bad omen or curse and were not wanted to leave.
 Lack of education on causes of health problems and people with albinism seemed to contribute to this problem. Public health education on causes of health problem and lack melanin to people with albinism which is important for skin pigmentation is needed

Grandparents Caring for Grandchildren, Family Structure, and Depressive Symptoms in China

It is a cultural norm for Chinese older adults to engage in co-parenting and caring for grandchildren. Previous research documented health advantages for grandparents who provide occasional, extensive, or even custodial care to grandchildren in China. Yet there is little information regarding the impacts of living arrangement and its interaction with grandchild care on grandparents’ psychological well-being. Using three waves of the 2011-2015 China Health and Retirement Longitudinal Study (CHARLS) data, this study examined the longitudinal association of depressive symptoms with grandchild care intensity and living arrangement among adults aged 40 and above (N=5,037). Mixed effects regression models were applied to examine changes in depressive symptoms and the associations with explanatory variables. At baseline, about half of respondents reported caring for their grandchild (ren). And nine percent lived with grandchildren only, that is, in a skipped-generation household and taking a custodial grandparent role. Overall, depressive symptoms did not change over time. After controlling for sociodemographic and health covariates, we found that providing medium level of care (i.e., between three to 10 hours per day) was associated with fewer baseline depressive symptoms, whereas grandparents living with grandchildren had more symptoms at baseline relative to those living with others. Further, an increased level of caregiving in the skipped-generation households was associated with more depressive symptoms. Given that custodial grandparenting is a growing phenomenon in China, further research needs to investigate how to reduce caregiving burden and associated adversary effects and how to promote overall well-being in this population.

The Matriarchive as Life Knowledge in Es’kia Mphahlele’s African Humanism

Prominent South African writer of the black diaspora Es’kia Mphahlele attributes his humanist consciousness to his grandmother and mother. His various forms of life writing (blurring the boundaries of fiction, memoir and scholarship) suggest how decolonizing the mind entails a voyage into the self, which is simultaneously a return to the source. Referring to examples of Mphahlele’s writing, I make a case for oral traditions passed on from matrilineal members of the family to their (grand)children as foundational to the formation of self and subjectivity within the larger cultural biography of black intellectual culture and the black radical tradition. I position the women of the matriarchive as critical thinkers, and their gendered knowledge as vital to the decolonial imperative which underscores Mphahlele’s consciousness.

Polyglot Internationalism and the Matriarchive: The Case of Keorapetse Kgositsile

In this essay, I make a case for oral traditions passed on from matrilineal members of the family to their (grand)children as a key system of knowledge that has informed and shaped black intellectual culture and the black radical imagination in South Africa and its transnational iterations. I focus on the work of Keorapetse Kgositsile, who attributes his cultural and political consciousness to his grandmother and mother, and asserts that they equipped him with the wisdom to survive the hostile environment of colonial modernity and apartheid. I put forth questions about a gendered black radical tradition and the place of these (grand)mothers in it. I adopt the heuristic matriarchive, which holds together locally specific matrilineally inherited worldviews, intersubjective relations, vernaculars, and aesthetics. I show how these have shaped pan-African sensibilities in this towering figure of South African modernity. When we consider the manner in which this prominent figure of black intellectual culture carries with him what I call the matriarchive to inform his work and politics in his itinerancy in the black diaspora, we open possibilities to investigate how the matriarchive was brought into locution with transatlantic cultural and political production. The issue of transnationalism and vernaculars serves to illuminate the mutations and transformations of the matriarchive in his work, which has enriched a polyglot internationalism. I argue that his work, shaped by a distinct sense of custom, culture, and community, has transformed his interlocutors in the black diaspora.

CUSTODIAL KNOWLEDGE AND LEGAL PERCEPTION AMONG GRANDPARENTS RAISING THEIR GRANDCHILDREN

The current study examines the ways in which grandparents raising their grandchildren (GRCs) understand custody, perceive the legal system, and access resources related to their grandchild(ren)’s welfare. Due to the detrimental impact of the opioid crisis over the last decade, the number of skipped generation households is growing significantly not only in Alabama, but across the U.S.. Many GRCs lack crucial information regarding custody arrangements in a general sense or as it applies to education, healthcare, mental health, and financial aid. Critical gaps remain present in the GRC literature necessary to aid in future intervention studies and promote more effective support, resources, and policy for this population. The present study sought to examine the unique needs and experiences of GRCs, and to specifically explore legal aspects associated to their grandchild(ren)’s welfare. Using a mixed methods approach, GRCs in Tuscaloosa, Alabama completed a quiz of custodial knowledge, a survey on legal perception, and a semi-structured interview. Quantitative data revealed the most and least commonly understood aspects of custody, as well as opinions on associated legal systems related to a child’s “best interest.” Qualitative data analysis revealed the common themes related to custody to be unexpected assistance, ineffective assistance, leniency for parental deviance, fear of losing custody, and time and cost demands.

Discipline Beliefs of Grandparents Raising Their Own Grandchildren: Are They Sparing the Rod When Not Spoiling the Child?

Background: According to the Census Bureau, more than 7 million grandchildren (GC) in the United States were being raised solely by their 2.7 million grandparents (GPs) in 2012. Parenting a GC can be challenging for GPs, especially since behavioral challenges and neurodevelopmental disorders are more prevalent in this population. Although GPs are traditionally allowed to “spoil” their grandchildren, effective limit-setting and discipline techniques are essential for GPs assuming a primary parenting role. Given that corporal punishment (CP) …

Old Home and Caring Elderly Population: Need or Dilemma

Background: Number of elderly population is growing very faster all over the world. This growth in elderly population relative to other age groups challenges mostly the existing health services, family relationships and social security. In this article we tried to address the gravity of the issue at family, social and national level. We also examined the parents care scenario in Western World and Asian societies.
 Observations and conclusions: Our observations revealed that old people from both West and Asia are interested to stay in their home with their children and grandchildren. This is a way to transmit there real life experience to their third generation (grand children) which, however, is very essential for the emotional, humane and psychological development of our future generation of the World. The present day capitalistic attitude is eroding the emotion and affection to the old and a big number of then end up in West and although smaller in Asian countries, but showed increasing trend, end up old homes. There are, however, situations where facilities needed for care of older people who lost their children and sometimes ailing people in native countries where their children living or settled aboard. Taking into consideration of the growing issue and empathic care of those facilities in such situations run following guidelines and ethical rules.
 Bangladesh Journal of Medical Science Vol.18(3) 2019 p.453-457

How Dutch Education Systematically Discriminates Against Dutch Immigrants and Refugees

This article investigates whether Dutch education is suitable for (grand) children of immigrants, refugees and expats with children in mainstream education. The available Dutch sociological, educational and psychological research in education and, apart from that, the education output data are the input for this investigation. The conclusion is that Dutch education should examine their consciences because on all fronts (grand) children of immigrants, refugees and expats with children in mainstream education do worse in Dutch education than (grand) children of original Dutch heritage. Children of immigrants, refugees and expats with children in mainstream education often experience disadvantage and deprivation in Dutch education. UNESCO claims that Civil Society Organizations must be held responsible to prevent (grand) children of immigrants, refugees and expats from experiencing disadvantage and deprivation in Dutch education. The tasks of these Civil Society organisations are: a) hold states accountable for their legal obligations, b) bring education concerns to the attention of a state, c) safeguard the right to education, such as providing tailor-made education as a human right, and e) hold states responsible for violations, such as disadvantage, deprivation, discrimination and exclusion.

Hemochromatosis and Cystic Fibrosis Carriers Identify Risk for GLP-1 Agonist Associated Pancreatitis

GLP-1 agonists are widely used antidiabetic agents. Among their potential associated side effects is acute pancreatitis (AP). Its exact prevalence is unknown as are known predictors for its incidence. We present two cases that suggest that carrier states for hemochromatosis (HC) and cystic fibrosis (CF) are risk factors for GLP-1 agonist associated AP. Case 1 is a 39 year old Caucasian lady with type 2 diabetes diagnosed 2 years ago. She has morbid obesity, hypothyroidism and NAFLD. She had a history of symptomatic AP to liraglutide (Victoza), exenatide (Byetta), dulaglutide and sitagliptin. She is currently managed with Degludec insulin, repagnilide, metformin and prn Lispro insulin with a current HBA1c of 6.5. Work up for mild transaminitis and prior elevated ferritin revealed she is a heterozygous carrier for the C282Y HC mutation despite currently having normal ferrokinetic profile. Her ongoing glycemic care is now without any further use of GLP-1 analogs nor DPP-4 inhibitors. Case 2 is a 62 year old Caucasian lady with type 2 diabetes diagnosed 8 years ago. She has hypertension, hypercholesterolemia and sleep apnea. She had a history of developing symptomatic AP to exenatide ER (Bydureon), dulaglutide and liraglutide (Victoza). Her current antidiabetic regime consists of Detemir insulin, Aspart insulin prn, metformin, repaglinide, and canagliflozin with a current HBA1c of 7.7. Because of a positive history of CF in several grand children she had genetic testing that showed she is a heterozygous carrier of the Delta F5deletion mutation of the CFTR gene. Her ongoing diabetes care is without any further use of GLP-1 analogs. Our case series present two patients with class associated predilection for GLP-1 analog associated AP. Heterozygous carrier states for CF and HC may represent at risk clinical phenotypes for GLP-1 AP. Consideration should be given to genetic screening for these carrier states prior to commencing diabetic patients on GLP-1 analogs and possibly also DPP-4 inhibitors. Disclosure W.A. West: None. G.I. Uwaifo: None.

Grandmothers and Children\u2019s Schooling in Sub-Saharan Africa

Under poor circumstances, co-residence of a grandmother is generally considered to be beneficial for (grand)children. Empirical evidence does not unequivocally support this expectation and suggests that the grandmother’s importance depends on the family’s circumstances. We study the relationship between grandmother’s co-residence and children’s schooling in sub-Saharan Africa under a broad range of circumstances. Results make clear that the effect of a co-residing grandmother varies but is almost always positive. Grandmothers over age 60 are most effective in helping their (grand)children. They are particularly important for girls, and when the mother is deceased or not living in the household. Grandmothers are less effective in situations with few opportunities, as in very poor regions or in communities with few schooling opportunities. Our findings indicate that providing support to grandmothers should not be overlooked when designing policies aimed at strengthening the position of women and children in the sub-Saharan African context.

Meals and Eating Practices within a Multi-generational Approach-A Qualitative Insight Study

Background: Eating behaviour is predominantly learned in childhood during socialisation, growing up in a cultural context. Various studies suggest that parents play an important role in the patterning of the eating behaviour of children. Very few studies consider the development of meals and eating practices in the context of multi-generational influences, therefore, the aim of this research project was to investigate influences on eating behaviour in one multi-generational family, presently living in South-West Germany. The parents, first generation (F1), were born at the end of 19th century. The couple had 15 children, the second generation (F2), and two of those children are alive today. There are 31 grandchildren (F3) and 50 great grand children (F4) and currently more than 10 great grand children (F5). The purpose of this study was to gain insights into the onset of eating behaviour and eating practices within a single multigenerational family perspective. Methods: This study is a single case study of a multi-generational family living in South-West Germany. Qualitative interviews with an aide-memoire were used within the matrilineal branch of the family, tracing four generations and spanning a time frame of three centuries. Results: The predominant role of women in meal preparation, use of family recipes, customs and food practices can be traced into the F4 generation. It appears that the matrilineal dissemination of meal structures and opinions, family recipes, use of cherished cookbooks, customs, is stronger than in the patrilineal mode and can be traced to the F4 in the present. Conclusion: To date very few studies have been conducted with a three generational, let alone multigenerational, approach on tracing eating practices within one family. The findings permit a better understanding of the onset of eating practices in a broader familial and cultural historical context.

Honorary citizenship in Moscow history

There was no accident in appearing of honorary citizenship class in Russian empire in the end of 18 century. It helped to solve several problems: removal of social tensions, integration problem of other worship and new ethnic groups, choosing people and giving them special privileges for the benefit of Russian state. Advantages of eminent citizens written by Katherine the 2nd in letters patent were: exemption from corporal punishment, conscription, ability in owning country yards and gardens (except for populated estates), moving around city in a carriage pulled by 2 or 4 horses. Titles of eminent citizens were inheritable. Grand children of eminent citizens who were bearing the title blamelessly could ask for nobility on reaching 30 years old. In 1832 Emperor Nikolay the 1st established manifest about class of honorary citizens. Honorary citizens were divided in personal and hereditary. Morozovy, Ryabushkinky, Guchkovy families were the famous representatives of this class. The title of honorary citizen was removed by VCIK and CNK decree from November 11 (24) 1917 about abolition of classes and civil officials. Soon it was decided (on the similar principals) to reward honored citizens with “honorary citizen” title for the benefit of the city. New title establishment not only helped to solve the problem of national scale but also encouraged the development of patronage, culture, science and municipal administration system in the whole Russian economics.

The Qualitative Analysis on the Adversity & Family Resilience of the Teenaged Grand Children at the Lower Class Grand-Children Family

The Qualitative Analysis on the Adversity & Family Resilience of the Teenaged Grand Children at the Lower Class Grand-Children Family

War and values: An empirical analysis

The paper considers the influence of war experience on the norms and values of the Great Patriotic War veterans and studies the intergenerational transmission of the values created by the war to the veterans’ descendants. The study conjectures that the war developed higher civic culture and fostered ability to collective action, altruism, and self-reliance. The war enlarged the “space of freedom” for its partici- pants, providing the new experiences of autonomy and grassroots self-organization and promoting the feelings of dignity and common belonging to the destiny of one’s native land. The paper shows that similar norms and values are, ceteris paribus, more common among the veterans’ (grand)children than among the other Russians.

Challenges of the Elderly In Zambia. A Systematic Review Study

Aging is a phenomenon that is found worldwide. In developed countries, the elderly living conditions are better relative to their counterparts in developing countries. Zambia has a population of slightly over 500,000. A big number of these people reside in rural areas. The aim of this paper was to investigate the challenges experienced by the elderly in Zambia. This was a desk study that used both a quantitative and qualitative methods focusing on the analysis of available literature on aging in Zambia. The results revealed that households with old people are among the poorest in the country. The other challenge faced by the elderly especially in rural areas is social stigma arising from being suspected of practicing witchcraft. They are also left out of the HIV/AIDS statistics and programmes: Currently there seems to be no available HIV/AIDS statistics and programmes for the elderly people aged 65 years and above. Lack of family support and the burden of orphans. Most of the elderly are poor and cannot manage to support their grand children in terms of school, decent shelter, clothing and medical care.