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2000 Jordan Institute
for Families

Vol. 2, No. 3
June 1997

Grandmothers Who Care for Drug-Exposed Children

Nationally and in North Carolina, "grandcare" is on the rise. Between 1990 and 1996 the number of children under 18 being raised by grandparents grew 44 percent. In 1990, 111,000 children in North Carolina lived in households headed by grandparents; about 30 percent of these (33,624) lived in households where the grandparents were the sole caregivers (Stanley, 1997).

There are many reasons for this increase. Child abuse and neglect, teen pregnancy, and parental incarceration are common reasons. The major factor cited in many studies, however, is substance abuse (Minkler & Roe, 1993). As most social workers know, drugs and alcohol interfere with parents' abilities to care for their children. In cases where mothers abuse drugs while pregnant, the consequences for children—and those who care for them—can be severe.

While raising the average child can be difficult, children born crack-exposed or addicted require a level of care far beyond that of a healthy infant. Some of the outcomes typically associated with prenatal exposure to crack include pre-term delivery, low birth weight, growth retardation, irritability and lethargy, poor sucking ability and muscle tone, irregular sleep patterns, and attachment difficulties (NCFCRP, 1996). Older children may also have ongoing health problems as the result of prenatal exposure to drugs (Minkler & Roe, p. 159).

In their 1993 book Grandmothers as Caregivers, Meredith Minkler and Kathleen Roe looked at the challenges faced by 71 African American grandmothers who were the primary caregivers for their crack-exposed children. The interviews were conducted over a 15-month period beginning in 1990; the grandmothers ranged in age from 41 to 79, with a median age of 53.

In addition to the burden of physical care of these infants, grandmothers interviewed by Minkler and Roe identified several factors that contributed to the high levels of stress they experienced. These included:

  • Problems with government assistance. On the whole, grandmothers participating in this study felt unsupported by the government when it came to meeting the needs of their grandchildren. When they did qualify for financial assistance, it usually came in the form of AFDC rather than the more substantial support provided to non-relative foster parents. As recipients of welfare, they felt stigmatized in a way that foster parents are not. A 58-year-old grandmother said, "They make you fill out forms, save receipts, justify everything you do. They tell you what you can and cannot buy and even question my judgement . . . it's insulting!" (p. 94).

  • Trouble with an adult child still using drugs. Balancing their concern for their adult children with their need to keep their grandchildren safe was a difficult task for all of the grandmothers in this study. Some tried hard to keep the maternal-child bond strong; one grandmother constantly reminds the children not to call her `Mama,' that they have a real Mama. Others, afraid of the risk of violence and the disruption they cause in the lives of the grandchildren, cut ties with their adult drug-involved children (p. 169).

  • Worries about elderly parents. For several of the women interviewed by Minkler and Roe, caregiving for grandchildren was complicated by their responsibilities as primary caregiver for a frail or disabled parent or relative. The women reported that the combination of parent-care and child-care left them with the feeling that "everyone is depending on me" (p. 147). One women remarked, "I had planned to kick back and relax at this stage" (p. 148).

  • High cost of caregiving. Most of the women in the study experienced a serious drain on their finances after taking grandchildren into their home. One woman stated, "Before we were fine, we finally had plenty. Now, we can just barely make the basics, and it's getting worse" (p. 83). The emotional and physical cost can be a tremendous shock. For one respondent, the extra responsibility resulted in a separation from her spouse. Interestingly, women without a confidante were far more likely to report that their emotional health had improved since caregiving began (p. 77).

How can the child welfare system help ease the burden for caregiving grandmothers of drug-exposed children? Grandmothers as Caregivers concludes with a summary of a number of interventions being implemented around the country. Over 250 grandparent caregiver support groups have been formed in recent years. These support groups provide a place to share feelings and frustrations and to get information on services and resources. Occasionally these groups become a vehicle to lobby for more effective laws, both for grandchildren and the grandparents who care for them.

In California, a telephone "warm" line has been established for caregiving grandparents to call for emotional support and information. The service is staffed by volunteer grandparent caregivers who serve as peer telephone counselors. In the first six months of operation, the service received over 1,000 calls. In Deerfield Beach, Florida, a local senior citizen center operates a respite/intergenerational child care program. There are several training centers that provide special training to caregiving grandparents, in an attempt to meet the special needs of this population.

In the political arena, coalitions are forming to help concerned individuals, community groups, and agencies as they pursue the common goal of supporting and assisting grandparent caregivers. These efforts are occurring at the local, state, and national levels. In fact, in 1991 the first "Washington Summit" on grandparent caregiving took place. Ten leaders of the grandparent caregiver movement traveled to Washington, D.C. to meet with policy makers and key groups and organizations about the needs of relative caregivers raising children in what are being labeled "skipped generation" families.


MacLafferty, R., et al. (1994). Foster care: Parental drug abuse has alarming impact on young children. (GAO/HEHS-94-89). Washington, D.C.: U. S. Department of Health, Education and Human Services.

Minkler, M. & Roe, K. (1993). Grandmothers as caregivers. Newbury Park: Sage Publications.

North Carolina Family and Children's Resource Program. (1996). Child development in families at risk. Chapel Hill, NC: Univ. of North Carolina School of Social Work.

Stanley, L. (1997). Grandcare: Grandparents raising grandchildren. Chapel Hill, NC: Univ. of North Carolina School of Social Work.

U. S. Bureau of the Census. (1991). Current population reports: Marital status and living arrangements: March 1990. (Series P-20 NO. 450). Washington, D.C.: Government Printing Office.

1997 Jordan Institute for Families