Capstone PowerPoint Grandparents raising grandchildren in Shreveport, la
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Transcript of Capstone PowerPoint Grandparents raising grandchildren in Shreveport, la
GRANDPARENTS RAISING GRANDCHILDREN IN SHREVEPORT, LA: CHALLENGES AND RESOURCESLISH’A BOND
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
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.”
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
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.
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
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
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
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
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
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
METHOD
Data Collection
Primary
In-depth interviews recorded audibly
Supplemental
Unobtrusive client chart reviews
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?
DEMOGRAPHIC AND OTHER DATA COLLECTED
Age
Sex
Race
Marital status
Health conditions
Health insurance
Educational level
Employment status
Yearly income
Source of income
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
DATA ANALYSIS
Interviews
Themes and coding
Descriptive analysis
Chart Reviews
Descriptive analysis
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
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
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
RESULTS
15 participant interviews
One participant spoke Spanish only
Daughter-in-law answered the questions she knew and translated the ones she did not
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
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
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
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
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%
RESULTS
Resources Needed/Wanted
Money/finance
Food
Clothes
Utility bills
Medicaid
Home improvement
Support group
Legal resource
Housing
Transportation
RESULTS
Aware of Groups
93% were not
Would Join Support Group
Yes = 53%
No = 13%
Maybe = 33%
Reasons
Time constraints
Poor health
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%
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
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)
LIMITATIONS
Small sample size
Convenience sampling
Lacked control group
Single informant
BIAS
Positive response
Social desirability
Interviewer
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
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
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
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