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Older Adult Populations Serving as Caregivers

The intersection of old age and rurality presents a number of challenges, including low levels of social support and a lack of access to transportation, healthcare, and adequate housing. These challenges impact the ability of older adults to access important health and public assistance services. Consequently, older adults in rural areas tend to have poorer health outcomes than those living in urban areas. This includes higher rates of obesity and physical inactivity. In addition, according to the Housing Assistance Council, nearly 11% of older persons in rural areas live on incomes below the federal poverty level, compared to 7% of suburban older adults.

In addition to these challenges, 35.5% of older adults act as caregivers for their grandchildren in the U.S. and in rural areas it is 46.7% (U.S. Census Bureau, 2013-2017 5-Year American Community Survey). According to Census data from the 2017 American Community Survey, approximately 6 million children under age 18 were living in grandparent-headed households.

A program called Project Healthy Grandparents (PHG) was established by Georgia State University to address the needs of older adults as caregivers. This project found that grandparents assume the role of primary caregiver when the biological parent is unable due to substance abuse, incarceration, or death. The grandparents involved in this project have faced many of the same health problems that other older adults face, including high blood pressure, obesity, diabetes, poor nutrition, arthritis, and psychological problems. They also reported high levels of psychological distress and feelings of isolation. In general, many caregivers experience stress as a result of insufficient financial support, adjustments to their work schedule, declining personal health, and increased rates of depression and anxiety. Therefore, it is critical to address the needs of older adult caregivers, as poor health will impact their ability to care for custodial children.

In order to ensure that all children receive the best possible care, older adults acting as caregivers may benefit from services such as:

  • Case management
  • Referrals to health resources
  • Support groups
  • Assistance with caring for children who had prenatal exposure to drugs and alcohol
  • Home visits from a healthcare worker
  • Psychological counseling to reduce stress
  • Problem solving training

Select states also offer respite services such as in-home child care and resources, including financial assistance, for eligible grandparent caregivers. Since caregivers provide the first level of care for their loved ones, it is critical to support their role through integrated health and human services.

Services integration programs can help older adults to access the services they need. For instance, programs can assist older adults with enrolling in public assistance programs. Rural services integration programs that involve a one-stop shop for health and human services improve access to services by reducing the amount of travel to and from different providers.

Resources to Learn More

Elder Health in Rural America
This NRHA policy brief provides an overview and brief analysis of the current status of rural communities, rural elder health, policy, and practice, and suggests guidance/recommendations for future policy based on a systems approach.
Author(s): Hartman, R. & Weierbach, F.
Organization(s): National Rural Health Association
Date: 2/2013

The Health Status and Unique Health Challenges of Rural Older Adults in California
This policy brief examines the health of rural elders and, by contrast, their urban counterparts, and finds that both groups are more likely to be unhealthy than suburban older adults.
Author(s): Durazo, E., Jones, M., Wallace, S., Van Arsdale, J., Aydin, M., & Stewart, C.
Organization(s): UCLA Center for Health Policy Research
Date: 6/2011

Project Health Grandparents
Project Healthy Grandparents (PHG) was established in 1995 by Georgia State University to strengthen intergenerational families and to improve their quality of life by providing grandparents and grandchildren with comprehensive services and improve access to community resources.
Organization(s): Georgia State University