The "invisible caregiver": multicaregiving among diabetic African-American grandmothers.
OBJECTIVE
To explore the multicaregiving roles African-American grandmothers assume while self-managing their diabetes.


METHODS
This longitudinal, qualitative pilot study explored the challenges of self-managing diabetes among six African-American caregiving grandmothers. Data were collected at 5 times points across 18 months. Content analysis, guided by the Adaptive Leadership framework, was conducted using data matrices to facilitate within-case and cross-case analyses.


RESULTS
Although participants initially stated they cared only for grandchildren, all had additional caregiving responsibilities. Four themes emerged which illustrated how African-American caregiving grandmothers put the care of dependent children, extended family and community before themselves. Using the Adaptive Leadership framework, technical and adaptive challenges arising from multicaregiving were described as barriers to diabetes self-management.


CONCLUSIONS
When assisting these women to self-manage their diabetes, clinicians must assess challenges arising from multicaregiving. This might require developing collaborative work relationships with the client to develop meaningful and attainable goals.
Department of Social Medicine University of North Carolina, Chapel Hill, NC, USA. Electronic address: carthron@email.unc.edu.
Dana L
DL
Carthron
School of Nursing, Duke University, Durham, NC, USA.
Donald E
DE
Bailey
School of Nursing, Duke University, Durham, NC, USA.
Ruth A
RA
Anderson
D000368:Aged; D044383:Black People; D017028:Caregivers; D003920:Diabetes Mellitus / Q000451:nursing*; D006801:Humans; D016901:Intergenerational Relations; D007857:Leadership; D008875:Middle Aged; D001741:Black or African American
African American; Caregiving; Chronic illness management; Diabetes; Grandmothers raising grandchildren; Longitudinal; Multicaregiving; Older adults; Qualitative; Self-management