title: Rewards and unique challenges faced by African-American custodial grandmothers: the importance of future planning.
abstract: OBJECTIVE
  This exploratory study examined the context and consequences of custodial grandparenting, along with attitudes and preferences regarding future planning among 22 African-American custodial grandmothers.
  
  
  METHODS
  A mixed-method research design was employed. Based on our integration of two theories regarding future planning and health behavior change, caregiving, emotional distress, religiosity and spirituality, and future planning were assessed using questionnaires along with semi-structured interviews.
  
  
  RESULTS
  African-American custodial grandmothers (mean age M = 53.64, SD = 9.58) perceived their caregiving role as rewarding (72%) yet challenging (86%). More than 40% reported significant emotional distress (CES-D ≥ 16) that warrants clinical attention. Findings showed that while 64% of study participants had future plans regarding who will substitute in their caregiving role if they become incapacitated, only 9% had completed a living will. Three major themes emerged regarding custodial grandmothers' caregiving role which includes: (1) rewards; (2) challenges including feeling overwhelmed and health concerns; and (3) caregiving decisions including conflicts between 'My plan was…/put self on-hold' for grandchildren and difficulty with future planning. These themes highlighted the dynamics of caregiving across time, including current context and the ongoing process of decision-making.
  
  
  CONCLUSIONS
  Findings suggest that while African-American custodial grandmothers find caregiving rewarding, they face unique challenges in contemplating and developing future plans. Custodial grandmothers think about substitute caregivers for their grandchildren but need assistance communicating a plan focused on their own needs for future care. Culturally sensitive interventions designed to facilitate effective utilization of future plans within this caregiver population are needed.
authors.affiliation: a Department of Psychology , The University of Alabama , Tuscaloosa , AL , USA.
authors.forename: Martha R
authors.initials: MR
authors.lastname: Crowther
authors.forename: Chao-Hui Sylvia
authors.initials: CH
authors.lastname: Huang
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Allen
mesh_terms: D032722:Advance Care Planning; D001741:Black or African American / Q000208:ethnology*; D017028:Caregivers / Q000523:psychology*; D005260:Female; D000066502:Grandparents / Q000523:psychology*; D006801:Humans; D007872:Legal Guardians / Q000523:psychology*; D008875:Middle Aged
keywords: caregiving; cultural aspects; religion/spirituality