MEDICINE OUTSIDE THE BOX
Raising the Next Generation in Kentucky
A
5-year-old male is brought into the office for a well check . Like nearly 100,000 children in Kentucky , which has the highest rate of non-parent caregivers , 1 , 2 , 3 he is being raised by a grandparent due to his parents ’ issues with drug use , mental health and violence . Through the course of the visit , you learn that he has been in his grandmother ’ s care , along with his two siblings , since he was an infant . His grandmother struggles , like many grandparents in the community we serve , to raise a second generation of children .
12 LOUISVILLE MEDICINE
by LISA PFITZER , MD , FAAP & JENNIFER STIFF , MD , FAAP
The untold stories of these grandparents were the inspiration for an interview-based study , supported by the Institutional Review Board ( IRB ) of the University of Louisville and Norton Children ’ s Medical Group , to shed light on the daily challenges of those raising our pediatric patients . Fifteen grandparent guardians were interviewed , primarily via phone . These caregivers ranged from 40-80 years of age and are raising children 1 to 17 years of age , with an average age of 9.8 years old . Nearly half of the grandparents ( seven of the 15 interviewed ) are doing so as a single primary caregiver . Most participants were Caucasian females with an average of 12 years of education .
We often find ourselves wondering how grandparents came to be the caregivers . In our study population , 16 % of parents were deceased from a range of causes including cancer , motor vehicle accident ( MVA ), drug overdose and unknown causes . The top three reasons for a grandchild ’ s placement with grandparents were drugs , neglect and parental death . Grandparents shared scenarios with us that preceded their grandchildren ’ s placement : “ Someone called the police .” “ They were having a fight .” “ The police saw drug paraphernalia .” “ They were abusing several different drugs .” “ The house was deplorable , Child Protective Services ( CPS ) was called that night .”
Another grandparent offered , “ The mom asked me to be guardian , she couldn ’ t do it anymore , she was living in a truck .” A third grandparent with custody of four grandchildren described her adult son as a dad who abused alcohol , “ He was on a downward spiral , nobody was left ” while the biological mom was addicted to drugs .