An Exploration of Theories and Their Roles in the Study of Custodial Grand Families: A Scoping Review

Background and Purpose: Grandparents raising grandchildren are at an elevated risk of health-related issues. Custodial grandparents have a propensity for experiencing greater physical health declines, higher rates of depressive symptoms and stress levels, and poorer self-rated health. In addition to that, custodial grandparents with already debilitated health before the entrance of grandchild/children in their lives, are susceptible to further decline in health. Besides the natural predisposition to poor health, custodial grandparents are more likely to have poor social support, low-income and educational qualifications, and are members of racial and ethnic minority groups, characteristics often linked to poorer health access and outcomes.

Our scoping review examines and compiles theories across disciplines that guide research exploring the role of theories while studying the physical, mental, social, and emotional well-being of grandparents raising grandchildren.

Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Cochrane Review process. We conducted an exhaustive electronic search of the literature on six databases Academic Search Complete, AgeLine, APA PsycINFO, ERIC, SocINDEX, and Social Work Abstracts using the following search terms: [‘grandfamilies’ OR ‘grandfamily’ OR ‘grandparent’ OR ‘grandfather’ OR ‘grandmother’ OR ‘grandpa’ OR ‘grandma’] AND [‘raising’ OR ‘caregiving’ OR ‘caregiver’ OR ‘custodial’ OR ‘responsible’]. We included quantitative, qualitative, and mixed-methods peer-reviewed articles and book chapters published in English till February 2023.

Two authors independently screened 2,574 titles and abstracts using Covidence screening software and included 139 articles for full-text review. In case of disagreement a third independent reviewer contributed to the conversation. Finally, six authors used descriptive and narrative analysis to review the full text and excluded 103 articles and book chapters, giving a final selection of 36 articles.

Results: Our analysis identified the stress process model, family stress and resilience theory, life-course perspective, family systems theory, and attachment theory as the major guiding theoretical frameworks to address the health and social well-being of grandparents raising grandchildren. These theories inform 1) life stresses and strains affecting grandparents-grandchildren relationships and well-being; 2) coping resources for intergenerational solidarity; 3) social relationships and their impact on the health and well-being of grandparents raising grandchildren; 4) the role of formal and informal support in enhancing health as well as social relationships of grandparents; and 5) how demographic factors and policies impact relationships and well-being of grand families.

Conclusions and Implications: Our scoping review found a significant number of theories used across the disciplines that are suggestive of the multifaceted issues associated with grandparenting. Although theories guide the conceptualization of the research, there are few consistencies across studies and disciplines impeding the opportunities to use a multi-disciplinary approach to address the health and social well-being of grandparents. Policy and practice design should recognize relevant knowledge from various theories across disciplines to enhance the health and well-being of custodial grandparents as well as improve the quality of life of intergenerational households.