Grandparents are a representation of a considerable population of adults who have the duty of nurturing and teaching children below five years (Hayslip et al., 2013).

Grandparents as caregivers: A new role
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Grandparents as caregivers: A new role
Grandparents are a representation of a considerable population of adults who have the duty of nurturing and teaching children below five years (Hayslip et al., 2013). According to recent U.S census data, grandparents in the U.S.A provide care for up to 24 per cent of children under five years, this was more of the same as the total number of children that are cared for within the formal arrangements. Grandparents caregivers often face considerable challenges in raising these children considering the technological advancements witnessed over the past few years. In relation to nursing, grandparents a challenge when it comes to credible knowledge about what drug to administer or how to treat children under their care when it came to healthcare.

Significance to Nursing
Children under the care of grandparents have faced different impacts in their life, some have negative experiences in their overall health while others have been well taken care of and are healthily living. Considering the differences and the increasing challenges related to mental health and behaviour, children who experience these challenges under the care if the grandparents have shown significant detrimental and negative outcome (Bertram et al. 2013). The below literature review analyses and shows the significance of grandparents caregivers to this population of children
Literature Review
The below literature review was done across ten different articles, out of which four were excluded due to the variance in the intended outcome, basically not including the nursing aspect when it comes to carefiving by grandparents. The key words that involved in the search included; the relationship between grandparent caregivers and health impact; the benefits and challenges associated with grandparents as caregivers to children below five years; health related concerns on children and grandparents caregivers. These articles proved to be resourceful when it comes to the research topic.

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According to Fauziningtyas et al. (2018), the background of bringing up a grandchild can be both negative and positive, although this is more influenced by the cultural aspect of the family unit. For effective relationship, It is important for the grandchildren to have knowledge and information related to health care needs as well as their own. In as much as the caregiving role by parents is essential, it is important to ensure that the grandparents strike a balance between caregiving and resting as the process might be over tasking and a burden on their health conditions (Fauziningtyas et al. 2018). Health status of the elderly tends to lower given the age constraints.,
A study by Bigbee et al., (2016), showed that grandparents find it fun in the caregiving role they play in these children; Majority of the caregivers confessed to the joy of caregiving saying it was more fun and enjoyable compared to being a parent. They also admitted to being better caregivers grandparents as it was being a parent. Grandparents assume the new roles as caregivers because either they have been directly asked or they see a need to be involved in the role actively because they want to help. Most of the participants in the focus group admitted to being pushed by the love they have for the young children as well as they have for their children. Also, most of them mentioned the strong urge to stay close to family, most of the participants acknowledged this role as an important role to bring the family together.
Another study conducted by Kelley et al., (2015), there are more related themes that emerged from the study, after a focus group of 13 grandparents taking care of their grandchildren were analyzed, it emerged that most of the grandparents enjoy their roles as caregivers and in most grandparents, confessed to being faced with conflict on parenting with their adult children, over how best to raise the children under their care. Most participants agreed to the fact that they had an effective relationship with their adult children, they found it hard to share the caregiving role as there was a mismatch between their expectations related to roles and responsibilities. Most grandparents showed that they were confident in how they provided care given their vast experience in providing such care (Carr et al., 2016). Also, the majority of the caregivers also admitted to consulting YouTube or google to get credible information on child-rearing and also some agreed that they consulted their peers who have grandchildren for more information about caregiving.
Another group of study concentrated on the usefulness of the intervention assistance on the fitness of grand caregivers. Some of the intervention services given to the grandparents include; visiting case management, support groups and even legal support (Wu et al., 2015). Considering reducing healthcare attention awarded to the grandparents, they are likely to forgo their own care as their time is consumed in their new roles. Therefore, it is necessary to encourage these grandchildren not to avoid these services as they are critical for their improved mental and physical health.
Summary of Implications
From the literature review, the new role of caregiving by the grandparents has it’s pros and cons, considering the value it adds to the family system, it should be embraced with close scrutiny to the negative impacts it has. A grandparent caregiver should limit the overall tome they spend on caregiving. The general health of the children under their care as well as their own health should be critically analyzed and amicable solution should be put in place to counter the negative effects on the overall health of individuals involved. Nursing caregivers should emphasize the overall need to monitor the health of the caregivers as it has a direct effect on the overall health of the children.

Recommendations
There is need to carry out a credible study in this area as there is significant information missing when it comes to health implications and nursing practice in relation to offering adequate caregiving to children. For future effective evidence-based practice, it is necessary to understand the child’s behavioural, physical, environmental and psychological concerns to nursing care. Also, longitudinal studies should be conducted to fully understand the attachment the children have with the grandparent’s caregivers and the effect they have in their overall growth and development.

References
Bigbee J. L., Musil C., Kenski D., (2016). The health of caregivers grandmothers: A rural-urban comparison. The Journal of Rural Health. Doi. 10.1111/j.1748-0361.2010.00340.x. [PMC free article] [PubMed].
Carr G. F., Hayslip B., Gray J. The role of caregiver burden in understanding African American custodial grandmothers. Geriatric Nursing. 2017;33(5):366–374. doi: 10.1016/j.gerinurse.2016.03.004. [PubMed] [CrossRef]
Fauziningtyas, Rista & Indarwati, Retno & Alfriani, Delisa & Haryanto, Joni & Ulfiana, Elida & Efendi, Ferry & Nursalam, Nursalam & Khatijah, L.A.. (2018). The experiences of grandparents raising grandchildren in Indonesia. Working with Older People. 10.1108/WWOP-10-2018-0019.
Hayslip B., Jr., Davis S. R., Neumann C. S., et al. (2013) The role of resilience in mediating stressor-outcome relationships among grandparents raising their grandchildren. In: Hayslip B. Jr., Smith G. C., editors. Resilient Grandparent Caregivers: A Strengths-Based Perspective. New York, NY, USA: Routledge; 2013. pp. 48–69.
Kelley S. J., Whitley D. M., Campos P. E. (2015) Psychological distress in African American grandmothers raising grandchildren: the contribution of child behavior problems, physical health, and family resources. Research in Nursing and Health. 2015;36(4):373–385. doi: 10.1002/nur.21542. [PubMed]
Wu C.-F., Wang M.-S., Eamon M. K. (2014) Employment hardships and single mothers, self-rated health: evidence from the panel study of income dynamics. Social Work in Health Care. 2014;53(5):478–502. doi: 10.1080/00981389.2014.896846.

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