Chronic disease prevention and management among custodial grandparents: A nursing and community health education model

Close to 2.5 million grandparents have full parental responsibility for their grandchildren. Custodial grandparents, many of whom are poor, African American and Latino, have higher rates of chronic illness and depression than do non-custodial grandparents. Self-care for chronic disease prevention and management is compromised by child rearing demands, low income, inadequate housing and the scarcity of community resources for healthier lifestyles.

This paper will present findings from the nursing and community health education models of the Grandparent Resources and Caregiver Initiative Alliance (GRACIA) Project, a multidisciplinary, supportive service program for kinship caregivers. Located in Passaic County, New Jersey, GRACIA is a replicable program design for other urban and metropolitan areas. GRACIA offers a three part approach to address client health needs: 1) case management to identify health resources (insurance, primary care physician) ) and facilitate access,; 2) free, in home nursing assessment and counseling with follow up to promote preventative healthcare and encourage self-management of chronic illness; and 3) group health education programs presented in a social atmosphere.

Facing multiple chronic health conditions, self-reported physical health diminishment, and barriers to health care access, increased participation in GRACIA' s health services by GRACIA clients has been accomplished through innovative strategies to improve self- care. GRACIA's unique design, combining health education with socialization, respite and opportunities for open dialogue with health professionals will be presented. Findings from in-home nursing assessments and follow-up and results from a group health education model embedded in a family-centered socialization program will be discussed.