“What If You Die?”: Skipped‐Generation Caregivers' Reported Conversations With Their Grandchildren About Death

• Published date: 01 April 2021
• Author: Jessica D. Freeman,Jessica Elton
• Date: 01 April 2021
• DOI: http://doi.org/10.1111/fare.12541

J D. FUniversity of Tennessee at Chattanooga

J EEastern Michigan University

“What If You Die?”: Skipped-Generation

Caregivers’ Reported Conversations With Their

Grandchildren About Death

Objective: This study focused on grandparent

caregivers’ communication about death with

their grandchildren.

Background: Skipped-generation grand-

families have become more common in the

United States. However, much research on

death communication focuses on traditional

parent–child(ren) nuclear families, making it

necessary to understand how families with

other structures, such as skipped-generation

grandfamilies, address this topic.

Method: This qualitative study applied commu-

nication privacy management as a guiding the-

ory and used progressive focusing to collect 30

in-depth interviews with grandparentcaregivers.

Interviews were analyzed using thematic analy-

sis.

Results: Three themes and eight subthemes

emerged. The rst theme centered on grandpar-

ent caregivers’ motivations for disclosing about

death to grandchildren and comprised three

subthemes: Exposure to Death and Lifecycle

Concepts, Grandchild Curiosity, and Unique

Grandparent Caregiver Concerns. The sec-

ond theme reected grandparent caregivers’

Department of Communication, 615 McCallie

Avenue, Department 3003, Chattanooga, TN 37403

(jessica-d-freeman@utc.edu).

Key Words: caregiver, communication, death, end of life,

grandfamily, kinship.

motivations to conceal information about death,

which included Age Inappropriateness, Trauma

Aversion, and Lack of Utility. The third theme

captured grandparent caregivers’ perceptions

of whether their grandchildren were concerned

about caregiver death.

Conclusion: Like traditional parent–child(ren)

nuclear families, grandfamilies identify death as

an important but challenging topic to discuss.

However, the unique characteristics of grand-

families magnify challenges and complexities of

discussing death.

Implications: The ndings contribute to com-

munication specialists’, social workers’, and

psychologists’ understanding of how grandfam-

ilies manage privacy surrounding death.

Skipped-generation “grandfamilies,” or families

in which grandparents coreside with and take

on parental responsibilities for their grandchil-

dren (Shakya et al., 2012), are a continually

growing population in the United States (Ellis &

Simmons, 2014), with almost 2.6 million grand-

parents responsible for at least one grandchild

(Generations United, 2017). This increasing

population raises concerns about how those in

these families relate to and communicate with

one another. One area largely unexplored in

the literature surrounding skipped-generation

grandfamilies is the possibility of grandparent

caregivers’ deaths and how they communicate

374Family Relations 70 (April 2021): 374–389

DOI:10.1111/fare.12541

Skipped-Generation Caregivers and Death375

with grandchildren about this topic. Given the

advanced age of many grandparent caregivers

compared with the children’s biological parents

(Ellis & Simmons, 2014), caregiver death is a

salient issue facing these families. Moreover,

previous research has indicated that factors

surrounding the possibility of a grandparent

caregiver’s death can lead to stress and grand-

family relationship challenges (Dolbin-MacNab

& Keiley, 2009; Kim, 2015).

Communicating about the end of life (EOL)

can lessen the burden on family members with

literature surrounding EOL decision-making

focused on strong communication (Ahrens

et al., 2003; Martin et al., 2000). Such scholar-

ship addresses how traditional parent–child(ren)

nuclear families communicate about death,

especially in the case of a terminally ill

parent (Houck et al., 2007). However, lim-

ited research has looked at the context of

skipped-generation families. With this in mind,

the current exploratory study investigated how

skipped-generation grandparent caregivers in

the United States discuss death with their grand-

children, specically taking into account the

possibility of their own death.

L R

Skipped-Generation Grandfamilies in the

United States

Grandfamilies are family structures in which

grandparents reside with grandchildren in

either multigeneration homes where at least

one parent is present or skipped-generation

homes (Shakya et al., 2012) where no parent

is present. Grandparent caregivers may have

informal or legally formalized (i.e., legal cus-

tody, legal guardianship, foster care, adoptive)

child custody arrangements (Wallace, 2016).

Grandfamilies have been on the rise since the

1970s (Ellis & Simmons, 2014), the emergence

of this family type is often linked to the chil-

dren’s parents’ inability to raise their children

due to substance abuse; death; incarceration; ill-

ness; economic distress; or child abuse, neglect,

or abandonment (Generations United, 2017).

Examining the 3% of total American households

in which grandparents and grandchildren core-

side, 67% were maintained by a grandparent,

and about one-third had no parents present (Ellis

& Simmons, 2014).

Scholarship has widely documented the ben-

ets of placing children whose parents are not

able to care for them in a kinship placement,

including placement in grandfamilies where the

grandparent becomes the caregiver. Grandpar-

ent caregivers report an increased sense of pur-

pose and pride (Langosch, 2012), and children

in kinship placement exhibit “healthier levels

of behavioral and mental health functioning”

(Richardson & Gleeson, 2012, p. 111) compared

with children in foster care. However, children

placed in kinship care with grandparents also

experience several lifestyle and physical dis-

parities. Grandchildren in grandparent caregiver

family structures are more likely to face mental

health issues (Dubowitz et al., 1994). Grandpar-

ent caregivers are also more likely to live below

the poverty line (Ellis & Simmons, 2014) and

experience wellness challenges. Although some

research studies question the correlative role

between grandparent caregiving and physical

health issues (Hughes et al., 2007), the general

body of literature indicates that this population is

vulnerable to social, psychological, and physical

health disparities (Mosby & Wamsley, 2012).

Magnifying these factors is the inuence

of the advanced age of the grandparent care-

giver population. On average, grandparent

caregivers are younger than coresiding grand-

parents not responsible for their grandchildren

(Ellis & Simmons, 2014); however, Gener-

ations United (2017) reported that 40% of

grandparent caregivers, that is, grandparents

fully responsible for their grandchildren, are

older than 60 years of age. Given the aforemen-

tioned vulnerabilities, as well as the average

life expectancy in the United States (78.8 years;

National Center for Health Statistics, 2017),

mortality is a concern faced by many grandpar-

ent caregivers. Further complicating matters are

varying state laws enabling some grandparent

guardians to name successive caregivers in the

event of their death (Wallace, 2016). These

laws frequently favor permanent, formalized

caregivers over those who have not sought

legal guardianship or adoption to designate

successors. A limited number of states allow

less permanent legal custodians to do so, and

“presently only New York permits informal

custodians who can show that the parent(s)

cannot be found to name a standby guardian”

(Wallace, 2016, pp. 166–167).

Communicating about Death

Death is an important stage of the lifespan,

but many people tend to avoid talking about it