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    Ain't Parenting Grand?

    Suddenly Parents

    Difficult Issues to Deal With

    Sister Elizabeth Mullane, director of positive caring services and medical services at St. Vincent's Services in New York, often grapples with the more the difficult aspects of grandparents as parents.

    Many times a grandparent takes over parenting when "the parents cannot take on their responsibility because of a substance abuse problem or because [they] are in jail," she says. And in such cases, the grandparents are very likely to feel overwhelmed.

    "Probably the most important service that we can then offer to both the grandparent and the grandchild is respite care," she says -- that is, short term, temporary care of the child to give the grandparent a break from the daily routine of caregiving. "Even taking over for a few hours can be a welcome and essential relief," she says.

    Even in the best circumstances it is not easy for grandparents to become parents again," says Hollidge. One particularly difficult aspect is dealing with the legalities.

    "Grandparents are always reluctant to enter into formal arrangements," she says. "In many states it means having to take their own child to court to have that child declared an unfit parent."

    Some states, such as California and Delaware, have passed education and medical consent laws that allow grandparents who can produce an affidavit of residence and relationship to enroll grandchildren in school and sign consents for medical care. But legislation varies widely from state to state, according to the AARP.

    Discovering How Things Have Changed

    According to the AARP, the average age of first grandparents -- when their first grandchild is born -- is 47, which is very different from the image of gray-haired, rocking-chair-bound grandparents in earlier generations, says Mullane. Nevertheless, she says, even at this relatively young age, "it is still true that things have changed since these grandparents were first parents."

    Pediatricians can help by educating grandparents about some of those changes, says Andrea McCoy, MD, director of primary care at Temple University Children's Medical Center, in Philadelphia. For example, the "Back to Sleep" campaign is a recent effort to prevent sudden infant death syndrome, or SIDS. Grandparents need to be told that infants must be put to sleep on their backs, not on their stomachs, says McCoy, advice that runs contrary to what many of them did with their own children. "But we now know that by putting the infant on his or her back we reduce the risk of SIDS," she says.

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