Custodial Presentation.ppt

Eastern Kentucky University Grandmother Research Team : 

Eastern Kentucky University Grandmother Research Team Doris Pierce, PhD, OTR/L, FAOTA Endowed Chair of Occupational Therapy Veronique Munier, MA, OTR/L Occupational Therapy Research Coordinator Julie Baltisberger, MS, OTR/L Occupational Therapy Research Coordinator

Interest, Relevance and Need : 

Interest, Relevance and Need Professional interest in grandmother occupations Environment influences the human experience from early to late life ~ growing and aging in a shared living space Increasing proportion of children raised by grandparents presses the need for living space sensitive to both age groups

Continuum of Grandparent Caregiving : 

Continuum of Grandparent Caregiving Provision of Day Care Co-Resident with Family Custodial Grandparent, No Parents Present

Review of the Literature : 

Review of the Literature Pathway to assumption of care Health consequences of caregiving Influence of environment on development across the lifespan Health risks among grandchildren

Slide 7: 

Percentage of female Medicare enrollees age 65 and over who are unable to perform certain physical functions in 2002 Stoop/ kneel Reach over head Write Walk 2-3 Steps Lift 10 lbs Any of these five

Ecology of Human Performance : 

Ecology of Human Performance Dunn, W., Brown, C., & McGuigan, A. (1994). The ecology of human performance: A framework for considering the effect of context. American Journal of Occupational Therapy, 48, 595-607.

Purpose Statement : 

Purpose Statement Describe how custodial grandmothers meet the developmental needs of infants / toddlers using environmental, temporal, social and emotional strategies.

Methods : 

Methods Watching, listening and recording Initial visit Two videotape visits Interview visit

Participants : 

Participants

Data Analysis : 

Data Analysis Interview Ethnograph v5.0 to organize text by code words and define segments for each of the five contextual categories. Video Microanalysis of video footage using Final Cut Pro to log and track clips for each of the five contextual categories.

Purpose Statement : 

Purpose Statement Describe how custodial grandmothers meet the developmental needs of infants / toddlers using environmental, temporal, social and emotional strategies. Describe how custodial grandmothers meet the developmental needs of infants / toddlers using environmental, temporal, social, emotional and physical strategies.

Five Initial Coding Categories to Explore Challenges and Strategies : 

Five Initial Coding Categories to Explore Challenges and Strategies Environmental – elements of space and material objects used to care for an infant such as diapers, bottles, toys. Temporal - routines, sleep schedule, baby development, breaks from child care. Social - interactions of play, praise, discipline. Emotional - patience, burden, anxiety, sadness. Physical - caregiver actions of lifting, carrying, pushing, playing, sitting on floor.

Six Axial Code Categories to Illustrate Grandmother Caregiving : 

Six Axial Code Categories to Illustrate Grandmother Caregiving Routines for organizing and managing ‘new baby’ care. Life course transition incorporating prior mother role. Physical actions and capacity of caregiver. Social network as support mechanism. Relationship with child to maintain family heritage. Safety and health of child.

Routines : 

Routines “Yeah, she sleeps with me. So I’m right there when she hollers for her bobby. I hear every holler and move she makes.” Great-grandmother age 73 caring for 16-month-old child Grandmother Strategies Establish daily routine Nest routines Retirement Use previous skills Focus on the present Content with pace

Life Course Transition : 

Life Course Transition “Well, yeah, at my age I just had to get back into it again, and it was real hard for a while, real hard. But I made it pretty good and I a doin’ okay I reckon.” Great-grandmother age 73 caring for 16-month-old child

Physical Actions : 

Physical Actions “My wrists are weak, that’s why I always try to sit” (to feed baby his bottle). Video quote from great-grandmother age 67 caring for three-month-old child.

Social Network : 

Social Network “We all get together with friends and do things. Every one of them is just as crazy over her as we are. If we was to go without her, they’d probably run us off.” Great-grandmother age 61 caring for 13-month-old child

Relationship with Child : 

Relationship with Child “Jack’s first reaction was, ‘Are we going to keep her?’ And I said yes. He asked, ‘For how long?’ I said as long as it takes. Now he can’t imagine life without her.” Grandmother age 65 caring for 14-month-old child Grandmother Strategies Establish and maintain contact between child and birth mother through face-to-face visits / photographs / phone calls. Gentle ‘mothering’ interactions with child.

Safety and Health : 

Safety and Health Medicine bottles on bedside book shelf. Medicine is within toddler’s reach / grasp. Video from home of great-grandmother age 73 caring for 16-month-old child Grandmother Strategies Toy storage Dedicate play space Restrict access Child proof the living space Constant surveillance

Theory : 

Theory When presented with the situation to care, a grandmother activates prior role competencies and integrates the child into her existing routine with only subtle contextual adaptations and life course transition.

Slide 23: 

Similarities Routines Mother in Context Grand-mother in Context Life Course Physical Demands Social Network Relationship With Child Safety and Health Mothers express need for break from routine. New baby represents major turning point with need to reconfigure life and identity. Ambitious agenda of activity to accomplish each day. Change to exclusive socialization with other mothers of small children. Tentative in use of discipline; i.e., “no,” to shape baby’s behavior. Purchase electronic in-home surveillance systems, safety devices, disposable products. Grandmothers spend more time in home and easily incorporate baby into routine. Return to earlier identity and accommodate baby with only subtle change in lifestyle. Sit to rest and “prop” baby during care routines. Nests grandchild into existing friendships/ socialization pattern. Strong impulse to care transcends age; grandmothers express joy Fabricate home-made safety solutions from available materials “make-do”