Raising your grandchildren: how can grandparents cope?

Raising grandchildren while their parents work far away is common in Thailand, and it is tiring. In Thailand's 2017 Survey of Older Persons, 8.9% of the 41,752 people aged 60 and over lived with grandchildren without the middle generation, and an analysis of the 2011 survey found that regularly looking after grandchildren under 10 went with poorer self-rated health and lower psychological well-being. Things that help include agreeing the main rules with the parents early, keeping regular sleep, sharing jobs with relatives and neighbours, planning the grandchildren's meals around the food groups, and seeing a doctor if tiredness, pain or low mood goes on.

This article is about grandparents who are the main carers of their grandchildren. If you are a parent looking after both your children and your own parents, see Caring for kids and parents at the same time: how do I cope?

How many Thai grandparents raise their grandchildren on their own?

Households with grandparents and grandchildren only

In Thailand, a home where grandparents live with grandchildren and the parents live elsewhere is called a skipped generation household. Many parents move to cities or abroad for work and leave the children with their own parents. Thai studies give an idea of how common this is:

The national figure covers all people aged 60 and over, not only those who are raising grandchildren. The Khon Kaen study was in one province, so its figure may not apply to other areas.

Grandparents who are often stretched for money

The national survey shows that many grandparents in this role live in rural areas with less schooling and lower household wealth. On day-to-day functioning, after taking these differences into account, older adults in skipped generation households did better than those living with their adult children, but not as well as those living alone or with a spouse only. Hongthai and Jongudomkarn interviewed 29 grandparents in Northeast Thailand in 2019 who were raising grandchildren and earning for the family, and found that support from social and government services was limited.

Why does raising grandchildren feel so heavy?

What a national survey found

Komonpaisarn and Loichinger, at Chulalongkorn University, analysed the 2011 national survey of older persons in Thailand. Once they took into account which grandparents tend to take on care, regularly looking after grandchildren under 10 went with:

• poorer self-rated health
• more limits on daily activities
• lower psychological well-being

The care itself did not appear to bring physical health benefits. The researchers used statistical methods to account for which grandparents take on care, but this is an analysis of one survey and has not been checked in other years or areas.

What grandparents say in their own words

In the Northeast interviews, grandparents described three themes: sacrificing for the family as a value in life, getting through day by day to keep their minds well, and spiritual pride in being a grandparent. The researchers concluded that many carried burdens beyond what they could manage.

Common signs of carer stress

The US National Institute on Aging (NIA) lists signs of caregiver stress, written for anyone who cares for a family member:

• feeling exhausted, overwhelmed or anxious
• becoming easily angered or impatient
• feeling lonely or cut off from others
• having trouble sleeping or not getting enough sleep
• having frequent headaches, pain or other physical problems
• not having time to exercise or prepare healthy food for yourself

Signs like these are a cue to ask others for help rather than carry everything alone.

How can we agree on the rules with the grandchildren's parents?

Know the usual sources of conflict

Tangchonlatip and colleagues, at Mahidol University's Institute for Population and Social Research, interviewed 48 grandparents in rural Thailand who were raising grandchildren while the parents worked away. The conflicts they described with their adult children were about five things:

• the decision to care for the grandchildren
• how to raise and discipline the grandchildren
• where the grandchildren should live
• the grandchildren's schooling
• money sent home by the parents arriving irregularly

Grandparents used different ways to avoid or settle these conflicts, and Buddhist teachings played an important part in how families responded.

Talk it through early

One practical step, not something the study tested, is to go through these five points with the parents before or soon after the children move in, write down what you agree, and look at it again each school term.

Keep the parents close, even at a distance

Rose-Clarke and colleagues interviewed 24 adolescents aged 10 to 19 in rural Thailand whose parents had migrated for work. Most of their contact with their parents was by phone. The teenagers coped better when they had three things: warmth (love and understanding), financial support and guidance.

One way to keep those links going is a regular video or phone call at a set time, with school news passed on to the parents.

How can a grandparent look after their own sleep and energy?

Sleep

The US CDC recommends 7 to 9 hours of sleep a day for adults aged 61 to 64, and 7 to 8 hours for those aged 65 and over. Its healthy sleep habits include:

• going to bed and getting up at the same time every day
• keeping the bedroom quiet, relaxing and cool
• turning off electronic devices at least 30 minutes before bed
• avoiding large meals and alcohol before bed, and caffeine in the afternoon or evening
• exercising regularly

With young grandchildren, for example, you could rest while they nap, or ask another relative to take some early-morning or night shifts so that you get a few fuller nights.

Share the jobs

The NIA's advice on asking for help fits grandparents too: keep a list of jobs and let others choose, ask for small things first, send a text if asking face to face is hard, and be ready for some people to say no without taking it personally. Older grandchildren can take on simple jobs that suit their age, and neighbours may be able to share the school run.

Keep time for yourself

The NIA suggests finding something active you enjoy, such as walking, gardening or dancing, even for short periods, eating a balanced diet with plenty of water, and keeping time each week for something that has nothing to do with caring.

How should I plan my grandchildren's meals and days?

Food groups for school-age children

A Ramathibodi Hospital @Rama column, based on Thai Department of Health guidance, gives daily amounts for school-age children aged 6 to 12:

The column suggests 3 main meals a day without skipping any, especially breakfast, and 2 snacks in the mid-morning and afternoon that are not too sweet, too salty or high in fat, such as plain milk with a tuna sandwich, fresh fruit in season, or boiled corn. Ideas for busy mornings are in My child won't eat breakfast before school. What can I do?, and for children who refuse vegetables, see My child is a picky eater. What can I do?

Activity and sleep for the children

The same column suggests that school-age children are active for 60 minutes every day (in blocks of 10, 20 or 30 minutes if needed) and sleep 9 to 11 hours a day, or go to bed by 9 p.m.

How can I spend time with a toddler grandchild?

Everyday talk and play

For toddlers aged 1 to 2, the US CDC's parenting tips include talking with them and adding to the words they start, asking them to find objects or name body parts, playing matching games such as shape sorting, and letting them help with dressing and feeding themselves. These are everyday ways for any carer to spend time with a small child.

If something worries you

If you are worried about how a grandchild is talking or moving, ask at the local health centre or with the child's doctor.

Where can grandparents get help in Thailand?

Health centre and school

Tell the doctor or nurse at your local hospital or subdistrict health centre that you are raising your grandchildren. The NIA notes that health professionals may know about support groups and other help in the community. Let the children's teachers know who is caring for them at home, so the school can contact you directly.

Someone to talk to

In Thailand, the 1323 mental health hotline is free and open 24 hours a day.

When should a grandparent see a doctor about being tired?

Book an appointment

The NIA advises caregivers not to wait until they are completely overwhelmed, to tell their doctor that they are a caregiver, and to ask for a referral to a counsellor if they feel anxious, frustrated or down.

It is also worth seeing a doctor if:

• tiredness or poor sleep has gone on for weeks and is affecting daily life
• pain in the back, knees or other joints makes lifting or carrying the children hard
• you feel low, hopeless or have lost interest in things you used to enjoy

If you take any medicines or health products, tell the doctor or pharmacist.

Get help straight away

If you have thoughts of harming yourself or a child in your care, get help now: call 1323 or go to the nearest hospital emergency department.