Researchers have identified complex needs of custodial grandparent families and lack of access to needed resources such as housing, financial and legal assistance, and health care. Case management links these families with needed services while helping them develop skills to promote their health and well-being. This paper describes a case management program for custodial grandparent families using a nurse-social worker case management team. data were collected from 50 grandparents and 33 children using surveys and semi-structured instruments. Physical and mental health outcomes were measured using Short Form-12 Health Survey (SF 12) to measure the perceived quality of health for grandparents and the Child Behavior Checklist to measure the emotional and behavioral functioning of grandchildren. Grandparents more positively perceived their mental health after participating in the program. Perceptions about physical health were generally the same before and after the program. Grandparents' reported that many grandchildren had emotional and behavioral problems in the clinical range. These findings highlight the need for further research on the mental health needs of children being parented by grandparents as well as determining effective models and interventions to minimize adverse effects of parenting on grandparents. 1. Introduction Over the last two decades, the number of children raised by relatives in what is known as “kinship care” has grown exponentially, and most of the caregivers are grandparents. For many of these grandparents, raising a grandchild can be a long commitment [1]. While being custodian to grandchildren has positive aspects (e.g., the potential to guide the next generation into healthy and productive lives), research suggests that it can also be very stressful. With little opportunity to plan, grandparents are thrust unexpectedly into this challenging new role and confronted with a myriad of problems and issues in parenting their grandchildren. The challenges come out of complex social situations, including the death or unstable functioning of their adult children and the health and behavioral problems of the grandchildren [2]. Grandparents who are rearing grandchildren are often elderly and with low income and thus come into the custodial role with their own challenges. Many have chronic health problems, and the stress of caring for grandchildren increases their risk for cardiovascular and other health problems [3, 4]. Caregiving leaves little time or money to meet their own health and emotional needs [2, 5]. Also, grandchildren in
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