Taking care of grandchildren in old age: repercussions in grandparents' life and health

Renata Mirella Brasil da Silva Lima1, Alana Vieira Lordão2, Bianca Freitas Régis3, Samara da Silva Santos4, Amanda Ellen Costa da Silva5, Edilene Araújo Monteiro6, Maria de Lourdes de Farias Pontes7

1,2,3,4,5,6,7Federal University of Paraíba. João Pessoa (PB), Brazil.

Introduction

Both at the national and international level, extended life expectancy and population aging have resulted in increasingly more active older adults in society and in family contexts, evidencing greater social and functional participation. However, such demographic progress not necessarily translates into proportional improvements in the health conditions of this population segment.1-3

Added to that, several transformations in family structures have favored deeper insertion of older adults in the family nucleus, intensifying their participation in inter-generational relationships. In this context, they start to more expressively take on the grandfather and grandmother roles, actively collaborating to caring for and/or upbringing their grandchildren, which evidences the relevance of grandparenthood in contemporary family dynamics.4-5

In addition to characterizing the condition of being a grandfather or grandmother, grandparenthood refers to the functional dynamics of the relationship between grandparents and grandchildren, involving affective and social dimensions in the family context and representing a concept that goes beyond the strictly blood tie notion, for being associated with the grandparents' participation in their children's life, as well as with the inter-generational transmission of values.5

This relationship between different generations (inter-generationality) is essential for a well-prepared society duly instructed on the ways of acting and thinking about aging, as the demographic transition is constant in this sense. Therefore, the following benefits contributed by these relationships should be mentioned: improved coexistence and interpersonal relationships, bonding, promotion of new inclusion modalities, respect and less discrimination, in addition to sharing life experiences and affectionate exchanges, mainly in the family nucleus.6

Such relationships can oftentimes be exempt from duties and responsibilities, providing a milder way of aging, as in the case of grandparents with their grandchildren. However, when the function of taking care of that inter-generational relationship is added, this can generate certain physical or emotional overload, contributing to harms to older adults' health, mainly when care activities are intense and frequent.7-8

International data point out that aged grandparents that take care of their grandchildren with more intensity (in the co-parenting or legal custody condition) report worse harms to their health, either in the form of ailments or in terms of practicing less physical activity, when compared to those that take on the care role occasionaly.8

In addition to that, inter-generational care can oftentimes by assumed out of the social obligation and duty of helping a son or daughter, culminating in limitations and impediments in the aged grandparents' life.9,10 There can also be repercussions in emotional health, as the time devoted to care and the responsibility taken on by grandparents are oftentimes intensified and confusion in terms of family members' roles and duties in upbringing the children can become a reality capable of triggering possible conflicts.11-12

From the perspective of grandparents pursuing studies that take care of their grandchildren in any way, national data showed that tutoring these grandchildren can cause negative effects such as financial, physical and emotional overload, thus affecting older adults' quality of life.12

Despite being a relevant and current theme, the scientific production in the area is still undergoing an expansion process. Thus, the evidence showing the repercussions in the life and health of aged grandparents addressed in a personal and narrative way is incipient. Therefore, in order to understand the narrative of this population segment in the regional reality (where the scientific production in the area is scarce), the objective was to understand the repercussions in the life and health of aged grandparents that take care of their children.

Method

This is a descriptive and exploratory study with a qualitative approach that was developed with 9 aged individuals linked to an Aging Institute in northeastern Brazil. The eligibility criteria corresponded to older adults acting as support figures in the care and/or upbringing of grandchildren, either with a full- or part-time regime, and registered at the institution.

The study adopted the age restriction of up to 9 years old for the grandchildren because it follows the guidelines set forth by the World Health Organization (WHO), the Ministry of Health and the National Policy for Comprehensive Children's Health Care (Política Nacional de Atenção Integral à Saúde da Criança, PNAISC), which consider subjects aged from 0 to 9 as “children”. In addition to that, it corresponds to a childhood phase that demands more supervision and assistance in activities, requiring a singular share of attention and care in which various conditions in the relationships can exert an influence on their growth and cognitive, socioemotional and behavioral development.13-14

The study locus has 1,178 aged individuals registered and offers various activities, such as dancing, design, conversation groups, cinema, flute classes and martial arts. For registration purposes, previous geriatric evaluations and cognitive tests are applied by the team of professionals in charge, in order to ensure that the older adults have their autonomy preserved. In this sense, choice of this locus was driven by the scientific ambience provided by the environment.

As a first step, the participants were approached during the activities developed in the Institute and, if they met the eligibility and interest criteria, they were subsequently contacted by phone to schedule the interviews. Consisting in a semi-structured script and audio-recorded, these interviews were conducted individually in a private space at the Institute's premises from July to September 2023 and by a single interviewer, so that data accuracy was more consistent and continuous during the entire process, reducing external variables and corroborating to interpret and analyze the results.

The interviews included questions referring to sociodemographic data to characterize the participants (age, biological sex, schooling, family income, occupation, family situation, number and age of the grandchildren) and guiding questions grounded on the study object: What does it mean to be grandmother/grandfather to you?; How often do you take care of your grandchild and how does this care work?; How can taking care of your grandchild interfere in your health?; How can taking care of your grandchild interfere in you performing your activities?; and How would you summarize your grandmother/grandfather experience?

The recordings were transcribed and coded in a word processor; data saturation and sufficiency were identified when repeated patterns and absence of new elements were noticed in the answers,15 thus ending the recording phase. The data were processed in Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMuTeQ® 0.7 alpha 2 2020) and 3 classes were created, which served as the basis to name the thematic categories.16

The categories were systematized based on Bardin's content analysis,17following these phases: Pre-analysis, when the material was organized and the initial ideas emerged; Systematization and coding of the material; and Treatment of the data obtained, with categorization, interpretation and discussion of the content from the interviews beyond the actual words spoken.

The Descending Hierarchical Classification (DHC) resource was employed, a function that stratifies words into classes based on their semantic value, considering their frequency in the text and relevance of the words considering their Chi2 value. Indicated for qualitative studies, the Consolidated Criteria for Reporting Qualitative Research (COREQ) guide was adopted for the research methodological development.18

The study was approved by the Ethics Committee of the public Teaching Institution that supports the study locus, under Opinion No. 6,033,181 and in full compliance with National Health Council Resolution No. 466/2012.

Results

The study population was comprised by nine grandparents (coded as I1-I9), with grandchildren aged from nine months to nine years old. There were six women among the participants, aged between 65 and 75 years old; all of them were retired, five (55.56%) had Complete Higher Education, three (33.33%) had Complete High School and one (11.11%) had Complete Elementary Education; four (44.44%) of them lived with their partner, two (22.22%) did so with their family (including son/daughter, son/daughter-in-law) and three (33.33%) lived alone. Their monthly family incomes were also recorded, varying between three and fifteen minimum wages.

Despite the predominance of grandmothers, this prevalence cannot be considered a population trend in this study due to the small sample size, which restricts generalization of the results, even if the literature evidences the trend of grandmothers taking care of their children in studies with more robust samples.

As for the data referring to the fundamental guiding questions of this research and based on the three categories generated, the following thematic categories emerged: Category 1 - Care relationship between grandparents and grandchildren (Class 3); Category 2 - The grandmother/grandfather experience (Class 2); and Category 3 - Repercussions in the health and everyday activities of grandparents taking care of their grandchildren (Class 1).

Figure 1 shows a graphical representation of the most frequently cited and most relevant words, corresponding to each of the classes generated and in a broad view of the results obtained. The X² (or Chi-square) value refers to the test used to assess the relationship between the variables in a quantitative way; in this case, based on the X² value, we learn the relationship between a given word and the class generated, with values over 3.8 considered as importantly relevant. Consequently, the higher the value, the higher the frequency of the term during the interviews and, consequently, the stronger its relationship with the class linked.

Figure 1- Descending Hierarchical Classification (CHD) dendrogram. Research data (n=9). João Pessoa (PB), Brazil, 2023.

It is to be considered that the classes will be shown throughout the text in the best logical sequence order, so as to ease understanding the study objective.

Category 1 - Care relationship between grandparents and grandchildren (Class 3)

           This category deals with the routine and everyday life of the participating grandparents and with the way in which they include the care relationship with their grandchildren into their daily life, in order to identify the responsibility degree inherent to this care. Based on the interviews conducted, the heterogeneity of accountability is denoted, both in the care format and in the relationship they perceive. Whereas some of them assisted in sporadic occasions and voluntarily, other had a biweekly, weekly or daily responsibility, which can be seen in the following testimonies.

“[...] the one that's 7 years old lives next door, he spends a lot of time there. The 2-year-old, I stay with him when his mother has to work on Saturdays. I pick him up from the daycare center 3 days a week and stay with him there at the house until she comes back from work.” I1, 65 years old

“[...] the one that's 8 years old comes here every day because his parents work, he takes a bath at noon and then eats lunch to go to school. Mariana, who’s 5, stays more with her other grandmother, when she sometimes needs to go out somewhere, she leaves her here [...].” I5, 74 years old

“[...] her school is comprehensive, but the day she can't go, when she's ill, her mother doesn't send her, I stay there, or when she needs anything. [...].” I6, 67 years old

“I don't do it out of duty, but when he needs me, I'm there [...].” I7, 74 years old

“[...] my son has 2 from his first marriage and they lie with their mother, my schedule is every 15 days, which is when he picks them up to stay with them during the weekend, I go there to help with the children. [...].” I9, 65 years old

In addition to the testimonies, during the interviews it was noticed that having autonomy and independence allowed them to “choose” when to help, waiving responsibility in raising their grandchildren. In addition to that, being available to take care of the children was described as a pleasant feeling, as they were retired and their grandchildren were oftentimes the heart and soul of the house.

When asked about the need to postpone any activity to stay with their grandchildren, they did not consider it a problem because taking care of them was a priority for the grandparents, except in cases in which the commitments were related to their own health. Therefore, regardless of the care relationship, they perform that function naturally, without mentioning impacts or possible overloads.

Category 2 - The grandmother/grandfather experience (Class 2)

      The intention here was to understand how aged grandparents perceive this life phase, along with individual singularities. Among the experiences and meanings mentioned, positivity and benefits were unanimous, culminating in moving moments. Expressions including the words “love”, “affection”, “care” and “better/best” reflect the experiences they reported regarding this life cycle.

“It's better than being a mother [...] we do everything calmer, we can give more love, pay more attention, as we have more free time than the parents. […] it's with more affection […].” I1, 65 years old

“[...] It’s the best thing in the world. [...] It’s my vitamins, the will to live, I want to live to be 100 years old, but when I see them, I want 110.” I2, 66 years old

“They're the offspring of my offspring. [...] I give love, affection, and I'm there to help whenever they need me to. [...].” I3, 65 years old

“It’s having fraternal love [... It's as if I had been born again [...].” I4, 74 years old

“I only feel pleased […] it's really good to be a grandmother. You just go back to that life, only without the responsibility [...].” I6, 67 years old

“It was the best thing in the world. [...] It's a gift from God, a divine present, an opportunity to do many things with my grandchildren that I couldn't do with my own children [...] it was like being born again for me.” I7, 74 years old

“[...] I take better care of my grandchild than what I did with my son […] it's being a mother 2 times, it rocks.” I9, 65 years old

The word “love” was frequent during the interviews when they referred to their grandchildren and to the grandparenthood experience, loaded with a noticeable and differentiated emotion, something they tried to convey in excerpts such as the following one:

“[…] it's a different kind of love, it's several types of love that I gradually merge into my life, and several types of love, and a grandmother's love for her grandchildren is very strong.” I1, 65 years old

In addition to that, they spoke about “responsibility” and “affection” as a reference to the life phase they are undergoing, as they can now make the most of sharing time with the children, give more affection, in contrast with the time when they were parents themselves and faced educational and financial responsibilities. In their current condition of grandparents and retired, they could take that care differently, in a lighter way, without the burden they had before, a new opportunity.

Thus, perceiving that experience as something pleasurable strengthened the feeling of satisfaction in how they aged as grandparents and retired older adults, expressed in the word “vitamins” and referring to what their grandchildren represented in their life, making them feel happier and fulfilled.

Category 3 – Repercussions in the health and everyday activities of grandparents taking care of their grandchildren (Class 1)

When asked about interferences in their health as a consequence of taking care of their grandchildren, negative answers prevailed, evidenced in the word “no” from the dendrogram, where they again mentioned the benefits contributed by this role and leaving possible interferences aside, even when they did exist.

“Taking care of my grandchild is a therapy for me [... ] you take care of your grandchild, you're stimulating his mind[…] In addition to working on the mind, you also work on the body [...].” I1, 65 years old

“Look, it doesn't interfere at all in my case, because I don't take them to the doctor, that's the parents […]. Taking care of my grandchildren makes me feel young again.” I2, 66 years old

“I don't think it interferes in my health […]. It helps, because I have that love, that affection …] but harms to health is those grandmothers that live exclusively for that […] who don't buy something for them to buy something for their grandchildren.” I3, 65 years old

“Staying with my grandson is a therapy for me, I feel healthy.” I4, 74 years old

“It brings me joy, strength [...].” I5, 74 years old

“It doesn't interfere, because I already have those bone diseases [...].” I6, 67 years old

“Mentally, it's excellent for me [...] I want to play with him every time I get a chance [...].” I7, 74 years old

Thus, the testimonies make it clear that the repercussions they perceive do not represent negative interferences in their health; to the contrary, they contribute to preserving their well-being. Consequently, when asked (a priori) if taking care of their grandchildren might interfere in their health, they immediately answered “No”, asserting that it did not interfere. That frequency contributed for the word “no” to be the first to appear in Class 1, representing its greater relationship with the class; in other words, when asked about repercussions in their health, the grandparents asserted that it did “not” interfere in any way.

However, they were explained that the “interference” they were asked about could be positive or negative, so that they would think in the repercussions associated with taking care of their grandchildren. Therefore, the reports were gradually expanded, increasingly evidencing the positive perceptions of the experience.

As for routine activities, negative answers also prevailed; few participants identified interferences in their routine due to taking care of their grandchildren, as they considered it a priority before their own personal activities, leaving them aside and reinforcing their availability whenever necessary.

“When my grandchildren come they do interfere, because I can't clean the house with the boys there, I concentrate more on them [...] But nobody’s going to die for not cleaning a house 1 or 2 days. It's never bothered me, even because I'm not so much in direct contact, I'm not the upbringing grandmother, I just help [...].” I1, 65 years old

“All my activities, anything I'm going to do, I just check to know if I can go, because I'm not leaving him alone.” I5, 74 years old

“It certainly interferes. I like going to some parties during the weekends and it sometimes interferes in that, I have to choose one in the week so that I can go. Sometimes going to some fair, some exhibition, some craftsmanship market, but I go balancing it. [...].” I9, 65 years old

“It doesn't interfere at all, because I don't take them to the doctor, that's the parents [...].” I2, 66 years old

“It doesn't interfere in any way, they need me and I'm there.” I4, 74 years old

“It doesn't interfere [...] I'm not forced to take care of them, to decide not to do any activity because I have to take care of my granddaughter, there's no such thing, only when it's really necessary [...].” I6, 67 years old

“It doesn't interfere, because it's no sacrifice for me, only in severe cases.” I7, 74 years old

When relating the testimonies to the dendrogram, the words “teach”, “leave” and “play” refer to the type of care they provide to their grandchildren since, despite heterogeneity in characterizing the care they offer, none of the grandparents had any legal responsibility or custody over the children, as they were mere care assistants. Consequently, the grandparents devoted most of their time to entertaining the children, without any legal responsibility related to educating them.

This allows seeing their positive perception about the task of taking care of their grandchildren, oftentimes related to pleasant moments when playing the grandmother and grandfather roles becomes an enjoyable activity. They assert that having their grandchildren with them interferes in their life routine and house chores, but not substantially; it is a therapy for them, capable of working on the mind and the body.

Thus, when asked about interferences resulting from taking care of their grandchildren, they could not identify harmful ones, as this care is provided in a more flexible way, without any mandates and with their actions targeted at complementary assistance.

Discussion

Driven by factors such as the progressive incorporation of women into the job market, parents' financial burden and single motherhood, the changes in the traditional family structure during the last few decades have made grandparents take on an increasingly active role in taking care of their grandchildren. This involvement is especially noticeable with little children, who require more attention and dedication in that life phase.19-20

Added to this, the grandparents' participatory role in the family nucleus is justified by their greater time availability and by their lower responsibility burden, when compared to other life phases. However, it is important that the main responsibility in raising the children remains on the parents, with grandparents acting as support figures. Consequently, the importance of the grandparents' role as complementary caregivers is valued, which can contribute positively to older adults' health.20

The care frequency and relationship can modify the nature of the effects on grandparents' health, as shown in a study conducted in the Maturity University where the older adults identified the positive nuances inherent to care, such as a revitalizing sensation from inter-generational time spent with their grandchildren, preventing loneliness and isolation and balancing for losses. But also the negative ones, associated with the role of tutoring the grandchildren.12

In the current study, some grandparents lived with their grandchildren but had no legal responsibility over them; the children’s parents lived in the same house and were in charge of their upbringing. A number of experiences mentioned by older adults taking care of their grandchildren in Brazil show that the grandparents' health is negatively impacted when they live in the same house and are the legal guardians.21-22

It is important to recall that causality of these impacts can be influenced by a person's previous conditions, as some grandparents already have limitations or comorbidities and taking care of their grandchildren may lack significant relevance for their health conditions. Thus, it is demonstrated that this would not be the main cause of senility decline, which justifies the heterogeneity of the health repercussions resulting from the care provided.22-23

In addition to that, it is relevant to note that the participants included in this study were in good social conditions, with preserved autonomy and independence. This may have contributed to the positive findings related to the perception about the positive repercussions in life and health in the context of taking care of their grandchildren, as the benefits are more frequent in aged people with better family incomes and higher schooling levels.24

The context can modify the grandparenthood experience and a number of studies reveal that the accountability relationship in upbringing grandchildren can trigger harmful impacts on health decline, affecting mental health and with repercussions in the grandparents’ routine.22,25 In addition to that, the consequences can be potentiated in the case of longer-lived grandparents, mainly with younger grandchildren and given the physical demands required.8

From the grandparents' point of view, many of them highlight that, when compared to the time when they took care of their own children and as they are now retired and enjoy more free time, they have more opportunities to share time with their grandchildren. They remember the old-time professional and financial responsibilities they assumed as parents, contrasting them to the current scenario where, already free from those duties, they can devote more affection and attention to taking care of their grandchildren. 11,20

In addition to that, it is observed that interactions with their grandchildren introduce new experiences in the grandparents' life, as children undergoing a development process stimulate grandparents. Thus, the more solid the inter-generational relationship, the higher the potential for grandchildren to look up to their grandparents, especially when this relationship involves having fun, contributing to improved quality of life and health in the grandparents.11,26

However, heterogeneity of the contexts should always be considered; in fact, it is not certain that the mere act of caring can exert relevant impacts, as previous stressful factors such as socioeconomic conditions, responsibilities, life habits and pre-existing diseases can influence health problems.19

Nevertheless, the grandparents mention positive repercussions and benefits resulting from taking care of their grandchildren, even if it may interfere in their routine and activities. In addition to that, it is fundamental to consider that independence, autonomy and maintenance of family ties are essential aspects for older adults' health. A study conducted in China noticed a relationship between grandparents taking care of their grandchildren and greater life satisfaction, provided that the care offered is of moderate intensity, allowing grandparents to take part in other social activities.27-28

In relation to the interference in the grandparents' activities and although the relate having left some activities aside to devoting time to their grandchildren, they do not perceive that as a negative impact; they even feel useful when participating in that care and report positive repercussions in their life. As they feel more active and engaged, they are motivated to seek new activities, which contribute to improving their quality of life and mitigating functional, physical and cognitive ailments.23

The research participants' active life with physical and cognitive activities corroborates the finding of positive repercussions in health described in the literature, considering that physical exercise plays a fundamental role in older adults' quality of life. Despite the interferences in the routine resulting from taking care of their grandchildren, they do not consider them as harmful but as a natural duty of grandparents, exempt from demands and rendering care flexible and pleasurable.29

Those with responsibilities in the routine with their grandchildren (such as picking up from school or staying with them some hours a day) report that they are enjoyable activities because they stimulate their body through games and their emotions through the affectivity involved in care. These relationships can constitute one of the factors for healthy aging processes, 30 ratifying the complexity and amplitude inherent to the caregiver role, as it manifests itself through different nuances and feelings according to life situations and to the characteristics established in the care relationship.

Within this context, the experiences undergone by older adults that take care of their grandchildren in everyday life prove to be increasingly present in contemporary family settings, marked by increased longevity and by transformations in family configurations. From the Nursing perspective, analyzing this reality enables understanding how elements both internal and external to a person influence their biopsychosocial well-being, expanding the focus to determinants that exert direct impacts on older adults' health.

The following stand out as study limitations: the fact that the participants are in good social, economic and cognitive conditions, which influences the positive self-perception about the repercussions in health; a more restricted study locus, which serves a differentiated population segment characterized by autonomous and socially active aged individuals; non-participation of grandparents providing comprehensive care, so as to understand the different realities of grandparenthood; and not having explored the participants’ clinical and functional profiles, along with the small sample size, which limits diversity of the results.

Conclusion

This research reveals that these grandparents do not perceive relevant negative repercussions related to their life and health when playing the grandmother/grandfather role in old age; they only notice the positive, emotional and affective ones developed during the care process, in opposition to the negative results from other studies.

The relevance of this study for the training of professionals from the health area is understood, as care routines with grandchildren can exert a direct influence on older adults' health, either contributing to promoting mental health and quality of life or by representing potential biopsychoemotional risks resulting from care overload.

In addition, the increasing scientific production in the area contributes to strengthening diverse evidence that support devising public policies and developing health interventions targeted at older adults, who experience a senescence process and, in many cases, a senility one, a context where care responsibilities can represent a stressful factor with a negative impact on quality of life.

It is suggested to conduct studies with more older adults in their samples, contemplating different realities and more variables related to living conditions, to assess possible overloads and their repercussions, deepen understanding of the phenomenon investigated and support the planning of qualified health care for older adults from a professional perspective.

Authors Contributions

Study design: Renata Mirella Brasil da Silva Lima, Alana Vieira Lordão, Edilene Araújo Monteiro, Maria de Lourdes de Farias Pontes. Data collection: Renata Mirella Brasil da Silva Lima. Data analysis and interpretation: Renata Mirella Brasil da Silva Lima, Alana Vieira Lordão, Bianca Freitas Régis, Samara da Silva Santos, Amanda Ellen Costa Da Silva, Edilene Araújo Monteiro. Manuscript writing: Renata Mirella Brasil da Silva Lima. Critical review of the manuscript: Renata Mirella Brasil da Silva Lima, Alana Vieira Lordão, Bianca Freitas Régis, Samara da Silva Santos, Amanda Ellen Costa Da Silva, Edilene Araújo Monteiro, Maria de Lourdes de Farias Pontes. Approval of the final version of the text: Renata Mirella Brasil da Silva Lima, Alana Vieira Lordão, Maria de Lourdes de Farias Pontes.

Conflict of interest

The authors declared that there is no conflict of interest.

References

1. Instituto Brasileiro de Geografia e Estatística (BR). Censo Demográfico 2022: população por idade e sexo – resultados preliminares [Internet]. 2023 [cited 2025 Dez 28] Rio de Janeiro: IBGE, 2023. Available from: https://censo2022.ibge.gov.br/en/component/content/article/2184-news-agency/news/38187-2022-census-number-of-elderly-persons-in-the-brazilian-population-grew-57-4-in-12-years

2. Instituto Brasileiro de Geografia e Estatística (IBGE). Projeção populacional. A população do Brasil deixará de crescer 2041 [Internet]. 2024 [cited 2025 Dez 26]. Available from: https://agenciadenoticias.ibge.gov.br/en/agencia-news/2184-news-agency/news/41065-populacao-do-pais-vai-parar-de-crescer-em-2042

3. Organização Pan-Americana da Saúde (OPAS). Envelhecimento saudável. [Internet]. 2018 [cited 2024 Mar 25]. Available from: https://www.paho.org/pt/envelhecimento-saudavel

4. Sampaio MAP, Pereira SRB, Osório NB, Neto LSS. A construção da avosidade na literatura científica Brasileira: uma revisão integrativa de literatura [Internet]. Braz J Dev. 2021 [cited 2024 Mar 27];7(3):24565-76. DOI: https://doi.org/10.34117/bjdv7n3-252

5. Coelho LS, Osório NB, Neto LSS. Envelhecimento. Avosidade. Intergeracionalidade: revisão integrativa de literatura [Internet]. Rev humanid inov. 2023 [cited 2025 Dez 23];10(16):293-303. Available from: https://revista.unitins.br/index.php/humanidadeseinovacao/article/view/8117

6. Word Health Organization. Connecting generations: planning and implementing interventions for intergenerational contact [Internet]. Geneva: Word Health Organization. 2023 [cited 2025 Dez 23]. Available from: https://www.who.int/publications/i/item/9789240070264

7. Rosa DC, Carvalho TKP, Coutrim R. When grandparents manage school duties: educational practices of grandparents who take care of grandchildren [Internet]. Série-Estudos. 2022 [cited 2024 Mar 27];27(59):173-191. DOI: https://doi.org/10.20435/serie-estudos.v27i59.1546]

8. Jang H, Tang F, Fusco RA, Engel RJ, Albert SM. Grandparent, social relations, and mortality in old age [Internet]. Res Aging. 2021 [cited 2024 Mar 28];44(3-4):265-75. DOI: https://doi.org/10.1177/01640275211015433

9. Mansilla-Domínguez JM, Recio-Vivas AM, Lorenzo-Allegue L, Cáchon-Pérez JM, Esteban-Gonzalo L, Palacios-Seña D. The role of duty, gender and intergenerational care in grandmothers’ parenting of grandchildren: a phenomenological qualitative study [Internet]. BMC Nursing. 2024 [cited 25 Dez 26]. DOI: https://doi.org/10.1186/s12912-024-02151-0

10. Bragato AGC, Elias HC, Abreu M, Assis HMN, Paula FFS, Garcia LAA, Camargo FC, Santos AS. Domicílios multigeracionais: satisfação e dificuldades apresentadas por avós cuidadores de netos [Internet]. RSD. 2022 [cited 2024 Mar 28];11(9). DOI: https://doi.org/10.33448/rsd-v11i9.31915

11. Silva AAA, Souza S. Reflexões fenomenológicas na relação avós-netos: uma leitura compreensiva a partir da experiência dos avós [Internet]. Braz J Dev. 2021 [cited 2024 Mar 28];7(4):43160-80. DOI: https://doi.org/10.34117/bjdv7n4-671

12. Osório NB, Sinésio Neto L, Souza JM. A era dos avós contemporâneos na educação dos netos e relações familiares: um estudo de caso na Universidade da Maturidade da Universidade Federal do Tocantins [Internet]. Rev Signos. 2016 [cited 2024 Mar 29]; 37(2):207-30. DOI: https://doi.org/10.22410/issn.1983-0378.v39i1a2018.1837

13. Ministério da Saúde (BR). Política Nacional de Atenção Integral à Saúde da Criança: PNAISC [Internet]. Brasília: Ministério da Saúde;2018 [cited 2024 Abr 2]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2018/07/Pol%C3%ADtica-Nacional-de-Aten%C3%A7%C3%A3o-Integral-%C3%A0-Sa%C3%BAde-da-Crian%C3%A7a-PNAISC-Vers%C3%A3o-Eletr%C3%B4nica.pdf

14. United Nations International Children’s Emergency Fund (UNICEF). Early childhood development: For every child, early moments matter. 2025 [cited 2025 Dez 26]. Available from: https://www.unicef.org/early-childhood-development

15. Moura CO, Silva ÍR, Silva TP, Santos KA, Crtespo MCA, Silva MM. Methodological path to reach the degree of saturation in qualitative research: grounded theory [Internet]. Rev Bras Enferm. 2022 [cited 2024 Apr 2];75(2). DOI: https://doi.org/10.1590/0034-7167-2020-1379

16. Acauan LV, Abrantes CV, Stipp MAC, Trotte LAC, Paes GO, Queiroz ABA. Utilização dosoftware iramuteq® para análise de dados qualitativos na enfermagem: um ensaio reflexivo [Internet]. Rev Min Enferm. 2020 [cited 2024 Apr 2]; 24:1-5. DOI: http://dx.doi.org/10.5935/1415-2762.20200063

17. Bardin L. Análise de conteúdo. Tradução: Luís Antero Reto e Augusto Pinheiro. Lisboa: Edições 70, 1977. Título original: L' Analyse de Contenu.

18. Souza VRS, Marziale MHP, Silva GTR, Nascimento PL. Translation and validation into Brazilian Portuguese and assessment of the COREQ checklist [Internet]. Acta Paul Enferm.. 2021 [cited 2024 Apr 2];34:1-9. DOI: https://doi.org/10.37689/acta-ape/2021AO02631

19. Bragato AGC, Garcia LAA, Camargo FC, Paula FFS, Malaquias BSS, Elias HC, Santos AS. Grandparents that take care of grandchildren: analysis of the care profile and intensity [Internet]. Cogitare Enferm. 2023 [cited 2024 Apr 2];28. DOI: https://doi.org/10.1590/ce.v28i0.79812

20. Zanatta E, Arpini DM. Conhecendo a imagem, o papel e a relação avó-neto: a perspectiva de avós maternas [Internet]. Estud Pesqui Psicol. 2017 [cited 2024 Apr 5]; 17(1):343-363. DOI: https://doi.org/10.12957/epp.2017.35164

21. Coutrim RME, Silva P. Other subjects in the family-school relationship: the role of grandparents in the educational process of grandchildren [Internet]. Aula Abierta. 2019 [cited 2024 Apr 2];48(1):97-104. DOI: https://doi.org/10.17811/rifie.48.1.2019.97-104

22. Danielsbacka M, Krenková L, Tanskanen AO. Grandparenting, health, and well-being: a systematic literature review [Internet]. Eur J Ageing. 2022 [cited 2024 Apr 5]; 19:241-368. DOI: https://doi.org/10.1007/s10433-021-00674-y

23. Hughes ME, Waite LJ, LaPierre TA, Luo Y. All in the Family: The Impact of Caring for Grandchildren on Grandparents' Health [Internet]. J Geronto. 2007 [cited 2024 Apr 5];62(2):108-119. DOI: https://doi.org/10.1093/geronb/62.2.S108

24. Kretschmer AC, Loch MR. Self-perceived health in older adults with low education: demographic, social and health-related behavior factors [Internet]. Rev bras geriatr gerontol. 2022 [cited 2024 Apr 5];25(1). DOI: https://doi.org/10.1590/1981-22562022025.220102.pt

25. Azambuja RMM, Rabinovich EP. O avô e a avó na visão dos netos [Internet]. São Paulo: Rev Kairós Gerontologia. 2017 [cited 2024 Apr 6];20(2):311-332. DOI: https://doi.org/10.23925/2176-901X.2017v20i2p311-332

26. Azambuja RMM, Ramos MN, Ramos MCP. Avós e culturas: relacionamentos e vivências intergeracionais em tempo de pandemia COVID-19 [Internet]. RSD. 2023 [cited 2024 Apr 6];12(3). DOI: https://doi.org/10.33448/rsd-v12i3.40631

27. Gomes GC, Moreira RS, Maia TO, Santos MAB, Silva VL. Fatores associados à autonomia pessoal em idosos: revisão sistemática de literatura [Internet]. Ciênc Saúde Colet. 2021 [cited 2024 Ap 7];26(3). DOI: https://doi.org/10.1590/1413-81232021263.08222019

28. Ke S, Xingyue Y. Caring for grandchildren and life satisfaction of grandparents in China [Internet]. Aging Health Res. 2022 [cited 2025 Oct 07];2(3). DOI: https://doi.org/10.1016/j.ahr.2022.100095

29. Oliveira JC, Vinhas W, Rabello LG. Benefícios do exercício físico regular para idosos [Internet]. Braz J Dev. 2020 [cited 2024 Apr 9];6(3):15496-15504. DOI: https://doi.org/10.34117/bjdv6n3-429

30. Liu Y, Hughes MC, Roberto KA, Savla J. Physical and mental health of family caregivers of older parents and grandchildren in China [Internet]. Aging Health Res. 2022 [cited 2025 Oct 07]; 2(1). DOI: https://doi.org/10.1016/j.ahr.2021.100052

Corresponding Author

Renata Mirella Brasil da Silva Lima

E-mail: renata.brasil@academico.ufpb.br

The Author(s) 2026.  This work is licensed under Creative Commons Attribution 4.0 International. License text for use: https://creativecommons.org/licenses/by/4.0/