The use of home-based caregiver assessment to improve children’s health: a pilot project

Background: Grandparents Raising and Nurturing Dependents with Disabilities (Project GRANDD) is a support program for grandparents who are the primary caregivers of grandchildren with developmental disabilities, chronic illness, and behavior or learning difficulties. A critical problem contributing to diminished quality of life for the family is the grandparents’ own poor health, as well as the lack of access to available resources. This project pairs nursing students from the local university with grandparents participating in the GRANDD support program to improve the caregiving grandparents’ health. Methods: A total of 12 nurse practitioner (NP) students were paired with six grandparents. Students performed home visits and assessments, health histories, environmental assessments, and windshield surveys over the course of several weeks. Follow-up visits for medication reconciliation, referral to resources, or for patient health education were conducted in person or via phone. Results: The grandparents’ demographic characteristics were as follows: African American females, on fixed incomes on or near poverty level, had multiple co- morbidities, and showed reluctance in seeking help because of their role as primary caretaker. Nursing students demonstrated increased awareness of the cycle of disability and disadvantage, and improved skills that enable them to aid vulnerable individuals in accessing community resources. Conclusions: This pilot program had a positive impact on students and grandparents. Much is needed regarding outcome measurement and standardization of methods, but the initial results demonstrated a beneficial relationship between NP students and Project GRANDD participants, thus contributing to the ongoing effort to break the cycle of disadvantage and disability in this vulnerable population.