Stress & Caregiving among Luo Grandparents in Kenya

In many parts of the world, grandparents are increasingly taking primary caregiving roles for their grandchildren. Research suggests that, in the US, grandparents who are primary caregivers for their children experience higher levels of stress and are at elevated risk for illness. Some researchers suggest that one explanation for this is that, in the US, such “grandparenting” differs from usual cultural expectations about the relationships between generations. Grandparents in the US may lack social support and role models for taking on this role.

The stress hypothesis model is one theory that is used to explain this finding. This model proposes that when caregiving is experienced as a burden by the caregiver, it causes psychological distress, which can lead to an elevated risk for illness. One potential implication of this model is that in cultures where grandparents are normally involved in childcare, grandparent caregiving may be less of a risk factor. A study reported in Social Science & Medicine examines the stress hypothesis model in a sample of grandparents in Kenya.

The study is based on the Kenyan Grandparents Study, a longitudinal study in the Kenyan province of Nyanza. Participants in the study were 611 grandparents from the Luo ethnic group, the third largest in Kenya. Slightly over half of the participants were raising at least one orphaned grandchild within their home. Among the Luo, grandparent caregiving is more common than it tends to be within the US, where it is often a result of financial difficulties or incarceration on the part of parents. Luo also tend to live in more extended, multigenerational families, where there may potentially be more sources of support.

The participants were given biological assessments of markers associated with stress, including blood pressure and salivary cortisol. (Cortisol is a steroid hormone that is released during stress, and is therefore often used as a biomarker of stress in research.) The participants took a variety of surveys on caregiving intensity, health, and stress. The surveys also included questions about the household make-up, such as how many children were being cared for, and how many other adults were present.

Rather than simply translating an existing stress questionnaire used elsewhere, the authors developed a culturally specific Luo Perceived Distress Scale. This enabled them to ask about concepts that are culturally relevant to their participants, rather than using translated scales involving concepts that are irrelevant or meaningless among the Luo.

To examine the relevance of the stress hypothesis model among Luo caregivers, the researchers examined the statistical relationship between caregiving intensity, perceived distress, and the biological measures. There were differences between men and women, and also differences based on household composition. For women, perceived stress was higher among caregivers, and increased with caregiving intensity, but was actually lower for women who had a greater number of children to take care of. For men, caregiving was associated with lower perceived stress.

There was no significant relationship between caregiving and the two biomarkers of stress. The authors offer some potential explanations for this finding. For one, grandparent caregiving is more common among the Luo and, unlike in the US, does not defy cultural expectations about generational relationships. Another potential explanation is that Luo older adults are likely to have a higher baseline level of stress, such as lack of access to resources or illness, so that the effect of potential stressors such as caregiving would be smaller. This study shows how the nature and impact of caregiving can vary significantly across cultural contexts.



Ice GH, Sadruddin AFA, Vagedes A, et al. Stress associated with caregiving: an examination of the stress process model among Kenyan Luo elders. Social Science & Medicine; 2012. 74(12):2020-2027.

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