An emic view of caring for self: grandmothers who care for children of mothers with substance use disorders.

In the US more than 3.4 million children live with a mother who has a substance abuse disorder (SUD) and at some time in their life will be cared for by a grandmother. Most studies have focused on the economic, physical and emotional burdens of the conflated role of mother/grandmother. This study explores how 11 grandmothers cared for themselves while caring for the children of mothers with SUDs. The domain of inquiry was the self-care practices of grandmothers from an emic (generic) view. An assumption of the study was that the grandmothers represent a unique sub culture of women with particular beliefs, values and practices. An ethnographic approach was used to collect data from observations, in-depth interviews, and participant observation in various community settings. Patterns and themes revealed relational aspects of caring for self focused on the emic beliefs of self-care. The themes of being obligated and dedicated; distancing oneself as a reasoned action; and accepting the magnitude of the problem clearly identified the ability of grandmothers to take actions and make decisions about how to care for themselves. Leininger's three modes of care are represented in a schema of the emic view of caring for self. The schema is an illustration of the dynamic capacity of grandmothers to know and meet their own self-care demands and needs in order to care for their grandchildren. The need for increased awareness to change public policy and legislation related to the complex issues of caregiving by grandparents is addressed.