Program administrators, supervisors, and workers noted that they had learned a variety of lessons about how best to meet the needs of kinship care families. Kinship caregivers also commented on the benefits and limitations of the alternative programs. Among the lessons learned about kinship care families:
- Kinship families are diverse. A typical kinship care arrangement is commonly perceived as an elderly grandmother caring for a young, neglected child. Most caregivers are grandparents, but one-third are aunts, uncles, siblings, or other relatives. Moreover, while some grandparents are elderly, many more are under age 60 and many are in their 30s or 40s. In addition, kinship caregivers take care of children of all ages, from newborns to teenagers. And while kin are most likely to care for children who have been neglected, many children in kinship care have suffered physical and/or sexual abuse and may have been born with the human immunodeficiency virus (HIV+) or crack addiction.
- Kinship care families have a wide range of needs. Because they are not a homogeneous group, kinship care families may have a wide variety of service needs. For example, while older caretakers may need respite care and health services for themselves, younger caregivers are typically working and need child care assistance. Likewise, depending upon the ages and special circumstances of children in kinship care, they may need mentoring, counseling, specialized health services, recreation activities or special education.
- Kinship care families need more than money. While kinship caregivers have significant financial needs, money alone will not address the challenges they face. Most caregivers we spoke to noted their financial problems, but were actually more vocal about their frustration in trying to access health and social services for their related children, not to mention themselves.
- Kinship care families benefit tremendously from support groups. In each of the sites visited that had support groups, kinship caregivers found them extremely important. Caregivers often described themselves as embarrassed by the situation they were in and were relieved to meet others with similar experiences. Similarly, participants in caregiver focus groups who were not in a support group found the focus group meetings to be therapeutic and wanted to have ongoing communication with other kinship caregivers. In addition, support groups were an important respite opportunity for many caregivers, especially when they provided recreational activities for children. Support groups also offered important information about available services and how to access them through members' conversations about their experiences and through invited speakers' presentations.
|"She has such bad nightmares, she trembles and cries every night. She needs therapy, but [Medicaid] is limited. The therapy is starting to get her to be human again. She smiles now, which she never used to do, and even sings at home. Before she would be hit if she made noise."|
- Nearly all kinship care families need mental health services. Administrators as well as the kinship caregivers themselves identified mental health services as the forgotten or most insufficient intervention provided by alternative kinship care programs. Although children may suffer less trauma when being placed with a relative than with a stranger, these children still suffer a psychological cost when separated from their birth parents. Moreover, these children likely have unaddressed mental health needs stemming from the abuse or neglect they suffered. Likewise, kinship caregivers often have mental health needs over and above the therapeutic benefits derived from participating in a support group. For example, as kinship caregivers, grandparents must face the reality of their child's failure and may question their own ability as a parent.
- Kinship care families need safe and accessible transportation. Since kinship caregivers are often elderly and many are socially isolated, they often have difficulty getting to and from service locations, including support groups. Transportation is not just an issue in rural areas where public transportation is often absent. In some of the urban areas visited, kinship caregivers expressed fear about using public transportation or noted that it did not always take them where they needed to go. Older caregivers also noted that public transportation can be physically taxing.
- Kinship caregivers do not access available supports. Worker and caregiver focus groups offered two main reasons for the low use of available supports documented in national surveys. First, kinship caregivers often do not know that they are eligible for services and programs. For example, focus groups revealed confusion over TANF and Medicaid eligibility requirements. Second, kinship caregivers tend to avoid contact with public agencies. Many caregivers said that they did not want a handout; they had worked their entire lives and did not want to be treated like a welfare client. Many caregivers also feared that if they involved public agencies, the agencies might place related children in foster care. Some caregivers also noted that birth parents were still receiving cash assistance even though their child was no longer in their home. As a result, birth parents threatened to take back their children if the kin caregivers cooperated with child support enforcement or applied for benefits for the child.
- Kinship caregivers want permanency, too. Kinship caregivers were concerned about their ability to keep the children in their care and almost all said they were willing, if not demanding, to care for the children permanently. And, contrary to some past studies and common perception, many kinship caregivers were willing to adopt. However, many caregivers lacked knowledge about how to obtain permanent custody of their related child. For others, the legal fees (up to $5000 per child according to caregivers) associated with adoption or guardianship were prohibitive, especially those kin caring for several children. Many caregivers who attempted to access services from public legal aid agencies reported little success.