Exploring the Caregiving System Theory in Our Grandparents

Written by: Vanessa Cuppari

Perhaps my four feet three-inch-tall memory is biased, but the tomato plants towered in the air, drooped over my head, and tickled my shoulder as we moved between the walls of the garden. Immersed in overgrown vegetables, I followed my grandfather as he lumbered ahead, careful to stay on slabs of cardboard lining the dirt. We were checking the status of the blackberry bush again: this time, he kneeled in the soil and clasped one in his burly fingers for inspection. Heavy creases around his forehead and temple drowned out his eyes—only ever really opening in surprise—so I could never tell if he is squinting or just looking. Whether he knew it or not, his grip was a little too tight, and a few tears leaked slowly down the side of the berry. He mumbled something excitedly in a language I did not understand and signaled me over his shoulder.

After a few rounds of pneumonia at this point, he was about to stop smoking, but overall, PopPop was in surprisingly good health. By his late seventies, his hair showed more pepper than salt, and he maintained a perpetual bronze skin tone; most of his time was spent tending the garden or cementing the cracks in the driveway, the wine cellar, and the basement kitchen. He and my grandmother immigrated to the United States sixty years earlier, but his English, fragmented and unclear, routinely melted into an obscure Italian dialect. He tried; what wisdom he could not verbalize he compensated for by sneaking fifty-dollar bills into our fists (“for ice cream,” he’d say) and walking us to the park around the corner. And yet, he had a few signature phrases: “eat,” “get strong,” and “we love you.”  Somehow, my grandfather managed to avoid chronic medications until he was diagnosed with lung cancer in 2018. He passed a few months later at eighty-six.

A century ago, when the average life expectancy for American men was a mere sixty, hitting eighty-six was unlikely. Today, his age (the “oldest-old”) and cause of death are unsurprising among gerontologists, given that the older adult population has exploded 14-fold since 1900. Coupled with waning fertility rates, the proportions slant heavily toward older adults. In a thirty-year span, the median age of the U.S. population rose from 28 to 37.8.

But how can this age cohort grow at such a rapid pace? Simply put, they are staying alive longer than they ever have. Medical advances successfully reduced early mortality rates as well as championed vaccines and antibiotics to fight once-fatal diseases. As a result, older adults’ chances at survival increased significantly. Indeed, there are fifty times more “oldest-old” Americans (85+) than there were in 1900, and the proportions are projected to continue growing.

Even so, modern medicine is not the only means of achieving longevity in old age, as gerontologists are beginning to approach health through a holistic lens. Although the treat-and-discharge practice is more prevalent among physicians currently, care using social services makes a difference. Patients restructure their behaviors to promote a healthier lifestyle and, in the long-term, prevent their chances of illness. Beyond the medical necessities, meeting physical, social, psychological, and cognitive needs helps older adults live longer.

Consider the social needs that the grandparent role satisfies as the grandchild’s historian, nurturer, and friend. Could the building of intergenerational bonds (and alternatives, for those without biological grandchildren) enhance one’s life expectancy? Although some grandparents who act as primary caregivers to their grandchildren experience greater pressure and stress, the majority benefit from non-intensive provision of care, or involving themselves at their own pace.

Living across town, Nanny, my maternal grandmother, entwined herself in our lives easily with surprise visits. Sometimes she dropped off Entenmenn’s cakes (for me) and three boxes of Cheerios (for my mother) that she found on sale at ShopRite; sometimes she sought black coffee and conversation after work; sometimes it was an invitation to get mani-pedis at Kim’s, or chocolate chip pancakes (for me) and a root beer float (for her) at the diner. She was my safe place—the first person who listened to me as if she had endless time and as if I were truly the most fascinating person she knew. She passed at eighty-seven.

What drives this selflessness? Researchers understand the motives behind non-intensive grandparental caregiving (“helping behavior”) through an evolutionary lens, pointing to the ancestral goal of furthering longevity. Indeed, data from a 2017 Berlin Aging Study revealed that mortality hazards for grandparents providing non-intensive care were 37% lower than those who did not. Some reference the grandmother hypothesis, where post-reproductive women ensure their own genetic transmission by helping raise their grandchildren and teaching them prosocial behaviors in the process. Over the course of evolution, the rewarding practice of grandmothering, alongside the increasing older adult population’s influence, slowed the somatic aging of humans overall and developed a generalized neurohormonal circuitry deemed by Brown et al. as the “caregiving system.”

According to the caregiving system theory, humans are deeply sensitive to the needs of those who are blood-related or otherwise familiar to us. The orbital frontal cortex (OFC) in the brain analyzes viscerally emotional stored memories to detect social bonds in our lives. In our case, positive interdependency (genetic linkage) solidifies the bond between two individuals – meaning that increases in one’s wellbeing lead to increases in the other, and vice versa. Once the bond is established, the amygdala identifies when one member of the bond is in need and quickly activates the medial-preoptic area of the hypothalamus (MPOA) into “auto-caregiving mode.”

Because our behaviors and cognitions are inherently self-preservationist and avoidant to danger, activating the MPOA suppresses those competing impulses to ensure the wellbeing of the other. Individuals prioritize the allocation of resources not to themselves, but the person they care about. Brown et al. connect this maternal override to animals protecting their endangered cubs, but could it not also exist in the self-sacrificial nature of grandparents?

Social bonds, based on trust and positive fitness interdependence, also release oxytocin, the “love hormone” strongly associated with not only trust and empathy, but also helping behavior and stress-regulation. This neurotransmitter reduces activity in the hypothalamic-pituitary-adrenal (HPA) axis, which controls stress reactions, lowers blood pressure and cortisol levels, and accelerates stress-related recovery.

Intergenerational bonds bolster older adults with a sense of purpose, physical activity and continued cognitive and social wit. While the social act of caregiving for grandchildren is just one of several factors contributing to an individual’s life expectancy, extensive evidence argues that the benefits of non-intensive grandparenting extend beyond grandchildren. We enhance their quality of life just as richly as they do ours.

The day I returned home from a month studying in France—my first time away at sixteen—I saw, from the backseat, Nanny’s petite figure waiting at the door, her varicose veins under white embroidered capris and sandals. She had cataracts, so in the moments before she could detect me I saw her perched in front of the glass, as if on guard, and surveilling the yard intensely. When I came into view, she pushed the door open, and weeping as I bent to hug her first, her baby.

I keep her and PopPop’s prayer cards on hand. Perhaps it was not merely luck that kept them in my life for so long, as I had once believed.

About the Author:

Vanessa Cuppari is a psychology student at Loyola University Maryland. As an undergraduate, she explores the geropsychology field through coursework, research, volunteering, advocacy, and, of course, PLTC. When she has extra time, she enjoys solving crossword puzzles and writing. 

Works Cited:

Brown, Stephanie L. “The Human Caregiving System: A Neuroscience Model of Compassionate Motivation and Behavior.” Moving Beyond Self-Interest: Perspectives from Evolutionary Biology, Neuroscience, and Social Sciences, edited by Michael Brown, Oxford University Press, 2012, pp. 75–89.

Cameron, Kathleen. “100 Million Healthier Lives.” Social Determinants of Health | Grantmakers in Aging, 2018, www.giaging.org/issues/social-determinants-of-health/.

Hilbrand, Sonja, et al. “A Study of the Associations Among Helping, Health, and Longevity .” Elsevier Social Science and Medicine, 2017, pp. 109–117., doi:https://doi.org/10.1016/j.socscimed.2017.06.035.

Hilbrand, Sonja, et al. “Caregiving within and beyond the Family Is Associated with Lower Mortality for the Caregiver: A Prospective Study.” Evolution and Human Behavior, vol. 38, no. 3, 2017, pp. 397–403., doi:https://doi.org/10.1016/j.evolhumbehav.2016.11.010.

Hooyman, Nancy R., and H. Asuman Kiyak. Social Gerontology: A Multidisciplinary Perspective. 10th version, Pearson, 2017, Revel Social Gerontology, revel-ise.pearson.com/courses/5febb3cd51ff03001a9e2d6e/pages/urn:pearson:entity:729a781d-1821-4d72-9c3f-528568071c03?source=contents.

Sands, Roberta G, et al. “Factors Associated with the Positive Well-Being of Grandparents Caring for Their Grandchildren.” Journal of Gerontological Social Work, 2005, pp. 65–82., doi:https://doi.org/10.1300/J083v45n04_05.

Simpson, Kathy. Grandparent’s Role With Grandchildren and Fulfillment for Everyone, 16 Oct. 2020, extramile.thehartford.com/family/grandparenting/grandparenting-role/.

UC Berkeley. “Life Expectancy in the USA, 1900-98.” Life Expectancy in the USA, 1900-98, u.demog.berkeley.edu/~andrew/1918/figure2.html.