When Love Comes at a Cost: Mental Health Outcomes in Older Adults Providing Grandparental Care.

Background/objectives: Against the backdrop of increasing global aging and the trans-formation of family structures, grandparental caregiving has become commonplace, and its impact on the mental health of older persons is of great concern.

Methods: Based on data from the 2023 Xi'an Jiaotong University Urban and Rural Elderly Family Support and Psychological Condition Survey, this study analyzed the impact of grandparental care-giving behaviors on the mental health of the elderly through the Psychological Condition Measurement Scale (PCMS), and comprehensively assessed the presence, intensity, and heterogeneous impact of grandparental caregiving behaviors by gender by applying linear regression modeling, the Propensity Score Matching (PSM) method, and the Instrumental Variables Method (IVM).

Results: Grandparental care has a significant positive effect on the mental health of older people, but this positive effect diminishes as the intensity of care increases. The results of the sub-sample estimation show that grandparental caregiving has a positive effect on men's and low-intensity caregiving on women's mental health, but high-intensity caregiving has a negative effect on women's mental health. In addition, in-tergenerational financial support and intergenerational emotional comfort play an im-portant mediating role between grandparental caregiving and the mental health of older persons, in line with the explanatory framework of intergenerational exchange theory.

Conclusions: It is recommended that the Government support grandparental care for the elderly at the financial, social security, and policy levels; that society build a diversified system of elderly care services and strengthen public childcare services; and that families establish a value identity of two-way support.