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In the rural United States (US), high rates of substance abuse have precipitated the need for many older adults to assume the role of primary caregiver for their grandchildren. This situation is particularly common in rural Appalachia, a region known for both sparse resources and strong kinship ties. Drawing on in-depth interviews with twenty-one grandparent caregivers in rural Kentucky, we explore the fraught relationships these caregiving grandparents often have with their adult children, grandparents’ transition to the parental role and forfeiture of the grandparent role, and long-term concerns related to their capacity to physically and financially provide for grandchildren. Abbreviations:  GP: grandparent; GC: grandchild.

Sources of Stress and Strength: Contextualizing the Experience of Grandparents Rearing Grandchildren in Appalachia