t 73 and recovering from a twice-ruptured stomach ulcer, Ruth Brewer of Monroe, Ga., says she worries daily about death and prays it won’t happen to her anytime soon.

At least not until her granddaughter graduates high school, goes off to college and begins a life of self-sufficiency.

That day is still years away, but Brewer has a special reason for seeking divine assistance in the face of medical frailty. She is the only parent 10-year-old Nicole Cofield has ever known.

Nicole’s father died when she was 8 months old. Her brother, Joel, was 7 years old. Brewer said their mother was a drug addict with serious mental health problems and couldn’t care for them.

So Brewer took on the responsibility of raising her son’s children by adopting them, guiding Joel to top honors in high school and a coveted scholarship at the Massachusetts Institute of Technology this fall. Now, her energy is aimed at securing the same opportunity for Nicole.

“I was scared they’d be split up or I wouldn’t know where they went,” she said in a recent interview at her home. “We’re family and I’m going to do until I can’t do.”

Brewer’s resolve to again parent a family despite her senior years personifies one of America’s fastest growing and yet least recognized demographic booms: grandparents raising grandchildren.

An estimated 4.5 million children live in grandparent-headed homes in the United States, according to the U.S. Census Bureau. That’s 30 percent higher than a decade ago and translates into 6 percent of the nation’s kids. In the majority of cases, the Census data shows, the biological parents are dead or out of the picture.

Social experts call the increase and its ramifications a disturbing trend. They trace it to eight major cultural factors:

• Alcohol and drug abuse.

• Neglect, abuse and desertion.

• Increased poverty.

• Effects of AIDS.

• More mothers in prison.

• More single mothers.

• Undetected and untreated mental illness.

• High divorce rates.

Susan Kelley is one of those experts. She’s the dean of the College of Health and Human Services at Georgia State University in Atlanta, and the founder/director of the National Center on Grandparents Raising Grandchildren.

“It’s incredible, the number of mothers — especially single mothers — incapacitated by substance abuse, incarceration and mental health issues,” said Kelley. “They’re a hidden population.”

The consequence, she said, is heavier reliance on grandparents to raise their children’s children, either voluntarily or through order of the courts. And frequently with little warning or preparation.

Kelley said social history holds that rearing children with blood relatives whenever possible is preferable to putting them up for random adoption or into the foster care system.

Yet this traditional preference, she added, places a not-so-hidden burden on grandparents who are not physically, financially or emotionally ready for the challenges of parenting in the age of the Internet, iPods and instant messaging.

Understanding how grandchildren view and respond to the world around them and how that differs from the time when the grandparents raised their first family requires a support system that’s often not there for them, said Kelley.

This can lead to social isolation characterized by frustration, resentment and even anger, she said.

Dorothy Carrillo, associate director for operations at Georgia State’s School of Social Work, said the changes go beyond grandma adjusting to high-tech gadgets and a high-speed lifestyle. She said common necessities can also overwhelm.

“One day your grandchildren don’t live with you, and the next they do,” said Carrillo. “We’ve had situations where there weren’t enough beds in the house or no crib, no diapers, no car seat.”

Add to the equation that many grandparents rely on little more than Social Security income and meager savings to get by, and the problem grows much larger, said Carrillo.

The American Association of Retired Persons estimates that about 20 percent of grandparent-headed households in the United States fall below the federal poverty guideline of $20,000 per year for a family of four.

U.S. Census Bureau figures show the percentage of impoverished families varies widely from state to state, with Colorado and New Mexico at the high end with more than 30 percent and New Hampshire and Alaska at the low end at less than 5 percent.

The three most populous states — California, Texas and New York — all exceed the national average. They also account for nearly one of every five grandparents raising grandchildren, the Census figures show.

“While intergenerational families cross all ethnic and socio-economic lines, the growing number of grandparents raising grandchildren is far more likely to be a person of color and to live in poverty than those who are not,” said Kelley.

Studies by the National Center on Grandparents Raising Grandchildren show that the average age of the grandparents raising their children’s children is 57, but that about 25 percent of them are over 65.

This presents what Kelley described as “unique disadvantages” for seniors who had dreamed of taking it easy after a lifetime of work and worry.

“Some must begin new jobs after retirement in order to bear the increased burden of raising a second generation of children,” said Kelley, the center’s director. “Others must leave their jobs to provide child care. If they are in public housing for the elderly, they may be evicted because the children are restricted from residing in senior homes.”

In some states and communities, said Kelley, they may find their senior benefits reduced or eliminated “simply because they have undertaken to raise their grandchildren.”

While lack of money is often a huge hindrance, it is not the only significant one facing grandparents. Many of the grandchildren they are asked to raise suffer from behavioral and physical problems due to prenatal drug or alcohol exposure, sexual and physical abuse, feelings of abandonment and other mental health issues.

Experts in the field say there is little support for grandparents trying to cope with the extraordinary stress and anxiety associated with these emotional problems. The result, they say, is another generation at risk.

Judy Perdue of Project Healthy Grandparents, a community outreach program in Atlanta, said grandparents are asked to navigate the courts, social agencies and medical bureaucracies with little sympathy from those in charge of these institutions.

“They think ‘that’s their family,’” said Perdue. “They’re not willing to look at the intergenerational issue” and the reality that the grandparents need and deserve special attention.

“It’s really important people recognize the contribution grandparents make to our grandchildren,” said Perdue. “They are the unsung heroes of our culture.”

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