Two years ago, Ruth Maxey was raising six children, including twin granddaughters, a niece and the girl's three siblings.
She was also in her 60s.
It got to be too much, and in January 2011 Maxey had a stroke, not long after she retired from a demanding job as a hospital administrator. She has high blood pressure, which is a risk factor, but "I'm sure the job and raising the kids and the rippin' and runnin' had something to do with it," she said.
After her stroke, the three oldest children moved in with their grandmother in Rockford, and Maxey focused on raising the other three, including her two grandchildren, whose mother had died of complications from childbirth.
"I guess all would be good if I was 35 and I had the energy to keep up with them," said Maxey, 64, who decided to retire to focus on the kids. "I don't have the energy, but I love them."
Raising children can be taxing at any age, but it can put even more physical and emotional strain on an older person. Poor health, in turn can make it more difficult for some grandparents to perform caregiving duties.
Some research has found that grandparent-caregivers experience depression, high blood pressure and other health problems at higher rates than their peers who are not raising children.
"Considering the changes related to aging — hearing loss, vision impairment, gait abnormalities, cognitive decline, among many others — grandparents face significant emotional and physical challenges as they try to 'keep up' with toddlers, tweens, teenagers and pre-adults," said Dr. June McKoy, a Northwestern University geriatrician.
Most people assume that their full-time child-rearing responsibilities will end once their children are grown and out of the house, but millions of grandparents across the country find themselves nurturing another generation.
Their numbers have risen steadily over the years. Among the reasons: an illness, death, addiction, mental illness, incarceration or military deployment on the part of one or both of the child's parents. The prolonged economic downturn also has taken a toll on some families.
Of course, not all grandparents wind up caring for children under such difficult circumstances.
"With some families, what you see is shared parenting across the generations and a family adapting in a very positive way, such as helping a young parent going to school care for the child until the parent can assume more of the responsibilities," said James Gleeson, an associate professor at the Jane Addams College of Social Work at the University of Illinois at Chicago.
And some grandparents say their grandkids help them stay active.
Grandparent caregiving crosses income, racial and other demographic categories, Gleeson said, though African-Americans are two to three times as likely to be raised by a relative other than a parent, compared with other racial and ethnic groups. About a third of grandparents caring for grandchildren are single.
Nationwide in 2011, about 7 million grandparents lived with a grandchild younger than 18, and about 39 percent of them were primarily responsible for meeting their grandkids' basic needs.
In Illinois, grandparents were living with their minor grandchildren in more than 270,000 households. In 99,000 of them, an older adult had taken on primary responsibility for meeting the basic needs of at least one grandchild.
Daxa Sanghvi, caregiver specialist at the Kenneth Young Center in Elk Grove Village, said participants in a support group she facilitates for grandparents raising grandchildren often share concerns about the impact of caregiving on their health.
Sanghvi said many of the grandparents say they are stressed out and that conflicts about the grandchildren sometimes arise between them and their spouses.
"They have no time, no energy, and emotionally they are really deflated," she said. "They are not even thinking about themselves because they are going, going, going."
Many of the grandparents she works with are sleep-deprived and "trying to do so much it affects their emotional state as well as their physical state," Sanghvi said. "Sometimes they don't even realize how much it is affecting them."