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In their last trip before quarantining for coronavirus, Joanne H. Clough takes her daughter, Diane Roznowski, 23, and granddaughter, Carter Gens, 4, to visit Clough’s brother near Juneau, Alaska, in March 2020. Credit: Photo courtesy of Joanne Clough.

When her 22-year-old daughter died of an opioid overdose, Joanne H. Clough swooped in to raise her granddaughter, Carter, then 9 months old. Now Clough is taking care of Carter during another public health crisis — this time, trying to run her law practice from home and protect herself from the coronavirus while the energetic 4-year-old rides her scooter through the house and tests her patience.

Clough, 63, is raising Carter in a three-bedroom ranch house near Harrisburg, Pennsylvania. Above the fireplace hangs a portrait of her daughter Emily, who overdosed in 2016 after a years-long struggle with a heroin addiction. 

Clough, who raised two daughters on her own, never planned to raise another. “It’s certainly not what I thought I would be doing at my age,” she said. But one morning this spring, there she was, quarantined at home with her granddaughter, bending over to wipe up a mess with towels after Carter, who needs to be reminded to use the potty, peed on the floor.

“I love Carter more than everything, but it is really challenging,” said Clough. “She’s very smart, very bright, very precocious, and she’s in your face 24-7.”

Clough is one of roughly 2.4 million grandparents in the U.S. who are responsible for raising their grandchildren, their numbers highest in states hit hard by the opioid epidemic. With the coronavirus shuttering schools and forcing the nation into quarantine, these grandparents have shouldered extra duties feeding, caring for and educating their grandkids at a time when they are themselves especially vulnerable. Many are over 60, putting them at higher risk of hospitalization and death from Covid-19, which would upend their grandchildren’s lives for a second time.

An estimated 2.4 million U.S. grandparents are responsible for raising their grandchildren.

Many also have medical conditions that put them at further risk. After suffering a heart attack at age 58 during a difficult period of her daughter’s heroin addiction, Clough now takes daily heart medication. She’s also prone to pneumonia, for which she was hospitalized last year. 

The U.S. Centers for Disease Control and Prevention is asking older adults to protect themselves from the virus by self-isolating and avoiding contact with others, including relatives. But for grandparents raising grandchildren, that’s not possible, said Jaia Peterson Lent, deputy executive director of Generations United, a nonprofit advocacy group.

Critical Condition

The Students the Pandemic Hit Hardest

The coronavirus pandemic closed schools and launched a national experiment in remote learning that has been chaotic and stressful for millions of American families. But in some households, the shift to homeschool was particularly catastrophic. In this series we profile vulnerable children whose education was already precarious and how the disease has exacerbated gaps in opportunities and resources for communities already on the edge.

“These grandfamilies can’t take a break from each other,” she said. “These grandparents are the last option keeping children out of foster care.”

Related: More grandparents are raising grandchildren. Here’s how to help them

When grandparents find themselves responsible for raising their grandchildren, it often happens suddenly, without giving them a chance to financially prepare. Now the school closures and quarantines imposed to slow the spread of the coronavirus have increased their financial stress. Breakfast and lunch that children received for free at school are now being offered at pickup points, and getting there can be difficult.

Joanne H. Clough and her granddaughter, Carter, make Christmas cookies in December 2019 Credit: Photo courtesy of Joanne Clough.

Many grandparents are afraid to leave the house for any reason because of the virus, Lent said. If they venture out to the food pickup points, she added, some end up waiting in long lines with their grandkids, many of whom have disabilities or behavioral challenges related to childhood trauma. In large cities, many travel to two locations — one to get food for themselves and another for the children — while trying to avoid the public transit they typically depend on.

Other grandparents solve the groceries problem by finding someone to watch their grandkids as early as 5 a.m. so they can line up for senior shopping hours at the supermarket, Lent said. Her organization has compiled resources for grandparents and other relatives raising children during the pandemic.

At the Plaza West housing complex in Washington, D.C., which is designed for grandparents raising grandchildren, residents have made an informal pact to take care of each other’s kids if someone is hospitalized. But there’s still a lot of fear, said tenant Cassandra Gentry, 67.

“These grandfamilies can’t take a break from each other. These grandparents are the last option keeping children out of foster care.”

Jaia Peterson Lent, deputy executive director of Generations United, a nonprofit advocacy group

One tenant has tested positive for coronavirus, said Gentry, who is raising a great-granddaughter, 9, and a grandson, 14.

She worries about what she might do if she got sick. “Naturally grandparents don’t want to call the doctor,” she said. “We know if they take us to the hospital they’re going to keep us. But then what happens to our kids?”

When schools shut down, the kids’ teachers began sending schoolwork home. But Gentry didn’t feel equipped to help. “I’m not a teacher,” she said.

With the school year wrapping up, she fears her children have lost ground academically. “Teaching at home is just not the same as them learning with their peers,” she said.

Related: Parents of kids with disabilities worry coronavirus quarantine will mean regression

In Ludington, a small city in western Michigan, Jan Wagner, 69, said she has was not attempting to get her 14-year-old grandson, Holden, to do homework. 

Jan Wagner is raising her 14-year-old grandson, Holden. Photo courtesy of Jan Wagner.

Holden, whose mother was addicted to opioids and alcohol, failed to thrive as an infant because his mother “struggled to interact” with him, said Wagner. He didn’t learn to talk until he was 2, when Wagner took him in. Now he gets extra help in school for an emotional disability. 

Even under normal circumstances, getting him to do homework without a tutor is a challenge.

Instead of putting up a fight, Wagner has allowed Holden to stay in his bedroom when he wants to, playing video games with his friends online. “I’m not homeschooling,” she said. “He has the Xbox. He has the phone. He spends his time upstairs, communicating with the guys … I just don’t poke the bear.” 

“Naturally grandparents don’t want to call the doctor. We know if they take us to the hospital they’re going to keep us. But then what happens to our kids?”

Cassandra Gentry, 67, raising a grandchild and a great-grandchild

Wagner said she feels tremendous responsibility to avoid the virus so she can be there for Holden. She is at higher risk of complications from Covid-19 because of an immunosuppressant she takes for an autoimmune disorder. 

“I walk out the door and if somebody’s got a cold, I get pneumonia,” she said. “That’s why it’s extremely important that I stay isolated.”

Wagner said when she heard Lt. Gov. Dan Patrick of Texas suggest that grandparents would be willing to die to save the economy, she was appalled, in part because he ignored the fact that millions of grandparents have stepped in to raise kids like Holden.

“It hit me very hard,” Wagner said. “What an awful thing to say, because that would make my child an orphan again. He’s already lost his family.” 

“I walk out the door and if somebody’s got a cold, I get pneumonia. That’s why it’s extremely important that I stay isolated.”

Jan Wagner, who is raising her grandson, Holden

Wagner said she and her husband have exhausted their retirement accounts to raise Holden and are now living on Social Security checks. 

Related: Stuck at home with kids during the coronavirus? Here’s what to do and not do

In Pennsylvania, Clough also worries about having enough money to support herself and her granddaughter during the pandemic. She already plans to work until she’s 78, when Carter is set to finish high school. 

The quarantine is also taking a psychological toll, Clough said. There have been moments of joyful hilarity, like when Carter flew through the house on a scooter, wearing a bathing suit, demanding to go swimming. 

But Clough said she has struggled to maintain patience. “I tend to be a yeller, and that’s the worst thing to do with Carter. She escalates,” Clough said. “She’ll get really, really out of control sometimes — she’ll lash out and hit me.” After Carter whacked her grandmother in the knee with a karaoke microphone, on the spot where she had several surgeries, Clough tried to keep her calm and threw the toy in the trash. 

Carter Gens, 4, with her aunt Diane Roznowski (right) and great aunt Marian Clough (left) at Mendenhall Glacier in Juneau, Alaska in March 2020. Credit: Photo courtesy of Joanne Clough.

Roughly 10 days in quarantine, Clough’s patience grew so thin that an additional stressor became a breaking point. She had been trying to get in touch with her 23-year-old daughter, Diane Roznowski, who lives in Maryland and typically communicates with her 10 times a day. She messaged Roznowski and waited. In the morning, Clough saw her daughter’s phone had been inactive for more than 9 hours.

Clough said as she waited, she recalled the night she lost her daughter Emily, who went missing for 18 hours before she was found dead in her car. 

“I started freaking out,” Clough said. This time, it turned out her daughter was just sleeping in. 

“I love Carter more than everything, but it is really challenging. She’s very smart, very bright, very precocious, and she’s in your face 24-7.”

Joanne H. Clough, who is raising her 4-year-old granddaughter, Carter

Clough said she realized the strain of being apart from her daughter, on top of raising Carter alone while running a business, was too much. Luckily, Roznowski has a job she can do remotely and a relevant skill set: She works for Generations United as policy and program coordinator.

In late March, Roznowski left Maryland and joined their quarantine. Roznowski now takes turns minding Carter between conference calls. 

Two adults to one preschooler is a better ratio, Clough said by phone one afternoon. She spoke as Carter snapped glowsticks together into a 6-foot-long whip and swung it at one of the cats.

Roznowski has been offering guidance — “No Carter, you do not put Cheetos in the microwave!” — and has taken charge of shopping and putting Carter to bed. Within three days, she successfully coaxed Carter into sleeping in her own bed instead of her grandmother’s, which gave Clough more space to rest.

In quarantine, Clough and her daughter developed a routine, switching off between taking Carter on drives around town and making phone calls for work. Together they built a vegetable garden, now teeming with tomato and pepper plants.

On June 1, as Pennsylvania began a second phase of reopening, Carter returned to preschool. Wearing a fish-themed face mask, she ran in the door to see her friends, Clough said.

Clough said it was a difficult decision to send her back to school, given the risk of coronavirus exposure. Carter doesn’t get sick easily, she said, but “I worry that she could carry it home.”

The next day, Clough came down with a fever. “I’m freaking out a bit,” she said. But keeping Carter in the house no longer felt like a viable option.

“It was hard on her to be here,” Clough said. “She’s used to being around other kids all the time.”

This story on grandparents raising grandchildren was produced as part of the series Critical Condition: The Students the Pandemic Hit Hardest, reported by HuffPost and The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for Hechinger’s newsletter. 

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Melissa Bailey is a Boston-based freelance journalist and 2015 Nieman Journalism Fellow. She is working on Lost on the Frontline, a project by Kaiser Health News and The Guardian documenting the lives...

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