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 transformation of family structures, grandparental caregiving has become commonplace, and its impact on the mental health of older persons is of great concern. Methods: Utilizing data from the 2023 Xi'an Jiaotong University Urban and Rural Elderly Family Support and Psychological Condition Survey, this study employs the Psychological Condition Measurement Scale to assess mental health outcomes. A multi-method analytical approach is adopted, including linear regression modeling, Propensity Score Matching (PSM), and Instrumental Variables Method (IVM), to rigorously evaluate the causal relationship between grandparental caregiving and mental health, while addressing potential endogeneity and selection bias. Results: Grandparental care has a significant positive effect on the mental health of older people, but this positive effect diminishes and may even turn negative as the intensity of care increases. The results of the sub-sample estimation indicate that grandparental caregiving has a more significant impact on the mental health of female older adults, those aged 70-79, and rural older adults. In addition, intergenerational financial support and intergenerational emotional comfort play an important 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.