Caregivers’ health problems also can strain their ability to keep the kids in their care. But unlike licensed foster parents, they are not eligible for free services that provide caregivers respite from the demands of child-rearing.

When a health crisis strikes, caregivers are on their own.

Alice Doyel learned how hard it is for caregivers to get help when her seizures and immune disorder suddenly worsened in 2016. The 73-year-old south Seattle resident barely had the strength to take care of herself, let alone the energetic preteen grandson in her custody.

As Doyel’s health spiraled downward, so did the behavior of her grandson, TJ, whose early-life neglect and exposure to domestic violence predisposed him to angry outbursts, she said. Desperate for rest, she begged state social workers to find someone who could supervise her grandson for a few hours or days. Such assistance, she was eventually told, would cost her $1,500 for a weekend, and more if TJ exhibited behavioral problems.

“My response was, ‘I think we’d rather stay at the Fairmont Hotel for the weekend,’” Doyel said, referring to the luxury hotel in downtown Seattle.

Eventually TJ’s school helped find him an afterschool program, and Doyel’s health slowly stabilized. As she got better, so did TJ. Now 12, he is no longer the angry, sometimes-violent child she removed from neglectful circumstances six years ago.

It has taken most of that time for TJ to attach emotionally to Doyel, she says. Now his caring and concern for Doyel’s health shine through. “He’s so watchful,” she said. “Even if he’s riding his bike and I’m walking, he always waits to see if I’m OK.”

Foster care, Doyel says, would have been a disaster for a child like TJ. “He would have been one of the kids who would have been from home to home to home,” she said. “He would have been in the juvenile justice system.”

Similarly, Simmons believes that her godsons, now ages 11 and 13, would have bounced around in foster care after being abandoned by parents with a history of substance abuse and arrests, according to her petition for custody. The older boy, Emari’ay, didn’t speak until he was four years old, Simmons said, and he had to go through years of physical therapy to improve his motor skills. Xavier was expelled from kindergarten due to emotional outbursts. Both still struggle with developmental delays and the trauma of being separated from their parents.

For Simmons and Doyel, finding affordable mental health care for their boys, shuttling them to medical appointments and negotiating with schools has been an exhausting, and often lonely, slog. Unlike foster parents, they don’t have a state caseworker to help them find assistance and navigate services. But both women understood that giving up was not an option.

Today, Simmons’s godsons call her “mom.” Emari’ay dreams of being a pilot and is spending the summer helping teach other kids to play tennis. Xavier immerses himself in constructing complex worlds out of Legos, and says he wants to become an architect, or maybe a fireman.

“We have formed a strong bond and love and concern for each other that I never thought would be there,” Simmons said, “because I thought they were too emotionally damaged.”

In addition to providing critical stability, living with relatives or close family friends can alleviate some of the trauma associated with losing a parent, says Judge Frank Cuthbertson, a Pierce County Superior Court judge who presided for two years over cases in which children had been removed by Child Protective Services. He now oversees the county’s Mental Health Court, where many of the parents also are working to get their kids back.

In those roles, Cuthbertson has seen how kinship arrangements often create the best conditions for children to return to their parents.

The power of those family bonds was on display recently in Cuthbertson’s court room. After a long battle with methamphetamine and alcohol, combined with mental health issues, a mother graduated from the Mental Health Court’s 18-month program. Not only had she gotten her life back, she told Cuthbertson, but she also got another chance to be a mother to her preteen son. Throughout her treatment, the woman’s own mom had cared for her grandson, showing up often in court to support her daughter.

“If we didn’t have her mom willing to be a kinship caregiver while she went in and out of treatment, jail and everything else,” Cuthbertson said, that reunification “wouldn't have happened.”

Family members, Cuthbertson said, can “help rebuild the bonding between the parent and the child. That’s another reason why I think kinship caregiving is really important and something we don’t think about enough.”

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