06/21/2013 04:48 pm ET Updated Aug 21, 2013

Top 20 Things These Grandparents Have to Do Without

Grandparents raising grandchildren long for, pray for, and fight for three things: to keep their grandchildren safe, to see their adult children overcome their difficulties, and to come together as a family, healed and whole.

The road to achieving that is filled with sacrifices, large and small. They are sacrifices willingly endured; sometimes forced on grandparents, sometimes chosen. And always with the intention of doing whatever necessary to keep their family going, their grandchildren thriving.

I posed the question, "What are some of the luxuries you had to give up now that you are raising your grandchildren?" to a group of Grandmother's raising their "grands," as they are sometimes referred to, and here is a distillation of what they had to say.

1. Going to the dentist for themselves
2. Paper towels
3. Hair salon
4. Locking the bathroom door
5. Pedicures
6. Kleenex
7. Cable TV
8. Second car
9. Prescription reading glasses
10. Newspapers
11. Hobbies
12. Magazine subscriptions
13. Eating out
14. Sleeping through the night
15. Friends
16. Home repair
17. Leisure time
18. Vacations
19. Retirement

Number 20 deserves its own category, its own blog. The "list" started out as a fun exercise; funny things like "sleeping in bed without a child sideways in the bed between me and my husband" and "locking the bathroom door without a child screaming on the other side;" things of the "been there/done that" category from back-in-the-day when our own children were little and we were much, much younger.

Soon, responses began to evolve toward more serious financial problems. Issues addressed in my book, Raising Our Children's Children -- written over a decade ago -- but still exist today. Here is an excerpt that is, sadly, as relevant today as it was back then. An interview with Margaret -- an indefatigable grandmother in her sixties who founded the support group, Raising Our Children's Children (ROCC) in her inner-city community -- reveals the financial struggles she, and countless others, face every single day.

Margaret doesn't look quite as sharp today. Her eyes are tired, watery pale. Gone are those wonderful earrings. And she is moving very slowly.

The plan is for me to pick her up from work at the Health Center and drive her home so I can meet with the two children she's raising: Tamika, 13-years-old and, Charlotte, four. She begins by apologizing, in advance, for her messy house. I tell her, "Please don't worry about it. Who cares!" I say and mean it. "You should see the condition I left mine in today," I tell her. But she still frets. She tells me she just can't get going lately, she's been depressed. Money problems.

I squeeze into the cramped space next to Margaret's desk as she fills out time sheets. She talks to me slowly, mechanically -- as if she's reciting a grocery list to herself. She speaks so quietly, I lean forward across a pile of papers and strain to hear.

"I get a check from Social Security, but they take out some for Medicaid. It's funny, they say they are giving you Medicaid, but you're really paying for it." She receives a stipend every other week for her two granddaughters but would receive more if her grandchildren had problems or if she were a drug addict, or if she didn't work. She would receive much, much more if she were a foster care provider. She works part-time at the Health Center and doesn't mention what she makes there, but I imagine it's not very much.

"Shall I buy Tamika the shoes she wants, or pay the electric bill?"

Margaret tells me she tries to do everything right. She shops at the second-hand stores. She tells me people don't treat her with respect; they make her feel that she's begging. I ask her who she is talking about, and she says social workers, people at the welfare office, lawyers, politicians. One politician told her she must not be budgeting properly.

Number twenty is a national scandal, a societal shame. Grandparents learn to deal with less. What they can't deal with is the lack of this:

20. Health Insurance.

Imagine people at retirement age who have worked and payed into the system all their lives, an aging population now caring full-time for grandchildren (in many cases relieving the state of that burden), many with serious issues, without the "luxury" of health insurance!

As a resident of Massachusetts which provides Mass Health insurance for the financially strapped (aka Romney Care, aka Obamacare!) it always comes as a shock to hear that there are still so many out there hopelessly enduring an endless array of health problems, both their own and their grandchildren's, with absolutely no financial assistance. Approximately one half of the states refuse to implement Medicaid expansion as proposed in the new Health Care Reform bill. Millions of people are going to remain suffering; people like these.

Here is some of what they had to say:

Dawn: "My husband had two strokes and open heart surgery all within five months. Since then, has been without insurance. He takes about six meds, sees a PCP, neurologist, cardiologist, heart surgeon. That hospital bill in hand... no work in sight and no money to pay it. The hospital agreed to discount it down if he agreed to a payment plan... with what though? This country needs something to protect the health of its citizens."

Brenda: "I don't have the luxury of health insurance because I can't afford it. Luckily, my grand gets medical assistance because she falls into the "other" category in my state. Doctors are pretty good about paying when we can."

Donna: "Our biggest financial concern is medical insurance. After (husband) retires he will not be insured. With three of us on my plan, it will take most of my income to pay premiums. Unfathomable!"

Jen: "Now that we are on SS, we lost Medicaid. Too young for Medicare. Can't afford to buy a policy. It really stinks! Since husband had two bouts of different kinds of cancer and has a triple aneurysm almost ready to do surgery on... We are screwed!"

Imagine, health care for grandparents in this country is a luxury they can't afford!
But, in the end, the grandmothers responding came full circle after sharing all that they had given up, agreeing that it was all worth it. As Donna said, "Would I change any of it? NEVER!"