HARRISBURG (AP) — Joanne Clough forgot about the baby gate, which sent her sprawling into the dark room. Her first thought was about the toddler in arms. Her next thought was about her artificial knee, her pain and, with her cellphone downstairs, how she would summon help.

The 60-year-old lawyer can be forgiven for forgetting about the gate. It was the first one in her home since her own children were small. But Clough now has full-time responsibility for another young walker -- the 22-month-old child of her daughter, who died of a heroin overdose in 2016.

"I am a broken-hearted, mother-grandmother doing the best I can each day to just breathe, live, survive and raise my granddaughter so this addiction does not destroy us too," said Clough, who lives in Cumberland County.

Clough is among thousands of grandparents in Pennsylvania caring for a grandchild because one or both of the child's parents is incapacitated by opioid addiction or dead of an overdose. It's one more bleak consequence of the crisis which killed more than 4,600 people in Pennsylvania last year and has become the second leading cause of death for Americans younger than 50.

In Pennsylvania, about 88,000 grandparents are raising 195,000 grandchildren. In about 40 percent of those cases, drug or alcohol addiction is the main reason for the children being placed with the grandparents. But these figures don't tell the full story. Many more grandparents are raising their children under arrangements without knowledge or involvement of children and youth services.

The grandparents say they desperately need help. Some of them are retired, and the fixed incomes they were relying on to get them through the rest of their lives are now strained by the expense of raising one or more young children. About 20 percent are living in poverty. Others still work and now face expenses including daycare, which typically costs several hundred dollars per week. Saving for retirement can become impossible.

Those who gained custody without involvement of child protection authorities often did so to avoid having to go to court and make the case that their own child is an unfit parent. But it also denies them access to financial help that would be available to foster parents.

"Nothing drives a wedge between relatives more than one calling CYS on another or suing them in custody court," said Brian Bornman, executive director of the Pennsylvania Children and Youth Administrators.

If grandparents do involve child protection authorities, they could open the door to the child being placed being in the care of someone else. Or, if the grandparent is deemed appropriate and wants official status, they must submit to background checks and home visits by caseworkers, and meet assorted qualifications pertaining to things such as the square footage of their home.

Summing up the overall situation, state Rep. Eddie Day Pashinski of Luzerne County said, "Grandparents don't get a dime. They get nothing."

That's especially unfair, he argues, since grandparents who have rescued children from the consequences of the opioid addiction crisis are saving Pennsylvania taxpayers about $5 billion annually that would otherwise be spent on foster care.

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Deborah Friday had to tell state police her daughter was stealing her jewelry. That's when her daughter, who had three children and was pregnant with her fourth, admitted she was addicted to heroin.

As with many people who become addicted to heroin, Friday's daughter, now in her 30s, has alternated between recovery and relapse since acknowledging the addiction in 2012.

Friday and her husband, Mike, have custody of the four grandchildren, whose ages range from 4 to 10. They are in their mid-50s and live in Dixonville in Indiana County. She's a registered nurse at a hospital and he's a rural mail carrier.

"Any day I may have off is spent doing what needs done to keep the kids well, physically and emotionally. I would love to go to family support meetings but there is no time because I have to work or get the kids someplace," Deborah Friday said.

The grandmother said it helps she can work 12-hour shifts, giving her more days off to devote to the children. They don't qualify for any help toward day care.

Thankfully, they have family and friends willing to help with child care. Their youngest grandchild has three different sets of sitters in a week. All are past 60; two are 80.

Living with an addicted parent and then adjusting to life with their grandparents has had emotional and behavioral consequences for the children. "This has been a real challenge for our marriage - differences in parenting the kids, managing all the activities the kids are involved in and all the parenting," Deborah Friday said.

But worst of all, she said, is losing the ability to "spoil" the grandchildren. As one complained, "It is not like it used to be here - it was the fun place."

The biggest help, Deborah Friday said, would be for grandparents to qualify for the financial supports available to foster parents and some of the programs the children would be eligible for if they were living with their parents. Other things that would make a big difference are legal changes that would enable grandparents to step in when the children are at risk.

Through it all, Deborah Friday loves her daughter and prays for sustained recovery. Yet she also realizes that with the criminal record and lost career-building opportunities that accompany addiction, it will be hard for her daughter to ever fully provide for four children.

That points to something else she would appreciate from lawmakers: helping people in recovery to overcome criminal records related to addiction, so they can rebuild their lives and provide for their children.

Despite all the work and stress, Deborah Friday lives for arriving home from work, knowing four happy grandchildren will rush toward her. It serves to "remind me that we will make it through this time."

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The opioid crisis has given Vickie Glatfelter a worry she knows will last until her dying day.

Her son, Bob, died of an overdose, leaving behind a boy with autism. Glatfelter's grandson, who doesn't speak, is now 10.

Glatfelter, 56, and her husband, Bob, know they'll care for him for the rest of his childhood and beyond, probably until they become physically unable.

"Then what?" she said.

They've acted as parents to their grandson almost since his birth. The younger Bob Glatfelter and the child's mother weren't married, with both addicted to opioids. He moved back home with his parents not long after his son's birth. Eventually, during a time when Bob and his girlfriend were both gone because of rehab and jail, Vickie Glatfelter called Children and Youth Services in York County, where they live.

"I called and said I don't know what to do," she said.

CYS determined the grandparents were the best placement option and helped them attain legal guardianship. Later, after Bob died, they went to court and were given primary physical custody.

Because of his disability, their grandson receives a Social Security benefit and also qualifies for health insurance through Medicaid. He also receives a Social Security death benefit of about $500 per month, which will continue until age 18.

"It doesn't cover everything. It helps, believe me," she said.

Vickie Glatfelter and her husband both work full time. So just as they enter the time in their lives when they would otherwise be thinking about retirement, they face the costs of raising another child.

"I'll never have a normal life," she said.

At times she wrestles with anger about her situation, the lack of help from the system, that her son allowed heroin to cause such pain in all their lives and left an innocent boy without a father. At other times, she mourns the toll of a national epidemic and the loss of a son who was once so full of life and goodness. She sees her son in her grandson.

"It breaks my heart some days. I get choked up," Vickie Glatfelter said.

It also removes any doubt she will persevere, no matter the cost.

"I love him like he's my own," she said. "That's what I have left of my own son. I'll do anything I can to make sure he's as successful as he can be."

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By DAVID WENNER, PennLive.com
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