I thought I was done with school pick-ups and “use your words” when Social Security kicked in. Then Isaiah came to stay.

I walk into the parent-teacher conference and look down at the pint-size chair. I’m in my 60s, with a knee that needs to be replaced. Getting into the chair won’t be a problem, but getting out will require two young, healthy men and good leverage.

Situations like this are common when you find yourself parenting your grandchild. Nationally, there are more than 5.7 million children under the age of 18 being raised in grandparent-headed households, and the number is increasing daily.

My late-life round of parenting started when my stepdaughter spiraled into addiction and lost her apartment. Her 4-year-old son, Isaiah, came to stay in Papa and Grandma’s guest room in our Columbus home, along with a ragged stuffed toy named Mr. Pickles.

We started with an inflatable mattress because, like many in our position, we thought this would be temporary. And for a little while, it was. Isaiah lived with us during the week and visited his mother at whatever friend’s home she was staying in on the weekend. But my husband, David, (her father) and I watched as her situation became more chaotic. Finally, we stepped in and were awarded custody of our grandson.

David retired at 62 to stay home and take care of Isaiah. And our house again became a place of Tooth Fairy visits, backyard treasure hunts, Elf on the Shelf and many other wonderful things we never realized how much we missed.

But since David retired early, he had to accept a reduced amount from Social Security, as well as a reduction in his pension. I will probably work forever—or at least it will seem that way. I will be in my 70s when Isaiah graduates from high school and nearing my 80s when he graduates from college.

But we are lucky compared to others. One-fifth of the grandparents raising grandchildren are doing so on an income below the poverty level.

We quickly learned that Social Security will only allow you to claim your grandchildren for additional income if you adopt them; having custody or guardianship is not sufficient. But adoption is a permanent move that would signal the end of hope that Isaiah’s mother may someday recover. It’s also an expensive legal action that can cost $4,000 to $15,000. Many grandparents in our situation shy away from both the legal and the psychological costs. Instead, they live in that painful limbo between hope that their child will recover and resume parenting and fear that they will try to do so without being ready.

Medical costs became a major concern. Most insurance companies will not add grandchildren to a policy unless the grandparents have legally adopted them. In some states, if your income is low enough, Medicaid will supply coverage. If you live in a state that does not allow this, you are on your own.

Luckily, Medicaid covers low-income children in Ohio, so our lawyer made sure that the custody agreement stated that Isaiah’s mother had to provide medical coverage. This made him eligible for Medicaid. Since Isaiah has a malformed vein in his back and will require multiple treatments, this was very important to us.

Additionally, statistics show that due to previous trauma and living situations, custodial grandchildren are more likely to suffer from emotional problems. Girls often internalize issues, becoming depressed, while boys tend to externalize them, exhibiting behavioral problems. We would see this play out with Isaiah.

We were aware Isaiah was not where he should be verbally, but he had a wide vocabulary and did talk to us when encouraged. However, once he came to live with us, it became apparent that things were much worse than we had known.

Rather than ask for what he wanted, Isaiah would let out a high-pitched shriek if he needed something. As with many children who experience neglect, it had been the only sure way to get his mother’s attention. Often, we were faced with outright defiance. He would look right at us and do exactly what we had asked him not to do.

Worse yet, at night, the bugs came out.

Isaiah would think he saw spiders on the wall and scream hysterically in fear. He would bounce from tears to anger to desperation. All we could do was hold him tight and remind him how much we loved him.

After the first week, we were both shell-shocked. We could not help but wonder if this grandchild of ours had a mental illness. Or were we the ones falling short?

So our long-planned retirement vacation in Italy transformed into numerous closer trips to consult a child psychologist. There, Isaiah received help and, at age 6, a formal diagnosis: He definitely had ADHD. His anxiety and obsessive-compulsive behaviors were part of that. The diagnosis allowed us to get an IEP, or Individualized Education Program, which in turn allowed him to enroll in Summit Academy, a charter school dedicated to teaching ADHD children.

Now that I understood Isaiah’s challenges, I dug into my background as a former teacher. We worked on “using our words.” No more shrieking—it was bad for his vocal cords and our nerves. Name what you need, tell us what is bothering you. It was almost as if he had forgotten how to ask for things.

We went to the library and got books on spiders and insects. I ordered plastic replicas so we could touch them. We bought a magnifying glass and a plastic bug house so we could look at real ones up close.

Isaiah needed the security of consistent boundaries. His world with his mother was unpredictable, unreliable and without structure. Isaiah wanted to know that someone was in charge. We became that security, and we set those boundaries.

That meant I had to give up my grandparent role. Being a grandparent means you get to be the hero, the giver of candy, the favorite who serves up double dessert, even if they didn’t eat their dinner. When you are a grandparent who has to parent instead, that wonderful role is left empty—a loss to both Isaiah and me.

David and I learned that parenting has evolved since our children were young. It took some time to catch up. Words and actions that we considered part of being a kid are now a serious offense. When Isaiah, now in second grade, mentioned at school that boys date girls and sometimes boys date boys, we got a phone call. Not for the nod to gay relationships, but because he brought up dating, and that was considered inappropriate for a 7-year-old.

We didn’t realize how heavily scheduled today’s children are. There is a boy close in age to Isaiah who lives across the street from us, but this child is rarely home. He and his older brother play on soccer teams and baseball teams and football teams. One season is barely over before the next begins.

My youngest son was a wrestler in high school, so I am well aware of how time-consuming sports can be. But it never occurred to me that this kind of commitment now starts when children are 6 or 7 years old.

With the rest of our neighborhood composed of mainly older couples, Isaiah has no one to play with. His school is located 45 minutes away. None of his classmates live near us. My sister advised me to enroll Isaiah in some organized community sports. When his psychologist also brought this up, I decided we would just have to fit it into our lives. But when I got on the computer to find a team, it was too late. To get into spring soccer, you have to sign up in the fall. So we make do for now with swim lessons and gymnastics.

Frankly, I am concerned that once we add the commitment of practices and games to our schedule, Papa and I will need better vitamins—or something else—to keep us going. The most common complaint from grandparents raising grandchildren is that they are tired. And I am here to confirm that.

We are older, heavier and grayer than the first time around. Once dinner is over, homework is finished and the dishes are done, David and I are exhausted. We usually sit on the couch staring blankly at the TV. It’s not unusual for Isaiah to cross in front of us as he runs laps through the dining room, kitchen and living room.

I know I should stop him—especially when the dog joins in. Someone could trip. But it’s close to 8 o’clock and the only thought I typically have is, “Thank God, now I won’t have to walk the dog tonight!”

David and I no longer have the reserves we used to have. And it’s hard to develop an adventurous spirit when you have to weigh whether or not an activity might put Papa’s back out.

Because of this, I worry my grandson will not have the same experiences as children with younger parents. I look at how far the future stretches out for Isaiah and realize how little of it I will fill. I will likely never really know his children. I’ll miss out on celebrating his biggest achievements as an adult. I worry that he will have no one to call when life takes one if its unpredictable turns. And that makes me want to pull him into my arms and hold him tight forever, or at least until he says, “Grandma, are you tucking me into your heart?” And I press my cheek against his brown curls and whisper, “No, pumpkin, you’re already there.”