Enquiry about childcare responsibility should become routine in the assessment of the older patient

Abstract

Currently elderly relatives are being asked to assist with informal childcare more frequently. This role can lead to an increase in stress and fatigue. In someone with cognitive impairment it can put both adult and child at risk. Two hundred people attending the Carew day hospital were asked if they had supervised children in the previous 12 months. People were excluded if they had cared for children >12 years of age, had a Mini Mental State Exam (MMSE) of <10 or were resident in a nursing home. Thirty-two (16%, 25 female) had looked after children. Average age 79 years. Seven had a short-term memory of 0/3. Five looked after them on a daily basis, two with an MMSE <24. Five looked after them longer than a 10-h period/overnight, one with an MMSE <24. Members of the multidisciplinary team who participate in the assessment of older people need to be aware of their increasing role in childcare. As a result of our findings we propose that the time has come to include a question about childcare as part of routine assessment of the older patient.