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Updated: Jul 15, 2026
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Enquiry about childcare responsibility should become routine in the assessment of the older patient
C O'Dwyer1, A Moriarty, C Collins
1Department of Elderly Medicine, St Vincent's University Hospital, Elm Park, Dublin, Ireland. clodaghtipperary@eircom.net
Insights
Many elderly relatives provide informal childcare, increasing stress and risk, especially for those with cognitive impairment. Routine assessments should include questions about childcare responsibilities in older patients.
Area of Science:
- Gerontology
- Public Health
- Cognitive Impairment
Background:
- Elderly relatives increasingly provide informal childcare.
- This role can elevate stress and fatigue in older adults.
- Cognitive impairment in caregivers poses risks to both adult and child.
Purpose of the Study:
- To investigate the prevalence of informal childcare by elderly patients.
- To identify potential risks associated with this role in older adults.
Main Methods:
- Surveyed 200 day hospital attendees regarding childcare in the past 12 months.
- Excluded participants with children over 12, MMSE <10, or nursing home residency.
Main Results:
- 32% (16%) of participants provided childcare, average age 79.
- Seven had significant memory deficits; five cared for children daily.
- Five provided extended care (overnight/10+ hours), with some having cognitive impairment.
Conclusions:
- Multidisciplinary teams must recognize the growing role of older adults in childcare.
- Routine patient assessments should incorporate questions about childcare provision.
- This inclusion can identify at-risk individuals and facilitate appropriate support.
Background:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
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