‘I just can’t do it anymore doctor. I’m a wreck’.

Mary is a widowed 72 year old lady who has a bad back, sore wrists and shoulders and as a result, has difficulty sleeping and sometimes even dressing herself can be a struggle. These symptoms make her own life difficult but her main concern is not for herself. She’s afraid she’ll no longer be able to care for her 2 preschool grandsons.

She’s helping out her daughter who has had to return to work to help make ends meet now that her husband’s salary has been cut. Her daughter drops the two boys round on her way to work, 5 days a week, and picks them up on her return. 

Its a long day, but Mary is glad to be able to help out. She loves the kids and enjoys spending time with them but the physical and emotional demands of feeding, changing, cleaning up and entertaining them is taking its toll. She feels that her arthritis pains are worse, finds it difficult to make time to visit her friends, exercise or to attend her hospital clinic appointments.

She’s not alone. As the financial pressure mounts on cash strapped families in this recession,  grandparents are more frequently being asked to give a hand with childcare. Even during the financial boom, unpaid relatives were the main source of non-parental childcare in 11.5% of preschool children. There’s an increasing proportion of single parent families of whom 1/3 will avail of the services of an unpaid relative to help with childcare.  For many Irish grandparents, there’s no escape either. In Ireland, 20% of grandparents live in the same house as their grandchildren and up to about a third live within 25 Kilometres.

Looking after small kids is hard work. I frequently see young mums (more so than young dads…) overburdened with the physical and emotional demands of raising small children in my practice. Perhaps its not surprising that older people, particularly those with a pre-existing condition such as arthritis might struggle in the same situation.

However, a 2007 study found no evidence that ‘caring for grandchildren has dramatic and widespread negative effects on grandparents’ health’. It did suggest however that likelihood of negative impact of grandparent health  might be determined by the particular circumstances and ‘workload’ circumstances of the carer. For example, there might be a positive health advantage to those doing a little babysitting, but potential for problems where the grandparent is helping out in ‘skipped generation’ families (where the parents are, for whatever reason, absent), or those who provide ‘live-in’ care. It clearly depends on the circumstances.

Although there are no hard and fast rules to how to manage requests for looking after grandchildren, and I’m always cautious about offering life advice to my elders, here’s some of the advice.

1. If you enjoy looking after your grandchildren and feel up to it, keep on going! You are unlikely to do harm to your health and you are providing a great service to your children and your grandchildren.

2. In order to care effectively for grandchildren you need to look after yourself. This means making time to exercise, socialise with your friends and (if necessary) see your doctor. If you don’t have a hobby or outlet, get one. Its easier to say no when you’ve got an Art class to go to.

3. If you feel the need to set limits on your commitment, its better to do it early. Before the baby is born is ideal or at the very least, very soon after. It gives your family time to set realistic expectations and time to make alternative arrangements.

4. Don’t move in if you can help it. There’s evidence that grandparents who co-habit fare worse with their overall than those who live independently  As nice as it is to spend time with your grandchildren, its nicer doing so knowing that you can give them back.

5. If you find that you are not coping physically or emotionally and don’t feel comfortable or guilty bringing it up with your own children, it can be helpful to involve your doctor. I have, for example, written letters to my patients to ‘recap’ on advice given at clinic regarding the need to pull back form childcare which they can in turn, show to a relative.

Here’s a little bit of extra advice from Ile Nastase, the veteran tennis star on the benefits of exercise and of having small children around. 

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