A teenager comes home from school, only to immediately start working on family caregiving. She helps a grandparent bathe, reminds a parent to take their medications, and cooks dinner — all before starting her homework. This is daily life for a large number of children in the United States.
A joint report from 2025 estimated four million American children helped care for a sick, disabled, or elderly adult relative. It inferred that number from surveys of adult caregivers. As such, it likely misses children who give care entirely on their own and those who look after siblings with medical needs. The real number is likely even higher. This issue drew fresh attention in August, when The New York Times Magazine published a feature on it by Dr. Helen Ouyang.
Why Children Are Handling Family Caregiving
Several trends are pushing more care into the home. Baby boomers are reaching ages when the need for daily help is more common. Rising housing costs are requiring more families to live in households that span generations. Hospitals are discharging patients sooner, which leaves tasks once handled by nurses to family members.
In addition, federal cuts to Medicaid will likely lead states to reduce or eliminate optional home care services some families depend on. Medicaid is the country’s primary payer of long-term care in the home, managed by individual states.
About 63 million Americans already provide ongoing care for an adult or child with a medical condition or disability. Yet, the United States has no national paid family leave policy (some state programs exist). When adults cannot cover the gaps without risking job protection, children often step in.
What This Means for Older Adults Who Need Care
For many older adults, a grandchild’s help can mean staying at home instead of moving into a facility. Some prefer the closer bond it can foster between generations as well.
However, relying on a child for family caregiving carries risks. They may not know what to do in a medical emergency or how to handle medication safely. Additionally, they may not be physically capable of helping during transfers or if the older adult falls.
Also, care can stop suddenly when the child gets sick, has a school crisis, or grows up and moves away. Some older adults may feel guilty about leaning on a child or grandchild and that stress can affect their own well-being.
What This Means for the Children
Children who provide family caregiving in the home often take on tasks that would challenge many adults. They help older relatives with such tasks as managing medications, changing dressings, checking blood pressure, and bathing. Those duties can cut into time for homework, sleeping, building friendships, and engaging in childhood activities.
Many of these children say they do not mind helping and they often develop maturity and compassion. The concern lies in the lack of support. A federal Government Accountability Office (GAO) report found that the key federal caregiver programs focus on adults.
To address this, the GAO recommended that the Department of Health and Human Services (HHS) clarify the program’s eligibility rules online. The site said the program serves adults but did not mention that states and local providers can decide who counts as an “adult”. That means some caregivers under 18 may qualify for services like counseling, training, and respite care. HHS agreed and updated its website in May 2025.
Some schools and nonprofits, such as the American Association of Caregiving Youth, are improving help for student family caregiving. They offer home visits and respites so the students can take a break from caregiving.
Still, the current system has much to improve. As researcher Elizabeth Olson notes, support for family caregivers doesn’t usually receive push back. Once children enter the picture, however, it becomes a debate.
How Medicaid and an Elder Law Attorney Can Help
In New York, Medicaid can provide financial assistance for home care services, such as an aide to help with activities of daily living. However, there are eligibility rules and often planning is required. With the help of an elder lawyer, seniors can navigate the Medicaid application process and more easily realize the benefits that will help them live more comfortable, independent lives with less reliance on children and family caregiving.
Medicaid has income and asset thresholds that determine whether an applicant qualifies for assistance. Many seniors are over these limits, but with the proper planning and the help of and elder law attorney, they can often become eligible. Besides financial eligibility, Medicaid requires applicants to demonstrate a functional need for home care services. A comprehensive assessment is conducted to evaluate the applicant’s ability to perform daily activities.
Navigating Medicaid’s complex requirements can be overwhelming for seniors and their families. Elder lawyers specialize in helping older adults manage legal, financial, and health care issues, including qualifying for Medicaid.
Contact the experienced elder law attorneys at Kurre Schneps to learn how we can help secure Medicaid benefits to alleviate the burden on family caregiving.
