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MILLIONS OF KIDS PROVIDE CARE TO ELDERS AT HOME  
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Leah Fabel and Oona Zenda, KFF Health News
June 6, 2025
Governing
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_ More than 5 million teenagers take care of older adults as part of
their day, including nearly a third of high school students in at
least one state. Their numbers may grow if Medicaid gets cuts. _

These students are training for careers in caregiving but many high
schoolers are having to provide care in ways that distract from their
studies, Martha's Hands Home Care via Facebook

 

High school senior Joshua Yang understands sacrifice. When he was
midway through 10th grade, his mom survived a terrible car crash. But
her body developed tremors, and she lost mobility. After countless
appointments, doctors diagnosed her with Parkinson’s disease, saying
it was likely triggered by brain injuries sustained in the wreck.

At 15, Yang, an aspiring baseball player and member of his school’s
debate team, took on a new role: his mother’s caregiver.

Researchers estimate that Yang, now 18, counted among at least 5.4
million U.S. children
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who provide care to an adult in their home. As state officials eye
federal Medicaid funding cuts that could drastically reduce home care
services for those who are disabled or have chronic health conditions,
many predict that number will rise.

That’s bad news for kids: Studies show
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take on care for adults with medical conditions, their health and
academic outcomes decline. At the same time, their loved ones receive
untrained care.

“It all fell to me,” said Yang, whose sisters were 9 and 10 at the
time of their mom’s accident, and whose stepdad worked nights. His
grades fell and he quit after-school activities, he said, unable to
spare the time.

Early on, Yang found reprieve from a personal care nurse who gave them
supplies, such as adult diapers, and advice on items to purchase, such
as a chair for the shower. And for about a year, Yang was able to work
for a personal care agency and earn $1,000 a month caring for his mom
— money that went toward her medication and family needs.

But at the beginning of 11th grade, a change to his mom’s insurance
ended her personal care benefit, sending him into a runaround with his
county’s Medicaid office in Minnesota. “For a solid month I was on
my phone, on hold, in the back of the class, waiting for the
‘hello,’” he said. “I’d be in third period, saying, ‘Mr.
Stepan, can I step out?’”
A report published
[[link removed]*1qhd0ub*_ga*MTkzMTA2MTUyMC4xNzQ3MzQyMTIy*_ga_V393SNS3SR*czE3NDczNDIxMjEkbzEkZzAkdDE3NDczNDIxMjEkajAkbDAkaDA.#_Toc197957414]
in May by the U.S. Government Accountability Office reminded states
that National Family Caregiver Support Program
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grants can be used to assist caregivers under 18. However, the future
of those grants remains unclear: They are funded through the Older
Americans Act, which is awaiting reauthorization; and the
Administration for Community Living, which oversees the grants, was
nearly halved in April
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as part of the reorganization of the Department of Health and Human
Services
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under President Donald Trump.

Additionally, if Congress approves proposed cuts to Medicaid, one of
the first casualties likely will be states’ home- and
community-based service programs
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that provide critical financial relief to family caregivers, said
Andrew Olenski [[link removed]],
an economist at Lehigh University specializing in long-term health
care.

Such programs, which differ by state but are paid for with federal
dollars, are designed to ensure that Medicaid-eligible people in need
of long-term care can continue living at home by covering in-home
personal and nursing care. In 2021, they served almost 5%
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of all Medicaid participants, costing about $158 billion
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By law, Medicaid is required to cover necessary long-term care in a
nursing home setting but not all home or community care programs. So,
if states are forced to make cuts
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those programs are vulnerable to being scaled back or eliminated.

If an aide who makes daily home visits, for example, is no longer an
option, family caregivers could step in, Olenski said. But he pointed
out that not all patients have adult children to care for them, and
not all adult children can afford to step away from the workforce. And
that could put more pressure on any kids at home.

“These things tend to roll downhill,” Olenski said.

Some studies show benefits to young people who step into caregiving
roles, such as more self-confidence and improved family relationships.
Yang said he feels more on top of things than his peers: “I have
friends worrying about how to land a job interview, while I’ve
already applied to seven or eight other jobs.”

But for many, the cost is steep
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more depression, anxiety, and stress than their peers. Their physical
health tends to be worse, too, related to diet and lack of attention
to their own care. And caregiving often becomes a significant drag on
their education: A large study
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found that 15- to 18-year-old caregivers spent, on average, 42 fewer
minutes per day on educational activities and 31 fewer minutes in
class than their peers.

Schools in several states are taking notice. In Colorado, a statewide
survey
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recently included its first question about caregiving and found that
more than 12% of high schoolers provide care for someone in their home
who is chronically ill, elderly, or disabled.

Rhode Island’s education department now requires every middle and
high school to craft a policy to support caregiving students after a
study published in 2023 found
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29% of middle and high school students report caring for a younger or
older family member for part of the day, and 7% said the role takes up
most of their day. Rates were higher for Hispanic, Asian, and Black
students than their white peers.

The results floored Lindsey Tavares, principal of Apprenticeship
Exploration School [[link removed]], a charter high school in
Cranston. Just under half her students identified as caregivers, she
said. That awareness has changed conversations when students’ grades
slip or the kids stop showing up on time or at all.

“We know now that this is a question we should be asking
directly,” she said.

Students have shared stories of staying home to care for an ill
sibling when a parent needs to work, missing school to translate
doctors’ appointments, or working nights to pitch in financially,
she said. Tavares and her team see it as their job to find an approach
to help students persist. That might look like connecting the student
to resources outside the school, offering mental health support, or
working with a teacher to keep a student caught up.

“We can’t always solve their problem,” Tavares said. “But we
can be really realistic about how we can get that student to finish
high school.”

Rhode Island officials believe their state is the first to officially
support caregiving students — work they’re doing in partnership
with the Florida-based American Association for Caregiving Youth
[[link removed]]. In 2006, the association formed the Caregiving
Youth Project [[link removed]],
which works with schools to provide eligible students with peer group
support, medical care training, overnight summer camp, and specialists
tuned in to each student’s specific needs. This school year, more
than 700 middle and high school students took part.

“For kids, it’s important for them to know they’re not alone,”
said Julia Belkowitz
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and an associate professor at the University of Miami who has studied
student caregivers [[link removed]]. “And
for the rest of us, it’s important, as we consider policies, to know
who’s really doing this work.”

In St. Paul, Joshua Yang had hoped to study civil engineering at the
University of Minnesota, but decided instead to attend community
college in the fall, where his schedule will make it simpler to
continue living at home and caring for his mom.

But he sees some respite on the horizon as his sisters, now 12 and 13,
prepare to take on a greater share of the caregiving. They’re
“actual people” now with personalities and a sense of
responsibility, he said with a laugh.

“It’s like, we all know that we’re the most meaningful people in
our mom’s life, so let’s all help out,” he said.

* Medicaid
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* Trump
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