Takeaway
Some young people take on caregiving responsibilities at home, and we may miss this. Ask "Do you help take care of anyone at home?" and connect them with support resources as needed.
Lifelong learning in clinical excellence | November 5, 2026 | 2 min read
By Catherine Ling, PhD, FNP-BC, CNE, Johns Hopkins University School of Nursing
I first became aware of youth or child caregiving through a colleague’s encounter. She was walking across the National Military Medical Center’s campus and entered a building just ahead of a school-aged child with their father, a bilateral lower limb amputee, in a wheel chair. The child was opening the door to let the wheelchair in and my colleague helped widen the opening while telling the child what a great helper they were. The child responded that their Daddy had helped them to learn to walk and now it was their time to help Daddy learn to walk with his new legs.
Caregiving is born of necessity and it can be invisible if we’re not looking for it. As a family nurse practitioner, I’ve provided care to thousands of youth while assessing risks and developmental milestones. However, I haven’t routinely assessed for caregiving responsibilities until recently.
Youth caregivers seem to have a proportional relationship between the complexity, breadth, and time spent on these responsibilities and their mental health and educational achievement. School-based programs like the one run by the American Association of Caregiving Youth in Florida have found great success through multifactorial support.
Assessing
To identify youth caregivers, start with assessment. Simply ask young people if they help take care of anyone at home in addition to asking about social media and seat belt use. This is a risk factor that needs more clinical and research attention. Many questions have arisen for me over the last few years: How many children are providing routine care for family members? What is the distinction between caregiving as a responsibility that builds purpose and resilience, and caregiving as an Adverse Childhood Experience (ACE)? What is the true prevalence of youth caregiving and is it masked due to socioeconomic pressures and cultural expectations? What’s the impact on children who act as translators for parents or other family members? What is the impact on children who must act as parents to their younger siblings?
Connecting with support
Once identified, we can help connect the child and family with a support network—the hospital or clinic social worker, mental health professionals, school resources (counselors, nurses, teachers), social services, and other community-based organizations.
Reflecting on youth caregiving
I was born into a military family and married a military service member. Culturally, we’re expected to take care of our own at home so that our parents and spouses are always mission ready—but at what cost to children who must assume responsibilities typically delegated to adults?
I think of that child and of the long-term implications of helping Daddy walk again. I wonder if there were additional traumas, never assessed and never treated. Best practices await additional evidence and start with assessment now.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.