(NYT) – The modern health care system requires the work of caregiving to fall to whoever else lives in a household — even if they’re kids.

Isabella, who lives outside Atlanta, is one of an estimated four million children in the United States caring for an adult family member who is sick or disabled or old, according to a 2025 report from AARP and the National Alliance for Caregiving. That figure is an extrapolation from surveys of adult caregivers that include only children who are reported as additional helpers; it doesn’t capture those who provide care by themselves or attend to siblings with medical needs. Sociodemographic shifts will undoubtedly push their numbers higher: Members of the baby boom generation are aging into the years when they are likely to need daily assistance at home, while increased housing costs are packing more families into multigenerational homes.

The health care system is adding to these pressures. Financial incentives are shortening hospital stays, and services that used to be provided on the wards are left to those at home. (Read More)