What GAO Found

National data on individuals who care for family members can provide insights into the population of caregivers, but the surveys GAO identified do not allow for accurate estimates of minors who provide informal, often unpaid care to family members (caregiving youth). However, three state-level surveys GAO identified that collected data on caregiving youth showed that middle school students and racial and ethnic minorities played a larger role providing care for a family member compared to other students. According to selected studies, a GAO survey of 43 former caregiving youth and interviews with five of those youth, caregiving youth experience some positive effects from caregiving, but also face several challenges. For example, some respondents to a GAO survey reported experiencing stress and anxiety because of concerns about their family member's health condition.

Examples of Effects Youth Experience While Caring for Family Members

Key federal programs that support family caregivers focus on adults and not on caregiving youth. Under the three federal caregiver support programs administered by the Departments of Health and Human Services (HHS) and Veterans Affairs (VA), officials told GAO that family caregivers must be adults to receive supports such as counseling, referrals, and respite care. However, according to a 2024 federal register notice issued by HHS, states and service providers may determine when family caregivers younger than age 18 could be eligible to receive supports under at least one federal caregiver support program. States and service providers may be unaware of any flexibilities because the HHS website does not include this information. One of HHS's objectives in its 2022-2026 Strategic Plan is to support high-quality services for older adults and people with disabilities, and their caregivers. The plan states that to achieve this objective, HHS leverages resources to better address the needs of all caregivers across the age spectrum. Without complete information from HHS on eligible caregivers, states and service providers may not be aware that they have flexibility to provide services to certain family caregivers under 18.

England established a national policy in 2014 that calls for local governments to take reasonable steps to identify and assess the needs of caregiving youth in their area, according to stakeholders GAO interviewed. Local governments implement this policy by coordinating with municipal agencies, charities, and schools. Some English schools, for example, provide lunchtime groups for caregiving youth and use school bulletins to raise awareness about the population.

Why GAO Did This Study

Family caregivers provide informal, often unpaid, care to family members in their homes and communities. Research estimates that 3 to 5 million minors may be caregivers. Yet little is known about these children, referred to as caregiving youth, who care for family members with functional limitations, a health condition, or a disability. GAO was asked to examine issues related to caregiving youth.

This report addresses (1) information on caregiving youth in the U.S.; (2) how federal caregiver support programs address caregiving youth needs; and (3) how England, a recognized leader in supporting caregiving youth, supports those youth through policy and programs.

GAO reviewed relevant federal laws, federal regulations, and documents. GAO surveyed a non-generalizable sample of former caregiving youth ages 18 to 25 and obtained useable responses from 43 respondents. GAO analyzed or reviewed the results of school-based surveys of caregiving youth in three states where data were collected-Rhode Island, Colorado, and Florida. GAO reviewed scholarly, peer-reviewed literature on caregiving youth. GAO interviewed officials from HHS, VA, and the Department of Education; stakeholders in England; and representatives from 16 organizations selected for their work on caregiving topics or certain health conditions.