Caring without a roadmap: reflections on the US approach to Youth Caregiving
I’ve spent the past week and a half immersed in conversations with some of the most thoughtful and dedicated people working in the space of youth caregiving in the United States. From researchers to policy-makers to education leaders, each has offered a different lens on a shared challenge: how to support young people who provide care to family members, children and teens often navigating adult-sized responsibilities, while still trying to grow up themselves.
My Churchill Fellowship is grounded in a simple, yet layered, focus – what does best practice look like for supporting Young Carers across research, policy, and programming?
My time in the US is focused on understanding what an emerging market for Young Carer support looks like, how awareness is built, what gets prioritised, which models are used, and how momentum forms in the absence of a national mandate.
There’s no single blueprint, but what I’m seeing are patterns, sequencing, and creative approaches that offer valuable insights into how a movement begins and grows if we’re willing to pay attention.
In Australia, we use the term “Young Carer” to describe someone under 25 who cares for a family member with chronic or mental illness, disability, or substance dependence. It’s a term embedded in legislation and funding models, and one that many young people claim with pride. We have national data (albeit scattered over the past 25 years), a Federally funded bursary program, and organisations like Little Dreamers working to provide wraparound support. It’s not perfect, but it’s visible.
In the US, things look a little different. “Youth caregiver” is more commonly used, and the concept hasn’t yet found a strong foothold in national policy or public awareness. But that doesn’t mean it’s not happening. In fact, it might be happening on an even greater scale.
The American Association of Caregiving Youth estimates that over 5.4 million children under 18 provide care to family members in the US, a figure that may be conservative (AACY, 2023). A recent statewide survey in Colorado found that 14% of middle and high school students reported caregiving responsibilities, with particularly high rates among nonbinary youth, students from low-income backgrounds, and those from marginalised racial and ethnic groups (Armstrong-Carter et al., forthcoming).
And yet, these young people remain largely hidden from the systems that should be supporting them.
Some of the most powerful moments of my trip so far have been in conversation with Dr. Elizabeth Olson, a leading researcher and advocate in this space. Betsy talks about caregiving youth as experiencing “slow violence”, a kind of invisible, compounding harm that plays out not in a single event, but over time, through a lack of recognition, support, and tailored infrastructure. “The lives of youth caregivers are vigorously unimagined in the U.S.,” she writes, “sidelined by large caregiver advocacy organisations… and largely unknown by professionals who work with children and adolescents” (Olson, 2019).
It’s not that there’s a lack of care. It’s that there’s a lack of scaffolding around that care, no clear language, no national dataset, no policy mandate to include children in caregiving frameworks.
But my focus is not to compare deficits, but rather to understand what’s working, and what’s possible for Young Carers.
Last week I met with Stephen Osborn and Olivia Smith from the Department of Education in Rhode Island, who are working on integrating youth caregiving into state-wide education policy, something that remains almost unheard of across most US jurisdictions. Their work intersects with that of Dr. Leiha Edmonds, Dr. Andrea Kalvesmaki, and Dr. Julie Belkowitz, all of whom are pushing for stronger interagency coordination, more inclusive interdisciplinary identification, better data collection, and more inclusive definitions of family and care.
Across these conversations, a theme has emerged: while the US lacks a unified national framework for caregiving youth, there is extraordinary innovation happening at the local level. Programs like the American Association of Caregiving Youth, and the Caregiving Youth Project in Florida offer school-based counselling, respite opportunities, and academic support, all tailored to the needs of caregiving students. These initiatives are small, but mighty, and built by individuals who have spent decades pushing against structural invisibility.
In fact, what the US excels at is the micro: deeply embedded, community-based models that respond to the specific realities of their young people. In Australia, we’ve been working toward strong national consistency, which comes with the benefit of scale, but also the risk of rigidity. There’s something to be learned from the flexibility and responsiveness of the US approach, even if it is still too dependent on passionate individuals, geography and luck.
What I’m also seeing is a strong appetite for change. The 2022 National Strategy to Support Family Caregivers included, for the first time, an explicit reference to caregiving youth. It laid out over 300 actions across five goals, many of which have begun to be implemented through federal and state partnerships (U.S. Department of Health and Human Services, 2022; 2024). Yet most stakeholders I’ve spoken with acknowledge that youth remain underrepresented in the roll-out, “We are only as strong as the supports we offer to those who care, including young people.”
This sentiment echoed something I’ve long felt in my own work: that recognising Young Carers isn’t just about ticking a box. It’s about designing systems that honour the complexity of care, and the childhoods it intersects with.
So where does this leave us? I think the answer is somewhere in between. Australia has built important foundations: formal recognition, a growing evidence base, and a small network of funded services. The US, on the other hand, has grassroots momentum, locally-driven programming, and an emerging research community ready to lead change.
Perhaps best practice isn’t about choosing one path. Perhaps it’s about braiding the strengths of each: the clarity and scale of national policy with the intimacy and responsiveness of community action. Perhaps it’s about weaving together research that is co-produced, policy that is inclusive and enforceable, and programming that is flexible enough to meet young people where they are at.
I’ll continue listening, learning, and asking questions as I travel. But I sit in this first leg of my journey with a deep respect for the people doing this work in the US, often without a roadmap, often against the odds. They’ve reminded me that sometimes the most powerful change begins in the classroom, the clinic, or at the kitchen table, and that even without a national mandate, it’s possible to imagine a system that sees and supports caregiving youth in all their strength and struggle.
“The burden of care should never cost a child their future.” – American Association of Caregiving Youth, 2023
And it shouldn’t have to, on either side of the Pacific.
Written by Madeleine Buchner OAM
I’ll be continuing my Fellowship heading down to Florida next to see the inner workings of the leading US organisation for Young Carers, the American Association of Caregiving Youth, exploring local strategies, and youth-led approaches to identifying and supporting young carers. If you’re working in this space, anywhere in the world, I’d love to hear from you.
