Kinship Care

Overview

Kinship care is when a child lives full-time with a relative or close family friend instead of with their parents. The carer might be a grandparent, aunt, uncle, older sibling, cousin, or a family friend the child already knows and trusts. It can be arranged informally between families, or more formally through social services or a court. Kinship care is not an illness or a medical condition. It is a family arrangement, and this article focuses on the health and wellbeing needs of the child and the carer.

Yes. Kinship care is more common than many people realise, and it happens in every country and culture. Many children around the world are raised by grandparents, aunts, uncles or family friends rather than by their parents.

It affects children of all ages, from babies to teenagers. Kinship carers are often grandparents, but can also be older siblings, aunts and uncles, cousins, or trusted friends. It can affect families of any income, background or culture.

Symptoms

Common symptoms

• Feeling unsure about what is allowed and what help is available
• Worry about money, housing or legal arrangements
• Tiredness and stress from adjusting to a new daily routine
• Grief or sadness about why the child came to live with you
• Needing to learn new skills, such as dealing with schools or health services
• Feeling judged by other people, or feeling isolated

Symptoms in children

• Worry, sadness or tearfulness, sometimes long after the change
• Changes in sleep, such as nightmares or not wanting to sleep alone
• Anger, tantrums or behaviour that is hard to manage
• Clinginess, or going back to younger behaviour such as thumb-sucking or bedwetting
• Trouble at school, trouble concentrating, or refusing to go
• Feeling different from friends, or feeling torn between family members
• Stomach aches or headaches with no clear physical cause

Symptoms in older adults

• Feeling worn out or in more physical pain than usual
• Their own health conditions becoming harder to manage
• Money worries, especially after retirement
• Missing their own friends, hobbies or free time
• Sadness or grief about their own child's difficulties
• Feeling out of touch with modern parenting, school systems or technology

Causes

Main causes

• A parent is seriously ill, has died, or is in hospital
• A parent is struggling with mental health or substance use problems
• A parent is in prison or has been detained
• Domestic abuse or conflict in the home
• Neglect or concerns about a child's safety
• A parent working abroad, or family migration and separation
• A family agreeing informally that a relative is best placed to raise the child
• A court or social services deciding that a relative or friend should care for the child

Risk factors

• A sudden placement with little time to prepare
• Low income or extra costs, such as a bigger home or school uniforms
• Carers who are older or have their own health conditions
• Not having clear legal status, which can make paperwork harder
• Crowded housing or a home that needs changes
• A child with extra needs, such as a disability or learning difficulty
• Recent bereavement or family conflict
• Living far from the child's school, friends or other family

When to see a doctor

See a doctor urgently if:

• A child has a high fever, is very drowsy, has trouble breathing, or is badly dehydrated
• A child has an injury you cannot explain, or seems afraid of a particular adult
• A child or carer mentions thoughts of self-harm or suicide
• You have a health problem that is getting worse and making it hard to care for the child
• You have run out of essential medicines and cannot get more

Book a routine appointment if:

• Soon after a child moves in, to register them with a doctor (GP) and review their health records
• To catch up on any missed vaccinations, dental checks, eye tests or hearing tests
• If a child seems sad, worried, angry or withdrawn for more than a few weeks
• To talk about your own health, stress or tiredness as a carer
• If you need letters or reports for housing, benefits, school or legal processes
• To ask about local support groups and advice services

Diagnosis

Kinship care is not a medical condition, so it is not 'diagnosed' in the medical sense. Instead, the child's needs and the carer's situation are assessed. This usually involves a conversation with a doctor or nurse about the child's health, school and feelings, and sometimes an assessment by social services. The aim is to find out what support will help the child and carer thrive, not to judge anyone.

Tests that may be done

• A general health check for the child, including growth and development
• A review of vaccination records and any missed childhood checks
• Dental, hearing and vision checks
• Questions about sleep, eating, mood and behaviour
• A check on the carer's own health, including blood pressure and mood
• School reports or a chat with the child's teacher, with consent
• A review of any medicines the child or carer takes

What to expect at your appointment

Appointments are usually relaxed and private. You can bring someone with you. The doctor may ask sensitive questions about why the child is living with you. It helps to bring any letters from social services, court papers, the child's red book (health record) and a list of medicines. You can ask for extra time, an interpreter, or a follow-up appointment if you need one.

Treatment

The 'treatment' for kinship care is practical and emotional support for both the child and the carer. There is no single fix. The right mix depends on your family, your legal situation and how the child is coping. Support often combines healthcare, money and housing advice, help at school, and someone to talk to.

Self-care at home

• Keep a simple folder with all letters, appointments and health records in one place
• Write down questions before appointments so you do not forget them
• Ask one trusted person to be your go-to for advice and practical help
• Build small daily routines around meals, bedtime and school to help the child feel safe
• Take breaks when you can, and accept offers of help with childcare or chores
• Tell the school what is happening so they can support the child
• Look after your own sleep, food and health appointments
• Find out what financial help, benefits or grants you may be entitled to
• Ask about free legal advice or advocacy services in your area

Medical treatments

Doctors and nurses can help with the child's physical and emotional health, and with the carer's own health too. Support may include talking therapies for a child or carer, parenting and behaviour support programmes, and referral to child mental health services if needed. Where a doctor thinks it is appropriate, medicines may be offered for conditions such as anxiety, low mood or sleep problems, but this is always a shared decision to discuss carefully. Respite care, which means short breaks, and support groups can also make a real difference. Always speak to a qualified healthcare professional before starting or stopping any treatment.

When is surgery considered?

Surgery is not relevant to kinship care itself. Any operation would only be for a separate health condition, and would be discussed with the treating team in the usual way.

Living with this condition

Day-to-day life in kinship care is a lot like any family life, with some extra layers. There may be paperwork, court dates or meetings with social services. The child may see their parents, which can bring mixed feelings for everyone. Clear routines, honest but age-appropriate explanations, and steady adults around them help children feel secure. Try to keep the child's school, friends and hobbies going where you can.

Lifestyle tips

• Keep regular mealtimes, bedtimes and school routines
• Make time for play, exercise and being outdoors together
• Stay connected to the child's culture, language, faith and wider family where it is safe to do so
• Plan small things to look forward to, for the child and for you
• Keep in touch with friends and hobbies, even in a smaller way
• Limit screen time late at night so sleep is protected
• Be honest with the child at a level they can understand, without sharing adult worries

Diet and exercise

Everyone benefits from regular meals, plenty of vegetables and fruit, and water instead of sugary drinks. Try to move every day, even a short walk or dancing in the kitchen. Children do best with consistent meal and snack times, and with adults who eat with them. If money is tight, ask a health visitor, school or local advice service about food support, and speak to your doctor if you are worried about the child's growth or eating.

Mental health and emotional wellbeing

Kinship care often comes after loss or upheaval, so sadness, worry and anger are common for children and carers alike. Children may feel loyal to their parents and guilty about being happy with someone else. Carers may feel grief, resentment, guilt or loneliness. These feelings are understandable, and talking about them helps. If low mood, anxiety or distressing thoughts last more than a few weeks or affect daily life, please speak to a doctor or mental health professional. If you or a child ever have thoughts of self-harm or suicide, contact your local emergency number or a crisis support service straight away.

Prevention

Kinship care itself is not something to prevent. It is often the best and safest option for a child. What can be prevented is a crisis: early help for struggling parents, and early support for kinship families, can reduce stress and keep placements stable. If you are worried about a child's safety, speak to your doctor, health visitor, school or local social services.

Vaccines

Make sure the child's routine childhood vaccinations are up to date, and ask your doctor or pharmacist which ones are recommended for their age and health. Carers should also keep their own vaccinations up to date, including any offered because of age or health conditions. There is no vaccine for kinship care itself.

Screening programmes

Keep up with the child's routine developmental reviews, dental checks and vision and hearing tests. Adults should attend any screening offered for their age, such as blood pressure checks. Tell your doctor you are a kinship carer, as this can help them offer the right support.

Complications

If left untreated

• Money problems and housing stress for the carer
• Carer burnout, exhaustion and worsening of the carer's own health
• Children developing lasting anxiety, low mood or behaviour difficulties
• Problems at school, including missed days and falling behind
• Placements breaking down, meaning more upheaval for the child
• Family relationships becoming strained and harder to repair

Long-term outlook

The outlook for kinship families is often very good. Children do best when they have stable, loving adults, clear routines and early support. Many kinship carers say it is hard and deeply rewarding. Asking for help early, keeping health appointments and staying connected to support makes a real difference. Every family's path is different, and there is no single right way to do this.

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