Robin Eschman has raised or helped raise two biological children, seven children who came to her through long-term relationships, and 11 grandchildren. She’s 55 and lives with her partner, Debra Weathers, in the Atlanta metro area. At one point, there were 10 kids in the house at the same time. The family bought food in bulk, made great use of bunk beds and fielded an entire baseball team.

When she took in her first grandchildren about 17 years ago, Eschman thought the kids would only be with her for a limited time. She says she held onto that hope for years before coming to grips with the fact that her children were not going to be able to parent.

“To realize this is the rest of your life — I wouldn’t change it and put any of the children in foster care, but I wish I had let myself realize it from the get-go, that this was what we were going to be doing,” Eschman said. Her instinct was to expect the best-case scenario, that her children would eventually be able to take charge of their kids.

“You do live in a bit of a fantasy world. You see ‘Oh, they got clean for a while or stayed out of jail for a while’ and then bam, they’re back to doing whatever.”

Nationwide, the opioid epidemic has contributed to an increase in the number of parents who turn over caregiving responsibility to their relatives as they grapple with addiction to prescription drugs. More than 2 million people in the United States were thought to be struggling with an addiction to prescription opioid pain relievers in 2012, according to the Senate Caucus on International Narcotics Control, which also found that the number of accidental overdose deaths from prescription painkillers had more than quadrupled since 1999.

Substance abuse among parents, more generally — along with mental health issues, incarceration and domestic violence — has long been a factor in the incidence of grandparents raising their grandchildren.

The Census Bureau’s 2005 American Community Survey counted 2.4 million grandparents living with grandchildren for whom they were responsible. By 2014, the latest year for which data is available, that number had risen to 2.7 million. Meanwhile, the number of grandparents living in the same households as their grandchildren jumped from 5.7 million in 2005 to 7.1 million in 2014.

“We all anticipated an increase in the multigenerational, or intergenerational, homes and kinship families as a result of the recession, but I think it has been surprising,” said Stefanie Sprow, the Children’s Defense Fund’s deputy director for child welfare and mental health. “We passed that years ago and we’re still seeing this rise in kinship families and intergenerational families.”

The number of kids in foster care also started rising in 2013, Sprow said, ending a years-long decline.

While the reasons grandparents raise their grandchildren vary from one family to another, it is clear that the opioid epidemic has had a major impact on the broader trends, particularly within the white community.

For grandparents raising babies and toddlers, common concerns about whether children are reaching developmental milestones on time are shrouded in fear over whether parental drug use and neglect will have a lasting, negative impact. And grandparents often deal with their anxiety alone. They tend to blame themselves for their own children’s failings and do not want to talk about why they have primary responsibility for their grandchildren. When grandparents do look to their friends for support, their peers are more likely to be empty nesters, no longer able to relate to the challenges of raising children.

In order to serve this hidden population, the Senior Services Department in Clayton County, Georgia — where Eschman has raised her grandchildren — started the Kinship Care Program in 2003. Angie Burda, the program’s manager, developed a broad range of services, establishing support groups, educational workshops, and recreational activities for families with children of all ages. Including salaries and benefits for her staff, Burda’s annual budget in Clayton County is about $400,000 with more than half of that coming from the county and the rest from grants and federal sources. The program has been replicated by 11 other Kinship Care Centers across the state.

Eschman first discovered the Clayton County program in 2005. She and Weathers were trying to get a grandson out of the foster system — a process that dragged on for two years — when a state official said participation in the program might help their family. At first Eschman was wary. She mistakenly thought Kinship Care was run through the state’s Division of Family and Children Services, an agency she didn’t trust, but she took her grandkids anyway.

As it turns out, they had a great time.

“When our kids came out of a meeting with those other kids, we saw a light in them we had never seen,” Eschman said.

The children — then ranging in age from infants to high schoolers — had faced questions and teasing at school as early as pre-kindergarten because they didn’t live with their parents. At the center, they discovered a group of other kids with similar family arrangements. They begged to go back. Soon, it became a near-daily excursion for the family. Eschman and Weathers found solace in the companionship, too.

“We were able to spend a lot of time with people going through what we were going through,” she said. “It was amazing. We could cry, we could laugh, we could say ‘I’m ready to pull my hair out,’ and nobody judged you … To know that you weren’t alone anymore — that’s what got us through.”

Beyond offering these supports, the Kinship Care Center has been a uniting force for legislative activism. Eschman was among those from Clayton County making regular trips to the state capitol to advocate for a bill that would give grandparents and other relative caregivers new legal and financial benefits. In 2008, the bill that finally made it through the legislature gave grandparents a way to get a power of attorney without spending the time and money to secure guardianship or full custody of the children they were raising. This means grandparents like Eschman can now enroll their grandchildren in school and get medical care for them without first needing the consent of the absent custodial parent. But passage of the bill was only a partial victory. This legislation did not change the law on relative care subsidies

As it stands today, Georgia’s grandparents can qualify for relative care subsidies only if they apply for them as a condition of taking their grandchildren out of foster care. If they choose to keep their grandchildren out of the foster system entirely and take over caregiving before the child enters state custody, they are not eligible for the funds, which, in Georgia can be as much as $480 per child per month.

That’s a common restriction nationwide. The Children’s Defense Fund (CDF), a nonprofit child advocacy and research organization, has been fighting for more financial support for relatives caring for children outside of the formal system for years. But, according to the CDF’s Sprow, the fight is hard to win.

Some states have other priorities or they don’t have the money it would take to offer such subsidies, said Sprow, who has discussed the issue with state legislators through her work with CDF. And, of course, there are some lawmakers who see no reason for the state to start writing checks.

“Some states still view grandparents as having a moral duty to take care of these children,” Sprow said, explaining legislative reluctance to offer special subsidies for this group.

Generations United, a Washington, D.C.-based nonprofit focused on an intergenerational approach to policy, estimates grandparents and other relatives save U.S. taxpayers more than $4 billion per year by keeping children out of the foster care system. But calling it “savings” may be a stretch for those who see such caregiving as familial obligation.

The federal government is also reluctant to require subsidies for grandparent caregivers, although the Senate has proposed a bill that might provide some indirect help. Legislation still awaiting Senate approval would tackle a wide range of issues affecting intergenerational families. While Senate Bill 3065 does not provide any new subsidies for grandparents raising grandchildren outside of the formal foster care system, it does make important changes, including allowing states to use federal dollars on efforts that would help keep kids out of the foster care system. If the bill becomes law, states would be able to offer programs that can help keep families intact — mental health services, substance abuse treatment, and in-home parenting programs — rather than waiting to respond only after the child is taken into state custody.

The legislation, called The Family First Prevention Services Act, reauthorizes incentives for states to get kids out of foster care and into permanent placements. It gives the U.S. Department of Health and Human Services responsibility for developing model standards for licensing relatives as foster parents and it allows states to use federal dollars to build out Kinship Navigator programs, which connect grandparents and other relative caregivers with information they need to raise children and access services.

Sprow says that although many of the provisions in the bill are important steps forward, the Children’s Defense Fund will continue to lobby for additional financial support for grandparents raising their grandchildren informally — like Eschman.

One of Eschman’s grandsons, Michael, now 18, was in foster care for more than two years before Eschman and Weathers got custody. First, the government gave the boy’s mother time to prove she could be clean and sober for six months, hold a steady job and find a place to live. In the interim, Michael needed a place to live, but Eschman and Weathers were not considered suitable foster parents because there were already eight kids in their house. After two years and no turnaround for Eschman’s daughter, the courts began to assess the best long-term living situation, ultimately deciding on Eschman’s home.

The Family First Prevention Services Act calls for model standards to help states license relatives as foster parents. While setting a child limit or minimum bedroom sizes make sense when placing foster children with strangers, policy makers recognize the benefits of keeping kids with their relatives and are now urging states to make eligibility exceptions for them.

Nonprofits and social service agencies have played an important role in helping grandparents make relative care arrangements work. Caring for children in early childhood can be particularly hard, especially for grandparents older than 60, who make up about one-third of the population of grandparents responsible for their grandchildren, according to Census data.

Mary Brintnall-Peterson recognized this while working as a program specialist on aging at the University of Wisconsin-Extension more than 15 years ago. Before her retirement in 2009, Brintnall-Peterson developed a guide to assist these grandparents, and it has continued to be used across the country as a resource for grandparents faced with the challenges of raising young children. Brintnall-Peterson’s tips include establishing predictable schedules to create a sense of security, talking and singing to infants to help them develop language skills, childproofing the home to give toddlers a chance to explore safely, offering them choices to develop their independence skills, and responding to preschoolers’ many questions with patience.

Recent research on brain development highlights the importance of a child’s first three years of life, adding extra pressure on families to lay the proper foundation for a child’s later learning. And Brintnall-Peterson says grandparents often take on the challenge with the deck stacked against them. They almost only end up raising their grandchildren because of some type of crisis.

“And it means there’s a crisis with two parents because it means neither parent is available,” Brintnall-Peterson said. “The children have been through some pretty dramatic stuff.”

Children being raised by their grandparents often have trouble trusting adults, many have learning disabilities or health problems that go back to parental drug use, and they suffer from bouts of feeling abandoned, Brintnall-Peterson said.

These feelings of being left behind are a key obstacle for Paula Banks, 77, as she raises her 9-year-old great-granddaughter AriAnna in Boston’s Grandfamilies House. The public housing development was built to offer community and targeted supports to grandparents raising grandchildren. According to Generations United, the Grandfamilies House is one of about 16 similar developments nationwide.

Banks, who had two daughters, helped raised two of her grandchildren and four of her great-grandchildren, though AriAnna is the only one of whom she has custody now. While there are other relatives who could step in to take primary responsibility for AriAnna, Banks said she wants the job. AriAnna has been with her since she was an infant and they have become closely attached. Banks brought her home from the hospital after her birth, when Banks’ granddaughter declined to take responsibility for raising the baby. Despite the bond between the two, there are times when the fourth-grader is upset by her circumstances.

“Sometimes she gets depressed because her mom doesn’t come around much,” Banks said. “I just try to keep her busy.”

The Grandfamilies House was the first of its kind in the United States. It offers monthly get-togethers for residents and has long tried to create a community for intergenerational families. Similar housing developments offer support groups, child and family counseling, respite care, supervised activities for kids and information about state and federal programs.

These group homes are just one type of support available to grandparents.

Generations United’s 2015 State of Grandfamilies in America report ranked the states based on whether they had education and health care consent laws, de facto custody laws, policies that eliminated barriers to receiving support from Temporary Assistance for Needy Families (welfare), high placement rates of foster children with relatives, and participation in the National Family Caregiver Support Program, Guardian Assistance Program, and Lifespan Respite.

Every state had at least one supportive policy in place but none had all of them. Only four states received “passing grades” of more than 60 percent. And none demonstrated “a strong, comprehensive overall framework of key supports needed to ensure all children and caregivers in grandfamilies — a term used to describe families in which children are cared for by their grandparents — get the support they need to succeed and thrive,” according to the report.

Generations United Deputy Executive Director Jaia Peterson Lent said some states are home to individual counties with strong safety nets for grandfamilies, but these counties can operate as islands, making statewide grades a flawed measure, in some respects. The point of the ranking, however, is to encourage state officials to assess their policies and programs. And Peterson Lent says state governments must do more than simply have supportive policies in place.

“They have to make sure people are aware of them, are educated about them, and are using them,” Peterson Lent said.

When grandparents take responsibility for raising their grandchildren, keeping them out of the foster system, they not only save the government money, they improve the likelihood these children will succeed. A yearlong study of grandparents raising grandchildren and other types of kinship care produced for Georgia’s state legislature found relatives are better able to “provide a safe, stable and nurturing home for children suffering from the trauma of parental separation and other hardships.” Children in such care also have fewer behavioral problems in school and adjust to their new environments more successfully than their peers who are placed in foster care.

“While they face significant challenges,” Peterson Lent said, “we know that they do really well in the care of a supported grandfamily.”

In Boston, Banks will be 87 — if she’s still living — when her great-granddaughter heads off to college. But she doesn’t complain about raising three generations.

“To me, they’re my family and that’s it,” Banks said.

In Georgia, Eschman figures she and Weathers will have some time to travel in their 70s. Maybe then they’ll get a mobile home and just take off.

“We’ll have a P.O. box everybody can find us at,” Eschman said. “Until then, we’re going to take care of what we got to take care of.”