Caring for Adult Children

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Caring for Adult Children

Reference Number: MTAS-860
Reviewed Date: 09/04/2026

The Family and Medical Leave Act (FMLA) may allow an eligible employee to take leave to care for an adult son or daughter age 18 or older. The adult child does not have to have a lifelong or permanent disability, and the disability does not have to have existed before the child turned 18. For this type of leave, the adult child must meet the FMLA definition of “son or daughter” at the time leave begins. The employee must also be eligible for FMLA leave, and the city must be a covered employer.

When adult-child leave may apply
An eligible employee may take FMLA leave to care for an adult child when all of the following requirements are met:

  • The adult child is a biological child, adopted child, foster child, stepchild, legal ward, or child of a person standing in loco parentis.
  • The adult child has a mental or physical disability as defined by the ADA.
  • The adult child is incapable of self-care because of that disability at the time FMLA leave begins.
  • The adult child has a serious health condition under the FMLA.
  • The employee is needed to care for the adult child because of that serious health condition.

The adult child’s disability must substantially limit one or more major life activities. The FMLA uses the ADA definition of disability for this purpose. Because the ADA definition is construed broadly, a condition may qualify even if it is temporary, episodic, controlled by treatment, or expected to improve.

Incapable of self-care
An adult child is incapable of self-care when the child requires active assistance or supervision to provide daily self-care in at least three activities of daily living or instrumental activities of daily living.

Activities of daily living may include:

  • Grooming and personal hygiene.
  • Bathing.
  • Dressing.
  • Eating.
  • Instrumental activities of daily living may include:
  • Cooking.
  • Cleaning.
  • Shopping.
  • Transportation.
  • Paying bills.
  • Maintaining a residence.
  • Using a telephone or other communication device.
  • Using the post office.
  • Managing medication or comparable daily-living tasks.

The city should evaluate the adult child’s actual need for active assistance or supervision, not simply the diagnosis or the fact that the child is receiving medical treatment.

Examples
Depending on the facts, adult-child FMLA leave may be available for a parent caring for an adult child with:

  • A developmental or intellectual disability.
  • Down syndrome.
  • Autism spectrum disorder.
  • Traumatic brain injury.
  • Paralysis or a spinal injury.
  • Cancer or another serious long-term medical condition.
  • A serious mental-health condition.
  • A disabling injury after a motor-vehicle accident.

Another condition that substantially limits a major life activity, causes inability to provide self-care, and is also a serious health condition under the FMLA. A serious accident, surgery, illness, or other temporary condition can qualify if all adult-child FMLA requirements are met. The condition does not need to be permanent or lifelong.

Pregnancy and routine surgery
Pregnancy-related incapacity and prenatal care can be serious health conditions under the FMLA. However, a parent’s request for FMLA leave to care for an adult pregnant child must meet the special adult-child requirements described above. Pregnancy alone does not automatically establish ADA disability, incapacity of self-care, or the parent’s need to provide care.

Similarly, routine surgery alone does not automatically qualify a parent for FMLA leave to care for an adult child. However, surgery may qualify if it results in an ADA disability, incapacity of self-care, a serious health condition, and a need for parental care. Cities should not use a blanket rule that pregnancy-related conditions, surgery, or other temporary conditions can never qualify. Each request requires an individualized review of the adult child’s functional limitations, self-care needs, serious health condition, and the employee’s need to provide care.

Certification and administration
A city may request FMLA medical certification to confirm that the adult child has a serious health condition and that the employee is needed to provide care. The city may also seek information necessary to determine whether the adult child has an ADA disability and is incapable of self-care.

Medical information should be handled confidentially and should be limited to what is necessary to administer the leave request. The city should route these requests to HR or the designated FMLA administrator because adult-child leave involves several separate legal requirements.