ORLEANS — Carla Koehl, the executive director of the Cape Cod Foster Closet, set out one year ago to answer a simple question: how many kids living on the Cape are raised by their grandparents instead of their parents or a foster parent?

The raw data existed, but they were buried in census records without a county-by-county assessment. What she found after compiling data from the 2020 U.S. Census, U.S. Dept. of Health and Human Services, and a 2019 study by UMass Medical School was staggering: one of every 10 children living on Cape Cod and the Islands is being raised by grandparents.

That figure, compared with 2.6 percent of children in Massachusetts and 3.7 percent of children nationwide in the care of at least one grandparent, according to the U.S. Dept. of Labor, makes Cape Cod a hidden outlier, home to thousands of grandparents taking on parenthood for the second time.

“I was shocked that there weren’t ready numbers out there,” Koehl said. She said her organization had worked hard to connect with all the agencies on the Cape that might have them but found none did.

Grandparents filling in for parents face special challenges. Unlike foster parents, who care for less than one percent of children on the Cape, many grandparents are retired or planning to retire soon and have likely not accounted ahead of time for the costs that come with raising another child. Nor are they automatically connected to other caregivers in the same way foster families are, according to Barnstable County Health and Human Services Deputy Director Mandi Speakman.

And there’s another reality that Koehl said can drive social isolation and keep such multigenerational families — often referred to as “grandfamilies” — out of official records: most come to care for their grandchildren because of drug or alcohol abuse by their children.

“The resulting trauma, shame, and complex levels of grief are all factors that commonly contribute to grandparents’ social isolation,” Koehl said.

According to UMass Medical School, 80 percent of Massachusetts grandparents in caretaking roles in 2019 said the reason they had taken on guardianship was related to drug or alcohol use. Sixty-eight percent said they had custody because of opioids.

“The isolation keeps people from being counted,” Koehl said.

‘Invisible to Us’

When a family member is suddenly tasked with raising another child, organizations like the Foster Closet, which provices free clothes and supplies, can help ease the transition. “It means everything,” said Tracy Kelley of Mashpee, the aunt to a new 20-month-old baby now in her care. “A lot of people want to support their family. They want to take care of their loved ones. And sometimes that one barrier is just how can I have the resources to make it work.”

Kelley, who studied linguistics at M.I.T. and has worked in youth development, indigenous language reclamation, and other community-based projects, said she was directed to the store by members of the Mashpee Wampanoag tribe. She left the Foster Closet with new baby clothes, bedding, and a day-care bag, and she was encouraged to return for more.

But most so-called kinship caregivers, especially older adults, are not easily connected to financial and social resources for raising a child. The Cape’s network of councils on aging and faith organizations and the state’s Kinship Navigator Program all often direct grandfamilies to their store, but Koehl said the organization frequently learns about grandparents caring for children through the school system.

“A teacher will notice that Jimmy has been wearing the same clothes for five days in a row, and nobody comes to parent-teacher conferences, and his address has changed a few times,” Koehl said.

“That child may or may not come to the attention of the Dept. of Children and Families,” she added, “but whether they do or not, that teacher can just give us a call and we will bring them a bag of clothes and shoes and school supplies.”

While grandparents have to formally take over guardianship to make decisions about their child’s medical care or education, Cindy Horgan, the director of family support services at Cape Cod Children’s Place in Eastham, said many raise their children’s children on an informal or co-parenting basis that can hide their true roles and keep grandfamilies out of formal counts. “There are a lot of grandparents who are invisible to us,” Horgan said.

And without that formal guardianship, which can be recognized by the foster care system, government financial assistance in the form of child tax credits, supplemental security income, and supplemental nutrition assistance programs are much harder to get.

Even those who do have formal custody face a child-care system designed for younger adults.

Horgan said many grandparents have come to the Children’s Place unable to apply for free child-care services without a job. Others come for help because they live in senior housing that does not allow children. Some, Horgan said, told her “they were going to lose their housing.”

According to data from the U.S. Census’s 2017 American Community Survey, roughly 40 percent of grandparent guardians in Barnstable County are more than 60 years old. Horgan, who has worked at the Children’s Place for two decades, said she has noticed a demographic shift in grandparent guardians.

Where older grandparents Horgan has met have typically taken on caregiving after an adult child’s early death, imprisonment, or mental health crisis, the new generation of grandparent-caregivers are most affected by their adult children’s opioid use. Her organization’s services have had to shift to address what happens in households hobbled by substance abuse — and the trauma that creates for children.

“These children have been bathed in trauma,” Horgan said.

The Cape Is Not Fine

With a $20,000 grant from the Amelia Peabody Foundation in Boston, the Foster Closet is preparing a new helpline for grandparents raising children on the Cape. It will directly connect grandparents with other resources and support groups over the phone. “We are so often the first point of contact that any grandparent has ever had with a social service agency on the Cape,” Koehl said.

They’re already training volunteers now and compiling a database of resources grandparents need, but the service won’t likely be launched until the fall of 2025.

Horgan said that while the Children’s Place does not offer a support group for grandparents anymore, she receives several calls each week from grandparents asking for advice on how to get a toddler to stop crying or how to take care of parenting tasks that require them to use technologies they’re not familiar with.

When Koehl submitted the Foster Closet’s grant application to the Amelia Peabody Foundation, they told her they did not know grandfamilies were so common on Cape Cod.

“There is this perception across the world, frankly, that the Cape is fine,” Koehl said.

The new helpline, Koehl said, will also help fill an information gap about who the grandparents raising grandchildren are and what they need.

The Barnstable County Health and Human Services Dept. is currently six weeks away from releasing its baseline needs assessment for the county, a report Speakman said will reveal more about the population of grandparent guardians on the Cape.

There’s a perception that Cape Cod is exclusively a place for wealthy retirees, Speakman said. And that perception can make our communities slow to realize older people here need services like after-school programs and centers for mental health and peer support.

“We hear over and over again that ‘Cape Cod likes to do its own thing,’ ” Speakman said. “But the reality is that Cape Cod will sometimes do its own thing out of necessity.”

Services like the ones these grandparents need, she said, “don’t come over the bridge.”