The paper advances our understanding of care in transnational families by exploring how proximate family members engage in care within two institutional contexts, a school and a hospital. It considers how care processes and outcomes are shaped by the transnational character of families and by the related power dynamics inherent within families and institutions. It does so by studying language and literacy practices that people engage in when they act as language brokers and literacy mediators for family members who are accessing care. Working with two families in the United Kingdom and Sweden, our analysis draws on fieldnotes, interviews with caregivers, and interactional data. We describe the language and literacy practices and interactional events associated with our participants' institutional encounters, relating them to individuals' intersecting positionalities. Analysis demonstrates the ways in which these practices enable them to challenge inequalities inherent in health and educational systems.