Selective colleges are looking for students who use their free time in a worthwhile way, not only those who participate in organized activities, whether through school or elsewhere. Certainly, taking care of your sister will be viewed as "worthwhile" indeed, and admission officials will appreciate the commitment and responsibility it entails, if you explain your duties appropriately in your applications. (This might be via an essay, in a short-answer response on significant activities, in the "additional information" section that most applications offer, or even in a supplemental, unsolicited letter.)
Note, however, that selective colleges are also seeking students who "think outside the box." Although you may be confined to your home much of the time, there are still ways to create imaginative activities. For instance, you could start a blog on an area of interest, compose music or poetry, or contact your local newspaper about writing a weekly column on---what else--advice to teens who babysit! (Kind of a no-brainer, eh? :) )
Although your child-care will get high marks from admission officials, you will probably fare far better at decision time if you have some other, atypical activity on your resume, and there are plenty that you can do right from home, if you think hard enough.
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