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Palliative Care Center

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Siblings of Children with Serious Illnesses

Typical Feelings for Siblings of a Sick Child: Guilt

Feeling excluded can naturally lead to jealousy. Siblings may even wish a sick sibling would die. Then, if their sibling's condition does not improve, or worsens, the well siblings feel guilty or perhaps responsible.

Children ages 3 to 6 years are particularly susceptible. They are what experts call "magical thinkers," who believe their thoughts have the power to hurt others.

A magical thinker who feels jealous of a sibling or wishes for a sibling's death can feel responsible if his sibling's condition does not improve. The sibling's condition may even appear to be punishment for something the magical thinker did. Children at this age are capable of thinking, "Yesterday I stole my brother's toy, and today my brother is even sicker. It's my fault."

Parents can combat the feelings that lead to jealousy and guilt by making sure children feel included and loved and by assuring children that their feelings are normal. Parents should make clear to children of all ages, and magical thinkers in particular, that they had nothing to do with their sibling's illness.

Typical Feelings for Siblings of a Sick Child: Wanting to be Normal

Most children just want things to go back to normal. Parents should make every effort to keep siblings on their regular schedules for school, mealtimes, bedtimes, and extra-curricular activities.

Parents will need to rely on trusted family members and friends to ensure that this happens. Palliative care social workers note that sometimes families want to keep their child's condition to themselves and not ask for help. This is nearly impossible -- and could be detrimental to the well-being of the other children.

When children must be taken out of their normal comfort zones -- for hospital visits or perhaps for serious talks about the circumstances -- they should be permitted to leave the situation at any time.

For example, if children would like to visit their sibling in the hospital, they should be accompanied by an adult who can take them out of the room as soon as they are ready. Child life specialists can serve this function, or the child can come to the hospital accompanied by a relative or family friend.

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