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Siblings of Children with Serious Illnesses

When a child is seriously ill, the focus of the whole family shifts.

During long hospital stays or intense treatments, as parents spend a great deal of time outside of the home, brothers and sisters of a sick child can sometimes feel forgotten.

Palliative care teams, also known as pediatric advanced care (PAC) teams, partner with families to address the range of typical emotions that siblings of a seriously ill child may experience.

Typical Feelings for Siblings of a Sick Child: Not Belonging

A sick child's sisters and brothers often feel left out or ignored. Here are a few ways parents can make sure their other children feel included, needed, and attended to:

  • Find ways to let the siblings participate at home and at the hospital. Give them some way to help out at home, but don't ask them to take on a parent-like role. They need simple, age-appropriate tasks that contribute to the day-to-day functioning of the household, so they know they are needed.
  • At times when children may not be permitted to visit the hospital, ask siblings to draw pictures or make cards to put in the sick child's room. Ask them to collect some of the sick child's personal items, such as books or stuffed animals, to be sent to the hospital.
  • Answer the siblings' questions. Provide age-appropriate answers that are truthful, concrete, and thorough (but you don't need to provide more information than the child is asking for). No matter how hard parents try to protect their children from the reality of the situation, children frequently know when something is going on, and they will certainly have questions. Parents with the best intentions often evade their children's questions -- which adds to the children feeling excluded. Children need their questions to be validated.
  • Acknowledge sibling relationships. When a family is grieving the illness or the loss of a child, it may seem to siblings that the focus is on the parents' relationship with the child. The brothers and sisters have a vital relationship with their sick sibling, too, and that relationship should be acknowledged. If a family is mourning the loss of a child, specialists recommend that siblings, not only parents, keep memorabilia from the child, such as a lock of hair, a favorite doll, or photographs.

 

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 aged 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.

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