Caring for a seriously
ill child takes a tremendous toll on the whole family, and healthy siblings are
As parents, our exhaustion, stress, and uncertainty about how to respond to the
needs of other kids can leave us feeling guilty and drain our reserves — and
might tempt us to downplay or ignore the impact a child's illness may have on his
or her brothers and sisters.
Knowing what healthy siblings are going through and taking steps to make things
a little easier can let you deal with many issues before they unfold.
How Kids Might Feel
Family routines and dynamics naturally change when a child is ill, which can confuse
and distress healthy siblings. Besides fear and anxiety over the illness, they often
have the feeling of loss of a "normal" family life, and loss of their identity within
It's normal for healthy siblings to:
worry that the sister/brother will die
fear that they or other loved ones will catch the sibling's disease
feel guilty because they're healthy and can enjoy activities that the sibling
worry that something they did caused the disease
be angry because parents are devoting most of their time and energy to the sick
feel neglected and worried that that no one in the family cares
resent the sibling who never has to do chores
resent that the family has less money to spend now because the sibling is sick
be nostalgic for the past (wishing things could be like they were before the illness)
feel residual guilt for being "mean" to the sibling in the past
experience generalized worry or anxiety about an uncertain future
The way siblings express their needs can vary greatly — some may act out,
some may try be the perfect child, and many will do both.
What to Look For
Pay attention to any changes in kids' behavior, and talk to them often about how
they're doing and what they're feeling. The more room kids have to express their emotions,
the less emotional upset and fewer behavioral problems they're likely to have.
Signs of stress in kids
can include any changes in sleep patterns, appetite, mood, behavior, and school functioning.
Younger children may pick up on parental stress and show regressed behaviors (doing
things they did when they were younger and had already outgrown).
Even if you don't see any signs in your kids, you can be pretty sure that changes
to their routine and seeing their parents and other family members upset is likely
to be causing them stress.
Ways to Help
While you may not be able to take away the source of your kids' emotional pain,
you can help ease their stress and make them feel secure,
cared for, and supported.
These suggestions might help, but it's also a good idea to find support (through
counseling, a hospital support group, etc.) to help you take better care of all your
First, look forward. If you find yourself feeling guilty for not
being a perfect parent to your healthy children, don't beat yourself up — dwelling
on the past is not productive. Instead, try to make a point of recognizing your kids'
feelings and needs now, and move on from there.
Keep the lines of communication open. Pay attention to siblings'
needs and emotions. Encourage them to talk about their feelings — the good,
the bad, and the guilt-inducing — and try to read between the lines of their
actions. This can be difficult when you're exhausted, stressed, and away at the hospital
or clinic for long periods of time, but a little attention and conversation can let
your healthy kids know that they're important and their needs matter.
Keep it "normal" as much as possible. Try to maintain continuity
and treat your kids equally. Stick to existing rules and enforce them; besides minimizing
jealousy and guilt, this also sends a strong optimistic message about your sick child's
recovery. And try not to fall into the trap of relying on healthy kids as caregivers
before they're ready. Accept help so that your healthy kids can stick to their typical
routines as much as possible.
Say yes to help. Accepting help with transportation, meals, childcare,
and other daily activities can take some pressure off of you so that you have the
emotional reserves to be there for your family. You'll also be teaching your kids
a valuable lesson about accepting generosity from others.
It's OK to have fun. Enjoying yourself and having fun (for a change)
can go a long way toward relieving stress and recharging your battery. In addition
to trying to keep a normal schedule of activities, whenever possible set aside some
time for your kids to spend with friends and family without focusing on the
illness. You also can set aside one-on-one time with your healthy kids where the focus
is on them and everything that's going on in their lives other than their sibling's
Be patient with regressive behavior, especially on the part of
younger kids, who may have trouble making sense of emotions. At a time when parents'
nerves are frazzled, it can be hard to stay patient and attentive, but it's essential
for siblings. However, it's not a good idea to let kids — healthy or sick —
behave inappropriately or get away with behaviors that you would not have allowed
before the illness. Rather than make a child feel relaxed, this can increase anxiety,
jealousy, or feelings of abandonment.
Include siblings in the treatment and care. Including healthy
kids in some of the doctor visits and hospital sessions can help demystify the illness.
They also can benefit from connections to other patients' siblings. And giving healthy
kids specific, non-threatening "jobs" can help them feel like an important part of
the treatment process. Encourage their involvement and let them lead the way —
maybe they want to help with physical therapy, for example, or make cards, books,
or videos to keep a hospitalized child connected to life at home and school. Many
hospitals offer sibling counseling groups, workshops, and other programs that can
help your healthy kids feel less alone.