Caring for a seriously ill child takes a tremendous toll on the
whole family, and healthy siblings are no exception.
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.
By being aware of what healthy siblings are going through and
taking a few steps to make things a little easier, parents can
address 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. In addition
to fear and anxiety over the illness, they often experience the
feeling of loss of a "normal" family life, and loss of
their identity within the family.
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 cannot
- be angry because parents are devoting most of their time and
energy to the sick sibling
- 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 will vary considerably -
some may act out, some may try be the perfect child, and many will
do both. Most studies find that siblings of children with cancer
are not at any increased risk for mental illness, although they may
be at greater risk for behavioral and emotional manifestations of
their distress.
What to Look For
Pay attention to any changes in kids' behavior, and talk to
them frequently about how they're doing and what they're
feeling. The more room kids have to express their emotions, the
less emotional turmoil 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 alleviate their stress and
make them feel secure, cared for, and supported.
These suggestions might help, but it's also helpful to seek
support (for example, through counseling or a hospital group) to
help you take better care of all your children.
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; in addition to minimizing jealousy
and guilt, this also can send 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 maintain a normal schedule of activities, whenever
feasible 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
sickness.
Be patient with regressive behavior
, especially on the part of healthy 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. In addition, giving
healthy kids specific, non-threatening "jobs" can help
them feel like an important part of the treatment process.
Encourage their involvement in a variety of ways, and let them tell
you how they'd like to be involved - maybe helping with
physical therapy, for example, or making 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.
Reviewed by:
Michelle New, PhD
Date reviewed: January 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.