Helping kids cope with chronically ill siblings

The care that a seriously ill child requires can have a tremendous impact on the entire family. Not only are the parents and ill child affected, but can take a toll on siblings as well.

How siblings cope depends on a couple of factors, and age is a big one, experts say. For younger children, the interruption of normal life can be a big issue, explains Melissa Cavanaugh, certified child life specialist at Advocate Children’s Hospital in Oak Lawn, Ill.

“The parents are gone a lot and the children left behind have to stay with relatives and friends. That’s usually the first thing that starts to upset things,” Cavanaugh says.

At an older age, more fears, such as worry about a brother or sister dying, come into play. “Past experiences with loved ones in the hospital, both positive and negative, will play a key part in how they cope,” she says.

Coping techniques
Getting life back to normal as much as possible is very important. The best way to do this, says Cavanaugh, is to incorporate normal activities when siblings visit their brother or sister in the hospital, whenever feasible. For example, the healthy children can read stories to the ill child or play with toys.

When the hospitalized sibling is seriously ill, Cavanaugh says the child life department can use this time together to promote memory-making activities. “We encourage parents to make videos and movies of siblings together,” she says.

Getting back to normal can also mean carving out dedicated time to spend with the healthy child, Cavanaugh explains. Sometimes the healthy children can be unintentionally overlooked, so to speak, and a long hospitalization can be harmful to them emotionally, she says. “It may help to get another family member or friend to come and sit with the ill child for a while so parents can spend some one-on-one time with the healthy child,” Cavanaugh recommends. 

Get them involved
It’s important to allow the siblings to participate in the process as much as possible, and technology can be a great way to facilitate this. For example, if the ill child is able, Cavanaugh may suggest using Skype or Facetime so the healthy child can chat with an ill sibling.

She adds that encouraging siblings at home to make things like signs and pictures to put in their siblings’ hospital room can also help them feel included in the recovery process.

Healthy expressions
All in all, Cavanaugh says the key thing to remember is to maintain open communication. How well parents communicate what’s going on to the healthy child helps kids cope better. “The number one thing we suggest to parents is be open and honest to prevent misconceptions,” Cavanaugh says.

She adds that when parents do tell the healthy child what’s going, all the details aren’t necessary to share, “but it’s important to let the child know that their sibling is very sick so if the child’s wellness takes a bad turn, it’s not as shocking.”

It may help parents to designate a person who the healthy child can talk freely to, says Cavanaugh. “A lot of times children want to protect their parent’s feelings and won’t initiate conversations about their own emotions about the hospitalized child,” she explains.

She adds that it’s key to “understand that all people cope and deal with stressful situations in a different way, so it’s important to validate your children’s emotions and encourage them to express them in a healthy way.”

Projects such as journaling or making feelings boxes can help siblings express their emotions in a healthy way. For feelings boxes, Cavanaugh says healthy siblings decorate them and write down things that make them happy, sad or worried and put them in the box.

“A lot of people don’t want to prepare kids for the frightening things, but as adults, the more we know, the less anxiety we have,” she says. “And the same applies to children.”