For Patients & Families | Sibling Support

Sometimes when one child in a family has health care needs, brothers or sisters may have many troubling feelings such as sadness, worry, anger, or guilt. At times parents think this is their fault, but this isn't the case. In fact, it's normal for brothers and sisters to experience many conflicting feelings when they have a sibling who is ill or has special health care needs.

Some ways feelings are expressed

Often children don't know how to talk about their feelings. They express themselves in other ways such as:

• a change in eating habits (eating more or less)
• becoming quiet
• spending time alone or away from family members
• trying very hard to please parents or other grown-ups
• acting out by not listening, fighting, or even hitting others
• seeking more affection than usual
• returning to younger behaviors, such as bed wetting, "baby talk," or thumb sucking
• saying that they feel sick or acting like the sick child

Brothers and sisters may feel:

• sad: because they miss you and the sick child
• lonely and left out: These feelings may arise when brothers or sisters are spending more time than usual away from their parents or alone. They may feel left out if no one tells them what is happening.
• worried and afraid: They may worry about you and be afraid about what is happening to their sick brother or sister. They may believe that everything is changing and won't be the same again. Sometimes they think that they may get sick too or worry that their parents may get sick.
• guilty: Sometimes brothers and sisters think that they caused the illness because they did something mean or had mean thoughts. They may worry that it's their fault. They may also feel guilty because they are healthy and can do things their brother or sister can't do.
• jealous and angry: Brothers or sisters sometimes feel jealous or angry because of all of the attention given to the sick child. They may act out their anger by not following rules or fighting with others. They may complain of feeling sick to get more attention.
• confused: They may feel confused because they don't know what's happening now and what might follow and can't understand why it's happening.

Ways to help

Talk together as a family about what's happening with the sick child and why the child is sick. Give simple and honest explanations at your child's developmental level.

Tell brothers and sisters that it is important to ask questions and that you will try to answer them or find out the answers from the nurse or doctor.

Encourage brothers and sisters to talk about their feelings. Let them know that it's okay to cry, be angry, be happy, and have many different feelings.

Keep daily routines as normal as possible, such as school attendance, meals, naps, and bedtimes.

Give your other children special attention whenever possible.

When possible, bring brothers and sisters to visit the hospital. Talk with staff about how to prepare your child for a visit to the hospital. Arrange these visits according to your child's interest and comfort level. If a visit isn't possible, arrange phone calls.

Suggest that brothers and sisters draw pictures or make cards to send to the hospital.

Seek support from family and friends. Ask hospital staff about ways to find support for yourself and your family.