FOR Parents - Helping Siblings Cope

The injury and  hospitalization of a child can be frightening and confusing for the child's siblings. Siblings of all ages are affected by the hospitalization. Some of the emotions that siblings may experience when a brother or sister is hospitalized may include:

• Fear because of the circumstances of the injury and/or fear that their sibling may never recover and return home
• Guilt that they have somehow caused the injury
• Anger at parents for "allowing" the sibling to become injured and sick
• Abandonment feelings if parents are spending majority of their time with the hospitalized child
• Jealousy due to special attention that the patient is being given

These feelings may be expressed in a variety of ways depending upon their age:

• Regression to behaviors they have outgrown (thumb sucking, bedwetting)
• Changes in eating and sleeping habits
• Withdrawing from family or peers
• Acting out to gain attention
• Increasing dependence on parents
• Refusal to participate in school or family activities

Hints for helping siblings to cope:

• Provide  honest, age appropriate information regarding their brother or sister's injury, hospitalization and treatments.
• Provide opportunity  to visit the hospital even if they do not initially visit with their siblings. Visits can be reassuring and help clear up misconceptions about what is happening to their brother or sister.
• Prepare them for physical changes such as IV's, tubes, or casts. Explain what these items are doing to help their sibling to get well. Speak with the staff if you would like someone to help with preparation prior to visiting the patient.
• Plan special time with siblings so they do not feel neglected or forgotten.
• Maintain sibling's normal home, school routine, and caregivers as much as possible.
• Share your own feelings with siblings and allow them to express their feelings about the hospitalization with you.
• When you have to be away from home with the hospitalized child:
• Arrange to have someone both you and they trust stay with them;
• Check In by phone as often as you can.  For younger children, call at bedtime to say goodnight. Call after school to check how their day went.
• Send letters, cards or tapes.
• Allow siblings to keep a balance between increased responsibility at home and maintaining their normal activities

Check in with your children often about:

• How he or she is feeling, emotionally and physically
• How they are managing at school and with their friends
• Whether he or she wants you to do more or less to help or if they are needing reassurance or information
• Praise your children for the things they are doing well and for coping behavior. Let them know it is okay to participate in school and other activities and to have fun even though their brother is in the hospital.

Check in with your children’s school teacher or counselor

Make sure your children’s teacher and school counselor know that an upsetting event has happened.  Keep them posted throughout the recovery period, especially if it is longer than a month, so they can respond appropriately and provide extra support as needed.

If you suspect problems at school or are concerned about your children’s behavior or reports about teasing or rumors at school, contact the school and work with them to develop a plan to resolve any problems.

Help your children feel involved

Children benefit from feeling that they are involved in their sibling’s care. This means being part of conversations with and about their sibling. Ways in which brothers and sisters can help to feel involved:

• Introduce your children to the health care team. Take a tour of the hospital.
• Help them start a journal for themselves or to keep as a record for their sibling.
• Ask them to choose favorite dolls, books, or music to bring to the hospital to help their sibling be more comfortable.
• See if they’d like to paint a picture or do some crafts to decorate the hospital room.
• Arrange for the children at home to phone their sibling at the hospital if visits are not possible. This will help them feel connected.
• Write or tape-record messages from your hospitalized child and send them home to your other children. The children at home can respond by recording a bedtime story or favorite song. 
• Share photos and write emails, letters, and cards.

Additional Resources

Books for siblings

When Molly Was in the Hospital: A Book for Brothers and Sisters of Hospitalized Children  By: D. Duncan (1994). Rayve Productions Inc.

Curious George Goes to the Hospital
By: H. Rey and M. Rey (1966). Houghton-Mifflin, Boston.

Web sites