Parenting Siblings of a Child with a Serious Illness

It is important to talk to siblings about their experience and encourage them to share their feelings. Let them know that you understand and love them unconditionally. Hospital staff such as child life specialists, social workers, chaplains, and psychologists and other mental health care specialists can help provide support. Your hospital may offer support groups and other programs for siblings to help maintain a sense of belonging and normalcy.

Here are some ways parents can support siblings of children with a serious health condition:

Explain the unknown

Be honest and open with your children. Siblings are often scared because they don’t understand this new experience. Give an age-appropriate description of the illness. Your care team can help you talk about your child’s condition and treatments in ways siblings can understand. If you explain what’s happening, it can lessen fear and confusion.

It is also important to understand what each child thinks about the illness. Children might not know what questions to ask or be afraid to bring it up to parents. Check understanding and then clear up false beliefs or misinformation.

For example, a child may wrongly think that cancer is contagious. Some children may believe that people always die when they have cancer when, in fact, many children can be cured. 

Keep life as ‘normal’ as possible

Try to keep daily routines for siblings as predictable and stable as possible. Siblings should continue to go to school and participate in hobbies and activities. Each family is different, but it may be best for siblings to stay in the family home if there is a caregiver who can stay with the sibling.

Family members and friends can help you support siblings and spend time with them when you are not able to.

Make time for siblings

Find ways to spend special, one-on-one time with each child. Read a book, play a game, take a walk, or do a fun activity together. This time can give families much-needed stress relief and build connections. When you are away from home, be sure to find ways to connect with siblings through video calls or virtual activities. 

Siblings may often hear how “strong” or “brave” the child with serious illness is. Talk to the sibling about how strong and brave they are being, too. Ask siblings how they are doing. Listen, maintain eye contact, and ask follow-up questions. Be sure they know that they are important to you and have unique qualities that make them special.

Acknowledge difficult emotions

It’s normal to get angry when a loved one has a serious illness. Children can get angry at the illness itself or at God for letting it happen. They might be angry that things are no longer like they used to be or be angry at their sibling for getting sick.

Give children and teens a way to express their anger. For example, encourage your child to draw a picture or write down their feelings in a letter or a journal. Relaxation techniques such as deep breathing can also help your child manage emotions.

A child undergoing treatment tends to get gifts and special treats from friends and extended family. This can lead to feelings of jealousy in siblings. Let them know that you understand and look for ways to include siblings and help them feel valued.

Some siblings may imagine that being at the hospital is fun because their brother or sister gets gifts, does not go to school every day, and spends extra time with you. They may only see pictures of your sick child smiling and having fun. If so, it is OK to share age-appropriate information about a more typical day, such as waiting for appointments, taking medicine, and having procedures.

Relieve guilt

Some siblings may think they caused their brother or sister to get sick because of something they thought, said, or did.

Some may feel guilty that they are healthy while their brother or sister is not.

Some ways to lessen siblings’ guilt may include:

• Tell siblings there is nothing anyone can think, say, or do to make someone else get sick.
• Allow them to help their brother or sister in different ways. They will feel less powerless.
• Show siblings it’s OK to have fun and be independent even when their brother or sister is sick.

Prepare for uncomfortable situations

It’s natural for children to feel uncomfortable when others see their brother or sister sick. People may ask questions about the illness that the siblings don’t know how to answer. Prepare children for questions and help them know what to say ahead of time. Help siblings know what to do in specific situations and encourage them to tell you when something makes them uncomfortable.

• Consider whether you are comfortable with teachers or others at your children’s school talking with siblings about the illness. Let the school know how you prefer they communicate about your child’s illness.
• Encourage siblings to share what it feels like when someone asks questions or stares at their brother or sister in public.
• Check in regularly with the sibling’s teachers and other trusted adults. Help the sibling identify a support person they can rely on at school and at home.

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