How Siblings React to Hospital Care

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Sibling reactions to illness and hospital care

When your child or teen is severely ill (sick), it affects the whole family. The patient's siblings can face many challenges. Siblings might be away from the patient and their parents for a long time. The family might visit an unfamiliar hospital, and their daily routine could change.

When facing these challenges, siblings may act differently than normal. They might:

Act jealous of the sick child or teen
Cling to or follow you
Demand more attention than usual
Show less interest in normal activities

Every child reacts to stress in a different way. Your sick child’s siblings need to know that you understand their feelings and that you still love them. The changes in their behavior will not last forever. They will often get better or go away as your family adjusts to a new routine.

Sibling questions, fears, and reactions

Siblings often have questions and fears, but they may not talk about them unless you ask. These can include:

Not understanding why a family member is sick, and they cannot come home
Wondering if they, or your sick child, did something wrong to cause the illness
Worrying that they could catch the illness
Wondering who will take care of them if you or another caregiver are at the hospital
Wondering if they will be able to keep doing their usual school activities (concerned about changing their routine)

Some common reactions of siblings to a sick child or teen are:

Fear – It can be scary when siblings do not know what is going on. They might be scared about what could happen to your sick child.
Guilt – Siblings need to know they did not cause your sick child’s illness.
Sadness – Many siblings feel sad when there are changes in their family. They need to know that sadness is normal.
Worry – Many siblings feel nervous for your sick child or teen. It can help if they can share their worries with a child life specialist or other health care provider. These specialists can explain the illness and treatment.
Left out – The needs of the sick child can overwhelm siblings. Siblings might feel that they are not as important as they used to be. They need to keep sharing important moments with their families. This is true even if parents or caregivers seem busy.
Anger or Jealousy – When the sick child gets so much attention, siblings can feel angry or jealous. They need to know it is OK to have these feelings. They need to remember that their family still loves them very much too.
Sleep problems – Siblings may have problems sleeping or have nightmares.
Embarrassment – They may be embarrassed by a sick child’s illness, or when someone stares at the sick child in public.
Loss of control – Siblings may feel they cannot control what is happening.

A child feeling worried, sad, and left out — Watch siblings for common reactions such as guilt, sadness, worry, or feeling left out when another child is severely ill.

Every sibling may feel and experience things differently. It may help if they can share their questions and feelings with a child life specialist, psychologist, or another person they trust.

Talking to siblings about illness

Your sick child’s brothers or sisters need information about their sibling’s illness and treatment. The information should be correct and fit the child’s age. If you need help finding the right words or need advice about how much you should share, ask your care team for help.

Many times, you should let the child lead the conversation. Start by asking your children if they have any of fears or questions. They might want to talk to about how frustrating it is to have a sick brother or sister. It is healthy for siblings to share feelings. Listen to your child without judging them. Let them know it is OK to have those feelings and concerns.

Do not feel like you have to have an answer. It is okay to say, that is something I have been wondering about, too; what are you thinking about that? Answer as honestly as you can with simple words they can understand. Being honest builds trust. When you are honest, your children might bring other questions or fears to you later.

Sharing feelings in positive ways

It helps if your child can talk about their thoughts and questions with someone they trust. The person can be a friend, family member, teacher, school counselor, or a member of your religious community. Health providers like child life specialists can also help.

When things are hard to talk about, your children might want to write down their thoughts and feelings or find other positive ways to express them. They can use social network platforms to keep in touch.

Some children and teens can express their feelings better by doing art, music, or some other hobby they enjoy. You can ask a child life specialist, social worker, or other care provider for help and ideas.

Siblings staying connected with doing their hobbies together — Help siblings stay connected by encouraging them to continue their hobbies, including music.

Some siblings may also enjoy spending time with other siblings with whom they can relate. Ask your care team if the hospital offers sibling groups or activities.

Tips for supporting siblings

Children learn how to act by watching the people around them. At stressful times, they often copy what parents or caregivers doing. The actions of parents and caregivers will affect:

How siblings act around the patient.
How children relate to each other.

Remember that siblings need just as much attention and support as the patient, and sometimes they need a little extra. Some other helpful tips are:

Let siblings know who will take care of them while you are gone.
Talk to siblings’ schoolteachers or counselors so they know what your sick child’s siblings are going through.
When you are with each sibling, plan times for just the two of you to do something special. This can be reading a story, playing a game, or going on a short outing without the patient.
When siblings are not at the hospital, you might need help keeping the sick child and their siblings in touch with each other.
Child life specialists, nurses, social workers, and staff can suggest ways that families may stay close, even when they are far apart.
Encourage siblings to keep doing their usual activities outside of school. Too many changes at once can be more stressful.

Learning about the hospital

If siblings do not spend time at the hospital, they might imagine something different about what your sick child’s experience there. If possible, arrange for them to visit at least once. Health care providers can meet with siblings and tell them about what happens.

If siblings cannot visit the hospital, providers can help you talk about what happens there. For example, they can give you things to take home such as books, photos, or dolls to explain medical treatments. They can send letters that explain your sick child’s illness.

Your sick child or teen may take part in playroom activities and special events at the hospital. If their siblings are present at the hospital, they can join in and feel like they are part of what is happening.

Key Points

It is normal for your child’s sibling(s) to have questions, fears, and other common reactions to a sick child in the family.
Common reactions include fear, guilt, sadness, worry, feeling left out, angry, or jealous.
Answer questions honestly at the right level for their age.
Help siblings find positive ways to manage their feelings.
Help them understand what happens to your sick child and what goes on at the hospital.
Help siblings restore their connection with the sick child.