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What about me? Providing support to siblings during a hospitalization

March 27, 2015

March is National Child Life Month. As a Certified Child Life Specialist in the NICU, I find this month quite exciting. It is a time for Specialists to continue to spread awareness of the need for patient education and support during trying times in the hospital, and most importantly, we celebrate the importance of play! But, patients are not the only family members that Child Life Specialists serve. We also provide education and support to siblings. Regardless of age, siblings can struggle throughout a child’s hospitalization for various reasons, and it is important to recognize ways that they can feel supported and have an understanding of what is going on with their brother or sister in a way that makes sense to them.

As a Child Life Specialist, parents often ask me, “What can I do to help them?” when talking about their other children. The fact is, siblings want to be a part of the process. They want to understand what is going on within their families as most times they are just as concerned about their brother or sister as their grown up family members. Siblings may not know how to verbalize their questions or display their concerns, so their worries may manifest themselves in some behavior changes. It is key for parents to understand and recognize the reason behind these changes in order to support their child and to begin teaching positive coping skills.

Here are several keys to providing age-appropriate support to siblings during a brother or sister’s hospitalization:

Be honest with them.

Many parents struggle with this because they are unsure of what to say, or don’t want to scare the sibling. It’s helpful to remember, though, that children tend to ask questions when they are ready for the answers. Using age-appropriate, accurate and basic information is recommended. At particular developmental stages, children--especially preschoolers--have very vivid imaginations. If the information is not easy for them to understand, then they will often draw their own conclusions about what is going on. That can sometimes lead to some very inaccurate—yet often comical assessments of the situation. But humorous or not, the information needs to be clarified so they can begin to process it appropriately and work through any emotions they feel. Do not hesitate to ask for support from a Child Life Specialist if they are available to you and you are unsure of what to say.

Encourage them to be involved.

This can be challenging sometimes due to scheduling, distance, or other obstacles that a family may face. But, allowing the child to come and visit their brother or sister can be very therapeutic not only for the sibling, but for the patient as well. Also, having the sibling draw pictures or record themselves reading a recordable storybook, for example, may be helpful. Another suggestion may include having the sibling create an “All About Me” poster or sheet for the patient to help the staff learn about their brother or sister—even if the patient can also create one for themselves! If visits are not possible, then having video chats with the sibling can be a way to help them feel connected.

Maintain boundaries and routines as much as possible.

Children are creatures of habit and tend to love their routines. A hospitalization can quickly and easily throw that routine into a tailspin and sometimes take a child’s behavior with it. As adults, we have a different level of understanding as to why routines may need to be changed, but for a child that can produce a remarkable level of stress. Many times when children note boundary and routine changes, adults may notice sudden behavior changes. Children have multiple reasons for these behavior changes, including seeking attention, or establishing what the “new rules” will be—for example, if they engage in a behavior that they know is not typically accepted within their family, what will happen? Will they still get sent to “time-out”? If you notice your child displaying behaviors that are unusual for them, talk about it, and provide positive alternatives for coping instead of the negative behavior. It is important to keep the boundaries and routines as consistent as possible to provide a sense of security in what can feel like a very chaotic time.

The relationship between siblings is often a powerful bond. When one is in the hospital, it can be a time of great stress for the sibling that remains at home. As we know, siblings don’t often like to be left out of anything that the other does! Providing them with opportunities to understand why their brother or sister is in the hospital and being able to engage in helping or supporting their sibling can make the experience as positive as possible for the entire family.

Learn more about the Child Life Program at Arnold Palmer Hospital, here.