Helping your other children cope when their brother or sister is ill or in hospital

We know that life can be stressful when your child is unwell or in hospital. This stress is increased if you also have other children at home to look after. Parents report that sometimes brothers and sisters of a child who is ill can be affected too. They may show behaviour changes, such as being more clingy to their parents, tantrums or challenging behaviour, non-specific ailments such as tummy aches or headaches, sleep disturbances, noticeably low mood or becoming withdrawn. This page from Great Ormond Street Hospital (GOSH) aims to give you a few ideas about the issues that may be facing your other children.

All these ideas and suggestions come from our play team, who between them have many years of experience working with children, young people and families in hospital. If you have any ideas of your own or particular activities that work with your child, please contact us to tell us about them.

Any change to everyday routines can be unsettling. If a parent and brother or sister is away from home from any length of time, this will have an effect on your other children. Even if your children have their other parent or another relative they know well to look after them while you are staying in hospital, routines will change and things will be different.

If they are not sure what needs to happen at what time, filling in a care schedule for those adults caring for your other children at home can help.

Try to keep to routines as much as possible – for instance, by sticking to usual mealtimes and bedtimes. This will help brothers and sisters have a framework each day so they know what is happening.

If at all possible, brothers and sisters should still go to school and do their usual activities. Tell the nursery, school or activity leader that one of your children is in hospital – it is helpful for them to know just in case any problems arise. They may be able to offer additional support or reassurance to your other children while their sibling is unwell.

If possible, try to have some regular time with your well children, so that they know they are important to you too.

If it is impossible to be with your child at home, you could leave them an important item of yours to look after or as a comforter until you return.

It is natural for you to need to focus your attention on your sick child, but this can cause other children in the family to feel jealousy or resentment. This can be made worse if others (including relatives and friends) focus a lot of attention on the sick child.

Jealousy can be expressed in many ways, from general behaviour changes such as tantrums and arguing or by hitting out at or damaging things belonging to your sick child.

It may help to include your other children as much as possible, by inviting them to visit the hospital or make pictures for their brother or sister or talking to them on the phone. Some siblings find the hospital environment boring or stressful – ask them how much they would like to visit, have phone contact or be involved in their brother or sister’s care. Encourage relatives and friends to include your other children in any special presents or visits or to specifically visit them at home.

Some children react to their brother or sister being ill by becoming angry. Anger can be the easiest way for them to express complicated emotions, such as fear or lack of understanding. Angry outbursts and tantrums can be distressing for children and adults – children may feel remorseful or frightened at the strength of their emotions. They may need extra reassurance and help to explore big emotions.

Reassure your children that it is alright to feel sad or angry and give them the opportunity to share their emotions. If your children are young, you might want to play ‘hospitals’ or use art to explore how they are feeling. Story books about feelings can also be helpful.

Children may not always understand why their brother or sister is ill. It is possible that they may think that it is their fault. Explaining what has happened can be helpful to address any concerns or fears that they have caused an illness or injury. It is also not unusual for siblings to have feelings of guilt because they are healthy but their brother or sister is unwell. Play can be helpful for some children - talking to the play specialists at GOSH may be useful.

As they grow older, children start to notice when things look and feel ‘different’ to themselves and others. Having a sick brother or sister may be something that causes them to feel ‘different’ to their friends. Talk to your other children about their brother or sister and what makes them ‘different’. Together you could work out (and practice) what to say if other people ask them questions.

If their brother or sister shows behaviour that is challenging, they may be worried about going out as a family. Lots of places now do ‘relaxed’ events for people with additional needs that you might all enjoy – check out your local cinema or theatre for details.

In some ways, now it is much easier to keep in touch than it was previously. Use video calling to your children at home – perhaps to read a bedtime story or hear what they had done at school.

Video calling can also reassure your children about each other – talk to ward staff to see when would be a good time. You can use our free Wi-Fi to save data charges on your mobile phone.

Brothers and sisters at home may be interesting to explore the hospital too. You could also show them the virtual tour and short films about the wards at GOSH so they know what to expect. Visit our website for details.

Managing family life when one child is in hospital and others are being looked after at home is stressful. This may be the time when you will need to ask for help from family and friends, particularly if there are school runs or activities to organise.

Confusion is common if your children at home do not understand why their brother or sister is in hospital. They may develop their own explanation for what is going on or may imagine something far worse. They may worry that they are going to ‘catch’ an illness or fear that their brother or sister will never get well.

Try to give your other children as much information as they need to understand what is happening with their brother and sister. You could read a book or watch a story about being in hospital.

If you are unsure what to say or how to talk to your children about illness, treatment or being in hospital, talk to the play specialists at GOSH for some ideas and support.

Other people who do not have experience of having a sick child may not be able to understand the challenges you go through every day.

Children are more likely to ask honest questions about difference. Adults tend to avoid asking questions but this may add to feelings of isolation for families with a sick child. Consider what you could say if you are asked about your child’s illness or treatment. Consider ways that you can ask for the help your family needs. It is important for your other children to see you dealing with other people confidently – this will help them act in a similar way.