Ways to help siblings

Important things to remember

• It is important to talk to your other children about what is happening, as they will pick up that things are different.
• Keep information very basic at a level that the brother/sister will understand. The PICU psychologist or counsellors can help give advice if you need it, or if you want to talk things through before discussing something with your other children.
• Sometimes siblings may worry that they are to blame, and may also feel left out and anxious. Explaining the situation to them can help this, even if it means the sibling gets upset.How siblings may feel
• Siblings may be very worried about their sick brother /sister. They also have to cope with the loss of routine and normal family life.

They may

• worry that their ill sibling will die
• worry that they themselves or somebody else in the family may catch the disease
• feel guilty because they are healthy and can enjoy activities that the sibling cannot
• feel neglected and resent all the attention going to the ill sibling
• feel a general sense of worry and anxiety about the future
• Some things you can do to help siblings:
• Accept any help that is offered
• Make a list of people whom you can call on at short notice, for instance if you are running late for the school run (or for any unexpected crisis)
• Accept help with transport, cooking meals, childcare or just a cup of tea and time to chat, so you have more energy/time to be there with your family
• Try not to rely on older siblings to do more than they should 
• Stick to usual routines as much as possible
• Stick to existing rules – children will feel safer when they know the normal boundaries are still in place
• Where possible keep to siblings’ usual activities such as out-of-school clubs, time with friends etc.
• It’s ok to have fun – it will help to relieve stress and recharge everybody’s batteries

Make time for siblings

• Try to have some quality one-to-one time with your child’s sibling(s)
• This can be a brief, inexpensive activity: read a story while your ill child is asleep, go for a walk outside and look for treasures to bring back (leaves, stones, flowers), make a picnic lunch and find a nice spot outside to eat it, draw a picture together, put together a playlist of relaxing/uplifting music…
• Include siblings in treatment when possible: let them visit, make cards, read to their sibling, lend them a toy for their hospital bed etc
• Talk to your children and give them age-appropriate information
• They may overhear parts of conversations and pick up on your stress. Answer questions as honestly as possible. If you don’t know the answer it’s ok to say so and say “let’s ask someone who might know”
• Encourage your children to talk about their feelings and try to listen to what they are not saying; children show how they are feeling in their behaviour.
• Involve the school/playgroup etc. so they are aware of what is happening. They could offer a person to be around if your child needs to talk to someone

Ways to help your child with difficult feelings and behaviours

Angry feelings and aggression

• Name your child’s angry feelings. All feelings are ok, but children need help to express them in ways that don’t hurt anybody
• Help your child to express angry feelings with words, in play or in drawings.
• Set limits on inappropriate behaviour
• Use puppets, dolls, animals to help your child talk about feelings and experiences
• Refusing to do what they are told
• Give your child age-appropriate choices so he/she feels he/she has some control over what happens

Regression

• Many children return to doing what they did when they were younger: sucking thumb, being very clingy, wetting themselves. Reassure your child, give lots of comfort and then, as time goes on, start to encourage him/her to do more things for him/herself, praise appropriate independent behaviour that you notice
• Feeling and acting sad and withdrawn
• Let your child know that is it is ok to feel sad and that all feelings are ok
• Use play, drawing/painting or music (eg sad songs/happy songs) to give your child an opportunity to express his/her feelings, especially if he/she are unable to talk about them

Fears and worries

• Try to establish some regular daily routine, particularly around bedtime
• Make sure either you or someone who is looking after the sibling/s tells your child the plan for the day so he/she knows what to expect
• Reassure your child that he/she did nothing wrong to cause his/her sibling’s illness

The PICU psychosocial team is happy to meet you and your other children if you feel this would be useful during your stay. Please ask your nurse or doctor to contact one of us and we will arrange a time with you.

Be gentle with yourself and your family and allow time to recover.

However, when back home, if you do have concerns at any point, please contact your GP who can refer on for local support as needed, or contact the PICU psychosocial team.