How to Help Children Cope with a Sibling’s Chronic Illness

envious girl with mom and sibling in the backgroundWhen a family member is diagnosed with a chronic illness, he or she is not the only person who has to deal with the diagnosis—the entire family is affected by it. Think of a car: every part has to work properly and in conjunction with the other parts in order to run smoothly, right? Something as simple as a flat tire can cause the entire system to slow down. The family system is like that car. Each member has roles and responsibilities, and when one person has a medical diagnosis, it can throw off the entire system.

So when a child is diagnosed with a chronic illness, the entire family system is affected. Having a child with a chronic illness can be difficult for everyone. Managing schedules and doctor appointments, going to different therapies, and dealing with sudden changes of symptoms can be exhausting for the child with the illness as well as for the parents.

But what about the nondiagnosed siblings? How are they affected? Family routines and dynamics can drastically change when a child is diagnosed with a chronic illness. This change can affect the nondiagnosed siblings in different ways. Some normal emotions for nondiagnosed siblings include:

  • Guilt (because they are healthy and their sibling isn’t)
  • Anger (that parents spend more time with the diagnosed sibling)
  • Resentment (that the diagnosis has changed the family routine)
  • Worry (that their sibling will get worse or die)
  • Fear (that they or another family member will contract the illness)

What can you do as a parent to help your nondiagnosed children cope with their sibling’s illness? Here are a few tips:

Express Feelings

Encourage your kids to talk about their feelings, even when it’s not so positive, and validate them when they do open up. Model this behavior by expressing yourself in a truthful and age-appropriate way to your children.

Maintain Rules

Keep your family rules intact. Many parents feel guilty enforcing rules when there is an illness, but structure can help children know what to expect; it helps them feel safe.

Include Siblings

Do not allow siblings to be caretakers per se, but invite them to doctor or therapy appointments when possible. This can help them understand what your diagnosed child is going through.

Stay Active

Although some extracurricular activities might have to be altered, it’s important to find doable hobbies in which everyone can participate. Being able to enjoy the fun things in life can help the family cope better and feel “normal.”

Make Time

The diagnosed child gets a lot of your undivided attention. Be sure to take time out for your nondiagnosed children, too. It will help them know that they are still important to you.

It’s not always easy to see when a nondiagnosed child is struggling because he or she doesn’t always know how to express feelings. A few things you can look for are changes in sleep, mood, or appetite. You should also be aware of regressed behaviors or changes in school functioning. If you see these changes consistently, consider seeking the assistance of a therapist to help the child cope more effectively.

© Copyright 2014 All rights reserved. Permission to publish granted by Andrea M. Risi, LPC, Family Problems Topic Expert Contributor

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Parker c

    July 31st, 2014 at 10:12 AM

    Your brothers and sisters are your closest frineds ever. To think of losing one would be a terrible feeling especially for one so young who does not fully undersrand the concepts of death and dying yet. Great losses for anyone to endure.

  • wallace

    July 31st, 2014 at 11:22 AM

    One huge mistake that I have seen is when parents leave the other siblings out of the mix and don’t in some way that they can understand try to talk to them about what is going on with their brother or sister. I think that even though we think that this is helping and protecting that child, they are usually smart enough to know that there is something going on that you don’t want them to know about, and I think that we can all relate to feeling badly if we think that we are being left out of the loop. I am not saying that you have to share every single thing with them, but I think that you know your children well enough to know what is appropriate for them and what they can handle and at what time. This is not the time to be evasive because even when you are this often leads to even more worries and questions that there would have been if you had chosen to be upfront and honest with them from the start.

  • Andrea R.

    July 31st, 2014 at 12:39 PM

    Agreed Parker…siblings are a big part of our lives. Losing a sibling to a chronic illness can be extremely difficult for everyone.

  • Andrea Risi

    August 1st, 2014 at 6:37 AM

    Thank you for pointing that out, Wallace! Parents can talk to their non-diagnosed children in an age-appropriate manner, answering questions in a way that the child can understand. When family members know what’s going on, it helps relieve their worries.

  • janie

    August 1st, 2014 at 10:20 AM

    I know a family going through this very thing right now, one child devastatingly ill and the other child perfectly healthy but questioning why the brother and not him, why does he seem to have dodged the bullt and his brother have gotten so sick? It is heartbreaking really for this family to know that very soon not only will they lose this son but that their other child will lose his brother whom he loves very much and is not old enough to understand yet that there is nothing that is going to make him well again. I feel so terrible for them especially when you know that there is nothing that can be done by anyone to help them through all of this.

  • Paulina

    August 2nd, 2014 at 1:21 PM

    Even though they may not know how to express what they are feeling, even the myoungest children will be affected by a diagnosis like this.
    They might not know what to say but they may start acting out for example or doing things that you haven’t noticed them doing before.
    All of this could be stemming from the fact that something big is going on and they might feel tthreatened or hurt or just simply not understand why their regular routine has been dirupted.
    Sometimes this can’t be helped but if at all possible you should reassure them that this has nothing to do with them and that this is just a hard time that the whole family is going through right now.

  • Brandt

    August 4th, 2014 at 4:19 AM

    Continuing to make time for all of your children will be essentual during a family crisis like this.

    You may not feel like you have the time or energy to do any more than to take care oft he child who is sick, but your other children have not stopped needing you too just because something else is going on in the home.

    If there is anyway that you can help maintain a sense of normalcy for them it will go a long way with easing a lot of the tensions that understandably exist and will help them feel a part of this huge piece of the puzzle.

    And who knows? This could be an extra support arm that you have been looking for. All children want to feel involved and helpful in some way so letting them be involved in this way could be a huge help for everyone.

  • Andrea Risi

    August 4th, 2014 at 8:31 AM

    Janie – This must be a very difficult time for the family…and for their friends. It’s not always easy to know how to help others during a difficult time. Being available, whether physically or emotionally, can give some comfort.

  • Andrea Risi

    August 4th, 2014 at 8:33 AM

    As Paulina stated, it’s important to watch for signs from undiagnosed children. If you notice something unusual in their behavior, talk to him or her about it. Be open and welcome a conversation about their fears and other feelings.

  • Andrea Risi

    August 6th, 2014 at 7:22 AM

    I appreciate your insight, Brandt! Most parents feel overwhelmed with caring for the diagnosed child and finding separate time for the non-diagnosed child can be challenging. But as you stated, it can be one way to get the other children involved and included.

  • Steph

    August 7th, 2014 at 5:42 PM

    I think that as a parent I would have a very hard time dealing with the anger form someone else because I know that I would already be so mad at the world that this was happening to my family that I don’t think that I could take anything additional coming from anyone else.
    Kids though don’t know how to fully process their feelings, not that I would either if I had to deal with something so tragic as this.
    There would have to be a better way to find for them to channel that anger into something more productive and in a way that shows them how relevat their input is into the family.

  • Andrea Risi

    August 11th, 2014 at 6:43 AM

    Steph – You’re right: anger is a normal part of the grieving process that families experience in the case of a chronic diagnosis. When parents can find positive ways to channel that anger, they will model for their children how to deal with their own anger.

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