If your child is diagnosed with a serious illness your whole world can turn upside down. The physical and emotional demands of the situation are nothing short of overwhelming, as diaries are shuffled to accommodate appointments and everyday thoughts are replaced with worry. It’s one of the most stressful things a parent can deal with.
On top of this, your unwell child may not be the only one suffering, as research shows that siblings of sick children can develop a range of emotional and behavioural problems. This may be triggered by a disruption to family routines, lack of attention, a loss of companionship with their ill sibling and feelings of uncertainty.
Adding to a growing body of research on the subject, a study published this year in ISRN Family Medicine found that children growing up with a sick sibling can experience social withdrawal and have difficulty establishing trusting relationships, which can last right through to late adolescence.
Furthermore, research published last year in the journal Psycho-Oncology found that in the unfortunate case that a child passes away, their siblings may experience low self-esteem, low levels of personal maturity and sleep difficulties.
“When a child has a sibling suffering from a serious illness they can have many emotional reactions as they attempt to make sense of their changed world,” says family counsellor Martine Oglethorpe. “Kids may feel the usual sadness and distress for their sibling, similar to the reactions of other family members, but they may also have other emotions that are unique to them,” she says. “These feelings can include guilt that they are healthy when their sibling is not or even resentment because their sibling is getting all the attention.”
But of course, how a child reacts to their sibling’s illness depends on their age. “Young children can become anxious as they tend to think in black and white and can have a hard time understanding why their sibling looks fine one day and not the next,” says Philip Gosschalk, Director of Childpsyc Psychology Practice.
Oglethorpe says that this anxiety may lead younger children to regress in behaviours they had previously outgrown, such as bedwetting, tantrums and clinginess. Older children on the other hand may become withdrawn, have trouble concentrating at school and may isolate themselves from their usual friends and activities.
A major factor that prompts many of these behaviours is the inevitable disruption to family routines. “Kids thrive on boundaries and routines,” explains Oglethorpe. “So when both of these are compromised healthy children may become confused, which can come across as misbehaviour.”
To overcome this, Gosschalk stresses the importance of maintaining some sense of order throughout your child’s illness and advises that you keep as many of your routines as practically possible. “If you can still take them to soccer practice, do it,” he says. “It’s very easy to let your world become all about the illness, but you need to make sure you still get out of the house and schedule family time to minimise the impact on other children.”
It’s also important to make time for your healthy children even if they don’t appear to be distressed, because sometimes their outward composure can just be a brave face. As an example, when a team of researchers interviewed a group of 7 to 12-year-olds to ask them how they felt about having a sick brother of sister, one child said, “I don’t cry at school but I cry into myself. When I go to my bedroom I have a big cry because my sister’s gone away to hospital, and then I can’t really see Mummy or [my sister] because Mummy’s gone to hospital with her.”
The researchers go on to highlight the complex balancing act of siblings as they battle their own emotional struggles while often trying to protect their parents by not communicating concerns.
It is therefore critical that parents maintain strong communication with their children throughout the illness and explain what is going on in language appropriate to the child’s age. “Explaining to kids that it is a stressful time for everyone and that changes will occur will help them be better prepared,” says Oglethorpe. She also emphasises the importance of regularly talking to older children about how they are feeling to help give a voice to their emotions and prevent these emotions coming out in other ways. “All kids need to feel loved, secure and cared for, so this needs to continue for healthy children as well,” she says.
Besides showing plenty of love and affection for your healthy children, another important predictor of how well a child will cope with their sibling’s illness is how well their parents cope. “Children take cues from their parents, so if the parents are coping, the children usually are,” says Gosschalk.
Nevertheless, Gosschalk recognises that in such an emotional time it may be difficult to always maintain composure, so if you find yourself crying in front of your children, he suggests saying something like “Mummy and daddy are just a little sad but we’re okay now." Seeing you managing the situation will give them comfort.
While dealing with the challenges of a sick child is difficult for any family, be reassured that healthy children can also go on to develop many positive attributes as a result. For instance, their early understanding of the fragility of life can increase compassion and empathy, while learning to deal with stress can help develop maturity and resilience.
Despite the silver lining, if your child falls ill you will undoubtedly find yourself in an incredibly stressful situation. You will be forced to constantly juggle priorities and won’t always get the balance right. In this case, Oglethorpe says sometimes the best thing is to just take a deep breath and try again tomorrow. She assures that so long as you remain conscious of the challenges faced by your healthy children, there is every chance that things will return to normal.
Emily McAuliffe is a Brisbane-based freelance writer and photographer. You can follow her on Twitter at @mcauliffe_emily or visit her website at www.emilymcauliffe.com.