Helping siblings with emergencies and hospital stays
Siblings of children with complex health needs may experience situations such as their brother or sister having seizures, losing consciousness, having difficulty breathing or choking on food. When a child who has a medical condition has an operation or an overnight in hospital, this can be really hard for siblings, especially if this happens regularly. Siblings cope better if you have a plan for dealing with the situation.
Support siblings with medical emergencies
- If you are able to stay calm and take practical action, this will help a sibling feel less anxious about what is happening.
- Make a plan of action so that siblings know what they are expected to do when this is happening.
- If a sibling feels scared about helping in any way or is worried that they are going to do the wrong thing, then it is better that they are not expected to help. If anything goes wrong siblings should not have to feel responsible.
- Give siblings accurate information about the medical situation and about what you will do to help their brother or sister. If it is a regular event like a seizure, take time to look at books about it with the sibling. Explain why it happens and reassure the sibling that it is not going to happen to them (assuming that is the case). Keep them updated on a regular basis, in particular if there are any changes.
- When the situation is under control again ask siblings how they are and if they want to talk about the event. Get back into ordinary family routines as soon as possible to help sibling feel secure.
Support siblings with hospital stays
Siblings miss their parent and their brother or sister when they are away. They may worry if their brother or sister is going to be OK. Siblings may be concerned about who is going to look after them when a parent is away. And it can be difficult for siblings when everyone is making a fuss of their brother or sister.
Prepare siblings before a hospital stay
Put dates on calendar
Talk about what is going to happen and when – mark the dates on a calendar – talk about what routines will be in place for her/him when you are away, and who will help to look after her/him. Ask if there are any things that are particularly important at that time – things at school or a friend’s birthday party. Reassure her/him that she can still do these things and that the carer (person looking after the sibling) will be told they are important and will make sure they happen.
Give matter of fact information
Children need matter of fact information about surgery or treatment – do a simple drawing to explain the treatment or surgery, explain about anaesthetic and pain relief after the operation, talk about how it will benefit his/her brother or sister, talk about some of the things that may happen in hospital. With very young children you can role play with a doll to explain the procedures. Include normal everyday procedures as well, such as having food and playing with toys, so that familiar things are included too.
Talk about worries
If he/she is worried, say that you feel concerned too, and that it is normal to feel concerned when someone needs treatment or an operation. Also let him/her know you have confidence in the doctors and nurses and that you trust them to take good care of her/his brother or sister. If he/she is worried about how his/her brother or sister will communicate, reassure her that you will talk to staff about your sick/disabled child’s needs. Get the sibling to write down some things he/she would like the staff to know and take it to the hospital with you. He/she needs to be kept involved in the process. If he/she asks ‘Will he feel pain?’, it is always best to be honest and say ‘He/she may feel some pain and then the nurses will give him/her medicine to make him/her feel comfortable’ If you say now there won’t be any pain and the siblings observes a brother or sister in pain, then he/she will lose her trust in you.
Involve sibling with packing
Get the sibling to help you pack some toys or clothes for his/her brother or sister for the stay in hospital. Ask the sibling to give you something to take that will help you think about the sibling when you are away – like a photo or small toy.
Liaise with the hospital
- Call the hospital and ask to speak to the hospital play staff to help you support your sibling child too
- Ask staff to leave activities out for a sibling when he/she visits the hospital, show him/her the special equipment, enable him/her to help her brother with something, show him/her where things are.
- Get him/her to draw a nice picture to bring in to put over brother/sister’s bed on admission day
- Show him/her where he/she will be getting a snack and a drink when he/she visits
- Ask sibling if he/she has anything he/she would like you to ask the doctors. Ask staff to answer siblings’ questions.
- Ask the staff if they have any literature for siblings about the hospital or about this type of treatment/operation
Talk to family, friends and school
- Ask relatives when they visit to make sure to bring something for a sibling too and to ask him/her about things at home/how he/she feels/ and to make a fuss of him/her
- Tell relatives not to ask a sibling to be good or to help mum when a brother or sister is in hospital – this is a tricky time for siblings and it is normal to get a temporary decline in behaviour. It is better to say ‘It must be really hard for you, with mum away and your brother/sister in hospital’
- Visit teachers and explain what is going to happen and request that a sibling is treated sensitively during this time – a sibling may not work as well, concentration may not be as good as usual, and a sibling may miss some school to visit hospital. Find out if there are any things coming up that you would like to be present at and make plans accordingly. Ask teachers to make sure there are no negative consequences in school as a result of a brother or sister being in hospital. Get them to keep a note of work covered so that you can go over it at a later date.
During the hospital stay
The most significant factor in sibling adjustment to hospital stays is the length of time away from the parent and brother or sister. Of all the things to do the most important is that a sibling gets to see you lots during this time. If the hospital is near make sure he/she sees you every day and if further away make the gaps as short as possible. The long term benefits will outweigh the inconvenience and expense. Things that will help are:
- Being able to leave the ward to do something with a sibling – sports day or a trip to the shops for a treat – ask other people to sit with your sick child
- Ask a sibling to write or draw things to bring to you when he/she visits – ask someone else to keep a diary of all he/she has been doing so that you can talk about these everyday things together. Siblings need to feel that these normal things are still important to you.
- Ask him/her to make a card for her brother/sister
- Give the sibling something from his/her brother or sister – a card or tiny gift – so that the giving goes both ways
- Being able to play with any toys that your sick child has access to
- Letting the sibling do helpful things for your sick child – like wipe his mouth or comb his hair(if the sibling would like to do this)
- If your sick child has to be in seclusion to prevent infection see the sibling can speak to him/her on the phone. Keep contact between the children going.
- Maintain usual limits – normal bedtimes, good eating, behaviour standards as before – if you are lax about these the child can feel that you don’t care enough about him/her to impose rules
- Having someone else to listen to the sibling and give him/her attention while you are away
- Role model getting help and support for yourself. Take time to look after yourself – if the sibling knows that you are coping and feeling OK about things – he/she will too. Talk through your concerns with friends/professionals, so that you have an outlet for your own worries.