Hospitalization impacts the entire family. Brothers and sisters are affected when a sibling is in the hospital.  Parents may not be able to pay as much attention to the siblings while tending to the sick child.  Siblings also are usually concerned about the patient.  Some of the following behaviors may be displayed.

• Regression of recently learned skills (i.e. toilet training)
• Siblings may seem to act younger than normal (clingy, whining)
• Extremes in behavior (acting out, being "overly" good)

Things Parents can do to Help Siblings at Home:

• Arrange to have a familiar person be with the siblings when you are not able.
• Since you may be spending less time with the sibling, it is key to let that child know they are still important.  Set aside some time that is specifically for that child, this can be done in person or by phone.
• Remember to only make promises you have control over.  If you aren't sure about the patient's condition, let the sibling know that uncertainty exists.  Following through on promises is essential for trust formation.  Trust is a difficult thing to rebuild once it is broken.
• Encourage a routine as close to normal as possible.  The more consistency and familiarity the sibling is exposed to, the better chance they will cope positively.
• Maintain expectations for behavior and discipline style.  These are things that are familiar to the child, and help guide the child's behavior.
• Sometimes siblings worry about you returning, particularly if the patient is hospitalized a long distance from home.  It may be helpful to give the child something of yours to hold on to while you are gone, and then they can give it back to you when you return.
• Make a video or cassette tape of you reading a favorite bedtime story, singing a special song, or saying "I Love You!"  That way the child can listen to your voice when you are not able to be there.
• Leave notes around the home with messages from you.
• Mail letters home to siblings - kids love to get mail.

Ways to Help Siblings Feel Connected to the Patient:

• Encourage siblings to make pictures, cassette recordings, etc. to send to the patient.  These items can be put up in the patient's room.
• Arrange a time for the siblings to meet with a Child Life Specialist.
• Talk with siblings about the patient's routine, and the kind of things you may do at the hospital.  It is common for siblings to think that the patient is here "having fun" and "getting presents,"  and that the sibling is "not being included."
• Incorporate the patient into sibling play - "What would patients do or say."  Ask the sibling what they think happens at the hospital - this can be very enlightening!