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Erin Nicolas, MS, LPC, CPCS, RPT-S

When a child is first diagnosed with cancer, the parents’ focus is inevitably on getting their child the care and treatment needed. This focus continues through treatment and can last months or even years. It is the natural and logical focus for parents, and even siblings would agree that parents must attend to the sick child. Parents also do everything they can to ensure the siblings are taken care of. However, with doctor’s visits, hospital stays, and inevitable emergencies, siblings are bound to get less attention, and their own struggles to cope with their brother or sister’s illness may go unnoticed. To help siblings cope, it is helpful for parents to know how children process major life events in the first place.

Children cope with major life events in bits and pieces. Within a 20-minute period, they may go from crying with sadness to laughing hysterically at something they saw on TV. Children rarely sit around and ruminate on difficult topics. This behavior can seem erratic and even inappropriate at times, but it is what children do. Children also process through play, not words. It can be difficult to sit down and have a long conversation with your five-year-old about her sister’s battle with cancer, but playing with her will may allow you to convey information better and result in some level of understanding. Play is a child’s most natural and comfortable language, so we need to let them use it to process major changes. Lastly, children tend to focus more on how they are going to be affected by their sibling’s diagnosis rather than how others are affected. This isn’t selfishness. It is developmentally appropriate.

So how can you tell if your child is struggling with her sibling’s illness? Remember that children don’t often tell us their problems. They show us. The first sign that your child is struggling is behavior change. Some children act out to get attention while others may withdraw. Those who withdraw often do so because they don’t want to be more of a burden to their parents. Losing focus and dropping grades at school are also a sign of struggle as well as changes in sleeping and eating habits.

Children are easily affected by their environment so when life gets disrupted by something as big as cancer, children are disrupted as well. They mimic what is going on around them. Another sign of struggle is when your attempts to comfort them never seem to be enough. Lastly, children will often isolate themselves from friends or lose interest in things they used to enjoy.

Helping your children becomes the next challenge. It can be exhausting trying to find time for everyone when you are juggling medical care, work, and the needs of the family. Here are a few tips to help siblings get through this difficult time:

  • Keep the rules the same. There will always be exceptions and special circumstances, but consistency should be a priority.
  • Keep to your routine as consistent as possible. Bed times, homework routines, etc. need to stay the same whenever possible. Consistency makes life feel more stable and secure.
  • Be honest and age appropriate with the information that you share. Younger children obviously need less detailed information, but they do need to know how side effects may affect their sibling. For example, they need to know that treatments will make their sibling more tired and less likely to feel like playing. Allow them to ask questions and don’t be afraid to say “I don’t know.” Remind them regularly that cancer is no one’s fault.
  • Set up regular family meetings to check in. Keep the conversation open.
  • Play with them when you can.
  • Utilize choices whenever possible. Children feel more in control of their world when they are able to make choices, even choices as simple as what snack to pack for school.
  • Keep your kids in as many of their regular activities as possible. They need to know that it’s okay to still have fun.

Coping with cancer is never an easy task, especially when a child is the one who is suffering. Just remember, your whole family is in this together and all of your children need your attention more than anything else. So you may need to put off cleaning and laundry – or ask others to help so you can spend time with siblings.  They will be grateful for your love and hugs.