Wednesday

When a Sibling is Sick: Helping Children Understand Cancer

People often ask us if Joey's brothers knew he was sick. Yes, they did. They also ask if they knew he was dying. Yes, and no. We never specifically told them he would die from his cancer. We did say that some people get better and some people don't and we hoped that Joey would get better.

Which was the truth.

They knew he was changing and getting sicker and not getting any better. Children are intuitive and observant. They know more than we think they know, but there are definitely ways to guide them and answer their questions when a sibling is diagnosed with cancer.



Tell the other children about their sibling's diagnosis as soon as possible.  I want to reiterate that children are clever and observant. They will know something is wrong. They might overhear a conversation or ask why you are taking their sibling to the doctor so much. You can talk as a family, or you can separate older siblings and younger in order to have age-appropriate conversations.

Know and share the facts. Speak honestly to your other children about what cancer is and what it is not. Use the word cancer. Explain that our bodies are made up of cells, and sometimes something happens to these cells to make them sick. Some of the sick cells get together and cause harm to the body, making a person sick. Assure them that every illness is not cancer; but be honest that some cancers are more serious than others. Make sure they know it is not contagious.

Be prepared for all the feelings. Children will likely have many conflicting emotions: fear, anxiety, anger, resentment, guilt, loneliness, and even jealousy. Reassure them that every one of those feelings is normal. If they are feeling guilty that they made their sibling sick by being mean or teasing them, tell them that it is not their fault. Doctors know what causes some cancer, but not others. Relieve some of their fear and anxiety by letting them know that it is okay to ask questions. And then be sure to give honest answers. Even "I don't know" is an honest answer and okay to give.

Let them know that it is okay to cry, but it is also okay to laugh and be happy and have fun. While something very sad and hard is happening to someone they love, good things are happening, too. Friends and pets make us laugh, we scored a goal at our soccer game, we aced a really hard test, or we got invited to a really fun party. Life goes on even though someone is sick. Our happiness can help make our sibling who is sick feel a little better sometimes, too.

Be realistic about what will happen next. The hair loss, the vomiting, weight loss or weight gain, and all of the time that their parent is spending with their sick sibling can be upsetting. Some anxiety and anger can be quelled by letting kids know what is coming.

Stick to a routine as much as possible. With so many things changing, children find routine comforting. Sticking to schedules, bedtimes, and family traditions as much as possible will help bring some normalcy during a time of upheaval. Do prepare children for changes to routines, though; especially if someone else will be picking them up from school or taking them to practices and lessons.

Let siblings help, but don't give them more responsibility than they are ready for or can handle. Provide simple opportunities like helping with chores or keeping a younger sibling occupied. Teenagers can run errands or cook basic meals. Siblings can also step in when Mom and Dad are tired and overwhelmed. Brothers and sisters often have bonds that are very unique. Perhaps they can get a smile out of the patient or be there during scary procedures to offer comfort. Siblings can do something nice like make a craft, pick flowers, or just talk about normal kid things for a break from all the cancer talk.

Be prepared to discuss death with your children. The sad fact is that one out of eight children with cancer will not survive their illness. Here are tips for talking to your child about death.

Get outside help. Sometimes, it's just too much and completely overwhelming, so it's okay to leave these conversations to the experts. Your child's hospital will have social workers trained in these types of discussions and can recommend grief counselors and services. Some helpful websites are CureSearch.org and Cancer.net

When a sibling is sick, you might see the other siblings misbehaving more frequently, clinging, regressing, being demanding, complaining of being sick, or having nightmares and trouble sleeping. This is all within the normal range of behavior.

When Joey was sick and right after he died, Knox had night terrors. He would sit up in his bed and cry uncontrollably. He wasn't awake, so nothing I said or did could calm him. I just had to sit by his bed until it was over and make sure he didn't hurt himself.

Children are going to have questions, fears, and concerns when a sibling is diagnosed with cancer. Arm yourself with straightforward and age-appropriate answers. Be patient. Try to spend a little extra time with the child who is not sick. Give lots of hugs and reassurance. Remember, they are going through this hard time, too. While adults have the ability to understand all facets of the cancer diagnosis, children experience a great deal of misunderstanding of how the disease will affect their sibling. Following these steps will help bring a little healing in the midst of sickness.















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