Siblings and Hospital Days During Childhood Cancer

This page is for parents whose child has cancer and who also have other children at home. It covers what siblings go through, how to prepare them for hospital visits, and signs they need more help.

While one child is at the hospital, the other one is having a day too. It usually looks like this. An early wake-up at a grandparent's house. A ride to school from someone new. A vague answer at pickup about when Mom is coming home. Dinner in front of the television. Then a house that is either too quiet or full of adults talking in low voices.

NCI's guide for teens describes what siblings report from stretches like this. They include more time alone, more chores, more nights at a relative's house, falling behind in school, and pressure to be perfect so the parents have one less thing to worry about. Fear, guilt, anger, loneliness, embarrassment, and anxiety all show up, often mixed together.

Jealousy and feeling left out can show up too. NCI lists neglect and loneliness among the feelings siblings report. Naming these feelings out loud can help.

Children fill silence with guesses, and their guesses are worse than the truth. Two beliefs come up again and again: that cancer is catching, and that something they did or said caused it.

Ask directly what the child thinks is happening, rather than assuming. Children sometimes believe they caused the illness.

Then give clear, simple information that fits the child's age. NCI warns that untruths can make a child stop trusting you and the medical team, which costs far more later than an honest hard conversation costs now.

NCI advises regular conversations rather than rare big talks.

NCI advises including siblings in hospital visits when possible, or keeping in touch by video chat or phone.

Call the unit first and ask about its visitor rules. Ask whether a child life specialist is available. NCI says child life specialists help children cope with stress and difficult emotions.

Before you go, ask your care team what a visit will be like, and tell the child ahead of time what they will see and hear, including any changes in how the patient looks.

Routine is not a nicety here. NCI advises keeping things as normal as you can, and holding onto feeding and bedtime routines with infants in particular. NCI also advises keeping school and activities going.

NCI advises asking friends and neighbors for help so a sibling's routine stays steady.

NCI also gives a small, doable instruction for parents who feel stretched to nothing: set aside time every day with your other children, even if it is only a few minutes. A few minutes, reliably, beats a promised weekend that keeps getting canceled.

NCI advises keeping contact steady while the patient is in the hospital, through calls, texts, and visits. It also suggests shared time such as movies and games. NCI encourages siblings to keep friendships and activities that bring joy. Tell them out loud that having fun is allowed.

NCI says siblings may fall behind in school or take on too many chores. Consider telling teachers what is going on, and ask what practical changes could ease the load.

Sadness, anger, jealousy, guilt, and clinginess are expected. NCI lists creative outlets that can help, such as drawing, painting, music, gardening, photography, and journaling. NCI also points to sibling programs such as SuperSibs and hospital support groups.

Ask the care team for a referral if you see:

• Sadness that lasts for weeks (NCI advises professional mental health support).
• A drop in grades, or refusal to go to school.
• Withdrawal from friends the child used to enjoy.
• Any other lasting change that worries you.
• Any talk of not wanting to be alive.

Call or text 988, the Suicide and Crisis Lifeline, if a sibling of any age talks about wanting to die, about hurting themselves, or about the family being better off without them. Do not wait for the next clinic visit. 988 is for anyone in a mental health crisis, and it takes both calls and texts.

Also call your care team right away if a sibling suddenly cannot be left alone, stops eating, or says they feel responsible for the cancer. Ask whether a social worker or child life specialist can help.

For more on this, see Helping Siblings Cope and Talking to Your Child About Cancer. Parents running low should read Caring for Yourself as a Parent. Practical pages include Where Children with Cancer Are Treated, School 504 Plans During Childhood Cancer, and Helping a Child Take Medicine During Cancer Treatment.

• Support for Siblings When a Brother or Sister Has Cancer, National Cancer Institute
• Support for Families: Childhood Cancer, National Cancer Institute
• When Your Brother or Sister Has Cancer: A Guide for Teens, National Cancer Institute
• 988 Suicide & Crisis Lifeline, Substance Abuse and Mental Health Services Administration