Plan for hospital stays

Hospital stays are often stressful and worrying for all the family. Siblings find them very hard indeed. Siblings will cope best if well prepared in advance so that their emotional and physical needs can be met.

These are things you can do to make it easier for siblings

Inform siblings well in advance

• Explain plans for sibling's care and daily routines

• Mark the dates on a calendar

• Let him know who will be looking after him

• Find out if there are any events, like a friend's party, that she wants to take part in during this time

• Reassure her that you will ask the carer to make sure she can still do these things. Give your child choice about who cares for them.

• Let the sibling know about the times when you will be giving him your time and attention

Provide matter of fact information about surgery or treatment

• Do a simple drawing to explain the treatment or surgery

• Tell him about anaesthetics and pain relief after the operation,

• Explain why it is important for her brother to have this treatment or surgery

• Discuss the type of things that will happen each day in the 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.

Kids Health has a glossary of medical terms http://kidshealth.org/kid/word/

Ask him what he thinks about the hospital stay

• If she's worried tell her that it is normal to feel concerned when someone needs to go to hospital.

• Let him know that you trust the doctors and nurses to take really good care of his sister

• Ask her to write down some of things that the hospital staff should know about her sister – like how to communicate with her, what her favourite food is, ..

• 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.

• Acknowledge the sibling's feelings about missing you and being away from you. Young siblings can feel very upset and insecure about being separated from parents.

• 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

Just prior to the hospital stay

• 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

• Ask relatives when they visit to make sure to bring something for a sibling to do 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 or doing the sibling's bedtime routine if near enough – 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 – get 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 both children are happy with this)

• If your sick child has to be in seclusion to prevent infection see if 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

Your state of mind

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 worries.