The psychosocial professionals at the burns service where you child is treated can help siblings who are distressed by what has happened to their brother or sister. Please contact them if you have any concerns.
Children can feel anxious when they are separated from siblings and their parents. Depending on the age of the siblings, they may be concerned about whether they had a role in the separation, or whether their parents or sibling will come back. It is OK to tell them about the injury and the need for the hospital stay. Provide as much honest information as they can comprehend. It is also important to give them the opportunity to ask questions and express their feelings.
When siblings have been separated from their injured brother or sister, it is also important to prepare them for what they will see when they are reunited, whether this is their bandages and dressings, wounds, or scarring. Siblings might be unsure of how to deal with a brother or sister who looks different. The team at the burns service where your child is treated can be really helpful in preparing siblings to see their brother or sister in hospital.
Non-injured adolescents might ask to stay at home or with friends when you are in the hospital with their brother or sister. They can rely on the emotional support they get from their friends as much as that which they get from their parents. Giving them the freedom to switch back and forth between friends and home can be helpful to them. Speak to them as often as you can by phone.
When parents focus on the injured child, siblings can feel uncared for and unimportant. They can feel angry with the injured child and, at the same time, they can feel guilty for this. The intention of parents might be to protect uninjured siblings from unnecessary burden, but it is important to involve them as much as possible in discussions about what is happening, what is going to happen next, and what might happen in the future. A consequence of not doing this is that siblings feel excluded from family activities.
For this reason, it is important to maintain contact with children and include them as much as you can in decisions about changes to routines and roles. This can be of particular relevance if the injured child has to return to hospital later for further treatment.
People are likely to bring the injured child presents following their injury because they want to help them feel better. This can be hard for the siblings who can feel like they are overlooked. It can be helpful to remind visitors of this because siblings are also likely to have been upset by the injury.
Some siblings might try to keep a low profile to avoid causing further problems, whilst others might act out to gain attention and distract the family from the injured child. Therefore, it is essential that you communicate effectively with siblings and include them as part of the process of family adjustment following a burn injury.
The physical and emotional healing after a burn injury can be a lengthy process. Therefore, it is important that siblings have all of the information that they need and are not overlooked. You can always ask for help and advice with this from the burn service where you child was treated.
During the separation, the remaining parent/caregiver should try to keep the routine as normal as possible.
It can be useful to keep track of time using a calendar so that siblings are reminded when they should expect their parent(s) and brother or sister home again.
If there are any unanticipated changes then these should be communicated to siblings. A child is less likely to be upset by what they are told, than by their own interpretation of what has happened to their family.
Parent(s) spending time at the hospital should make it clear to siblings at home that they trust the person who is taking care of them, and that this person is in charge.
It is important to talk about what will change and what will go on as usual, how you will keep in touch, and whether they will have any additional responsibilities.
It is also important to ask whether there is anything special that they would like to do with you and their brother or sister before they are separated.
If siblings are going to be visiting their brother or sister in the hospital, prepare them for what they will see and how long they will be able to stay. For example, explain that their sibling might not look the way they remember. This could be because the injury or bandages make them look puffy, or because they will be lying down in the hospital bed and may have tubes or wires attached to them. There may also be noisy equipment in the room and many doctors and nurses taking care of them. It is also important to explain whether their sibling will be able to talk to them or not, and that, even if their sibling is asleep, they can still talk quietly to them if they want to.
A useful workbook for children preparing to visit a family member in hospital can be downloaded here.
This is particularly relevant if the injured child has to return to hospital later for further treatment.
When one child and/or a caregiver are going to be away for a period of time, it is a good idea to tell the siblings as far in advance as possible. This allows for the discussion about what is going to happen to take place several times before the separation occurs. This gives siblings time to understand that their parent and/or brother or sister will be leaving, to picture where they will be, and to anticipate what will be different whilst they are gone.
A useful workbook for children preparing to visit a family member in hospital can be downloaded here.
