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The Elizabeth A. MacDonald Charitable Foundation (eamf) educates and informs parents and families, healthcare professionals, schools, and community organizations about the sibling situation that inevitably happens when a brother or sister is battling a health crisis.  Reactions to this situation can manifest itself in many ways, including:

  • Physical ailments such as stomachaches and headaches can develop in siblings.

  • Mental health issues can arise, such as anxiety and excessive worrying.

  • Behavioral problems can develop.

  • Sleeping and eating patterns can change.

  • Schoolwork can be affected and grades can plummet.

  • Schedules are interrupted, and can prevent siblings from participating in their regular activities and socializing with their friends.

  • Siblings can become withdrawn from their friends and family, and relationships can suffer.

  • If siblings are adolescents or teens, they can take on more responsibility at home than is appropriate.


The most useful and practical recommendations eamf makes:

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For Parents

  • Spend some alone time with the sibling (i.e., an errand to the grocery store, going for an ice cream cone, to the park, or to a movie.)
  • If that's not possible, make a promise to the siblings that alone time will happen the following week and honor that promise.
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For Healthcare Professionals

  • Increase open communication to facilitate positive coping in siblings.
  • Provide opportunities for siblings to ask questions.
  • Respond with honest, age appropriate answers.  Use the third person technique, “Lots of kids think…”
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For Schools and Community Organizations

  • Pay attention to warning signs in children (i.e., changes in behaviors, attitudes, grades, or attendance).
  • Communicate openly with parents.  Be understanding of and empathetic toward siblings who are struggling through their daily tasks and routines while their family unit is being restructured around their brother or sister who is critically ill.

(courtesy of Akron Children’s Hospital Pediatric Palliative Care Curriculum)