When a family has a sick child, other siblings are often forgotten as focus shifts to the sick child.
It is the responsibility of palliative care givers to offer support to all family members through this trying moments.
In most cases, siblings have to offer support to their parents as well as to the sick child, a situation that leaves them traumatized especially when it comes to an end of life situation.
Speaking during a recently concluded pediatric palliative care training in Nairobi, the International Information Officer at International Children’s Palliative Care Network (ICPCN), Sue Boucher said siblings of a sick child may exhibit signs of irritability, anxiety, social withdrawal and start underachieving academically.
Boucher said that these are psychological reactions to the situation at hand, which call for support from palliative care givers.
She said that it is important to know that these feeling are normal and the siblings should be brought to a similar understanding.
Children should be treated equally taking into account the needs of the dying child and the palliative care giver should spend periods of time alone with the siblings.
If in hospital with the sick child, Boucher recommended that a palliative care giver should be in contact with the siblings, and keep them up to date with the developments of their sick brother or sister.
“Fear of the unknown is always greater than fear of the known and this can easily be done away with by constant communication.” She said.
After occurrence of death, the choice of viewing of the body should be entirely left to the siblings.
They may change their minds after sometime, so, it is important that you keep offering the option as this may help the child to begin saying goodbye.
It will also help the siblings to accept the reality and finality of death as well as understand what has happened. This will make them less scared of the situation.
It is necessary to give them clear and detailed information on what has happened as any gap may lead to lack of comprehension of the whole occurrence.
Other than making siblings understand that they are welcome to attend a funeral of their beloved brother or sister, there is need to assure them that it is the body of the person who has died that is being buried/cremated.
“Create opportunities for them to be involved so as to feel part of saying goodbye to their loved one.” Boucher said.
She added that it is necessary to prepare them for some of the things that adults who have no understanding of their may say to them as they have a negative impact in their subsequent life.
Busi Nkosi, an advocacy officer at ICPCN says it is necessary to have a deep understanding of the family you are helping, either by use of a genogram.
Nkosi says this will help know the challenges that face the siblings and the family at large as a result of the loss of a loved one.
“By understanding where each member falls in the family tree, palliative care providers will have a deeper understanding of the needs of the family.” Nkosi says.
Dr Jeremy Omondi, a pediatrician at Siaya District Hospital who was one of the participants in the training, says that children are sincere and they do not pretend and if the siblings fall in this category, offering bereavement support ought to be an easy task for pediatric palliative care providers.