Children's Hospital

Child Life

Preparing Siblings for Visiting in Hospital

Questions to consider before a visit:

What are the ages of the visiting children?
What do they know about the hospitalization? What do you think they understand?
How does your child usually handle stress?
What do you think your children's fantasies are of what their sibling is like right now? Which do you think is worse -- their fantasies or reality?
How did your children learn that their sibling was hospitalized?

Developmental Considerations:

Children's developmental levels influence how they understand and process events and information. The following section includes information about thoughts, fears, and feelings common in children of various ages, as well as possible responses of interventions to address these developmental needs.

Preschool Children

Believe that their thoughts, actions or wishes caused the accident or illness.
- Learn from children what they believe made their sibling sick or injured, then address any potential issues…"Lots of children think that, but it rarely happens that way."
Fear that this will happen to them.
- Reassure them that this will not happen to them, if that is accurate. If the patient was involved in a trauma, ask the child what can be done to prevent that sort of accident.
Feel anger and/or see a sense of abandonment with separation from parents during stressful times. They may believe that they deserve punishment or that further abandonment will result.
- Acknowledge and accept their feelings…"If you were in the hospital, where do you think your parents would be? What do you think your parents would do?"
Believe that staff members are hurting their sibling.
- Say, "The nurses and doctors job is to help stop the hurting, or keep it from getting worse." "Here is how the nurse and doctor help…"
Have a weak understand of internal bodies.
- Use illustrations or children's anatomy books. Ask the children to draw what they think or imagine.
Explanations of their siblings illness or injury may have nothing to do with reality.
- Provide honest, accurate information, updating as necessary due to changes in patients condition or due to sibling needs.

School-Age Children

Wonder if something they did caused the illness or injury. "If I had done something differently, this wouldn't have happened.
- Ask "What makes you think that?" Explain, “Lots of children think that, but it rarely happens that way." Give concrete examples: "If you wished this object to fall, could you make it happen?"
Worry, "Can I catch it?" and may not want to touch or go near the patient.
- Ask, "Do you think that you can catch this from touching?" Explain, "We wouldn't let you touch him or her if that would happen."
Wonder, "Will the patient be the same?"
- Possible responses:
  - Probably, we hope so.
  - He/ she need lot of help to get better.
  - It may take a long time.
  - We are not sure that all of the parts of her/ her body will work the same way. We can hope that they will.

Adolescents

Are likely to have a sense that they are being watched
- Provide privacy as appropriate. Ask if they prefer to be alone or have family staff close by.
May talk in medical jargon without fully understanding meanings.
- Ask what they understand about what is going on. Reassure them that there are adults who don’t understand many parts. Ask, "What does that mean to you?"

Preparation

When possible, use a Polaroid photograph to aid in preparing children for what they will see and experience at bedside. Briefly describe medical equipment that children will see and/ or hear.

Suggestions for Explaining Medical Equipment to Children

IV -- Medicine that works best when it goes right Into the Vein. The quickest way to help someone get medicine.
Restraints -- "Until she is more awake, these will help make sure that she doesn’t grab or pull a tube by accident."
NG tube -- Like a very soft straw that goes down her throat to her stomach; to help her stomach stay empty and resting while her body is working to get better; or to give her body tiny bits of food a drip at a time, so her body won’t have to work hard.
Ventilator/ Respirator -- Helps him/her get enough air in and out; helps her take good, deep breaths and get plenty of air while she is asleep or very sore or while her body is working to get better.
N.P.O. - nothing to eat
Electrodes, leads - Like Band-Aids with strings that go to the machine. A soft jelly-like medicine can feel exactly how a heart is beating and turn it into a picture on the monitor screen.
Foley bag - To collect and measure pee (use family term). Inside him/her there is a very soft, small tube that helps the "pee" come out. The tiny soft tube connects to the bigger tube that you see.

Additional Resources

Jessica's X-Ray by Pat Zonta. (school age)
A Trip to the Hospital by Kim Watson. (preschool, school age)
Cooper gets a CT Scan by Karen Olson. (preschool, school age)
Going to the Hospital by Fred Rogers. (toddler, preschool)
A Visit to the Sesame Street Hospital by Deborah Hautzig. (toddler, preschool)
Franklin Goes to the Hospital by Paulette Bourgeois. (toddler, preschool)
Let's Talk About Going to the Hospital by M. Johnson. (preschool)
Why Am I Going to the Hospital? By Claire Ciliotta. (preschool, school age)
Maggie and the Emergency Room by Martine Davison. (preschool, school age)
Helping Children to Overcome Fear by Russell Evans (school age) (teens)

This page was last updated on: May 10, 2011.

For more information about UMCH or to make an appointment, please call 1-866-408-6885 (patients) or 1-800-373-4111 (physicians).