Preparing your child for a sibling's surgery

Some children experience stress and anxiety when their brother or sister is preparing for surgery. The team at HCA HealthONE Rocky Mountain Children's at Presbyterian St. Luke's works to prepare the whole family for the surgery and make sure everyone involved feels comfortable and confident about the upcoming procedure.

For the siblings of young children having surgery, it's important to recognize the stresses and concerns they're experiencing. Siblings may feel afraid, worried or confused. They will also have to deal with being away from one or both parents, missing their siblings, or being away from home with different caregivers. Some common feelings siblings may have during this time include:

• Being Lonely - Siblings may miss having their brother or sister to play with, and their parents around to care for and comfort them.
• Being Left Alone - If siblings are not included in the conversation, they may feel ignored. Siblings may worry about who will take care of them. Who will feed them? Who will make sure they get to and from school? Who will make sure they are safe at home?
• Jealousy - Siblings often wish that they were the ones getting all the attention or presents from family and friends, and become resentful or jealous of their sibling.
• Guilt - Siblings may feel responsible for the hospitalization.
• Fear - They may think they can "catch" something from the sick sibling.

With the proper considerations and loving conversations, parents can help alleviate the concerns and emotions their children are feeling about their sibling's surgery.

Fortunately, there are several simple steps to helping children understand their sibling's surgery and the reasons for disruptions to their routine. Here are our recommendations for preparing siblings:

• Include siblings in conversations about the surgery in words they can understand.
• Make sure your children know why their sibling is having surgery.
• Keep care routines at home as normal as you can.
• Make sure siblings know who will be caring for them during the time you are away. Reassure them that these changes are temporary.
• Try to set aside time for you and your children at home so that they can get some special attention. Take extra time to notice good schoolwork or jobs done at home.
• Let the child at home know that it is acceptable to be afraid and to cry.
• Tell the truth when you answer your children's questions, however, keep in mind to use simple explanations your child can understand.
• Have your children at home draw pictures or make cards to send to the hospital. This can help them feel involved and helpful about the surgery.
• Make arrangements for alternative child care for siblings on the day of surgery, as siblings are not permitted in the recovery area.
• Set up times for your children to talk to each other on the phone or to visit (check with your Child Life Specialist about the possibility for a visit).
• Simplify your life as much as possible during this time, and don't be afraid to ask family and friends for help. Remaining positive and calm can help the entire family feel less stress about the upcoming surgery.

It's important to monitor your children and make sure they're coping well with the changes to their routine as a result of their brother or sister's surgery. Every child displays signs of stress differently, but some common signs that a child is under stress include:

• Eating changes (eating less than usual, eating more than usual, or being picky about what he or she will eat)
• Not wanting to talk or be with family members
• "Too Good" behavior or overcompensating for feelings of inadequacy
• Need for a lot of hugs and attention
• Doing things to get in trouble in order to get attention
• Saying they feel sick too

If your child is displaying these or other signs of stress or trouble coping, work to establish a sense of normalcy at home. You can ask your HCA HealthONE Rocky Mountain Children's at Presbyterian St. Luke's care team for more resources to reassure your child's siblings.

There are several resources to help your entire family prepare for the experience of a child's surgery, including:

When Molly was in the Hospital: A Book for Brothers and Sisters of Hospitalized Children by Debbie Duncan.

Let's Talk About When Someone You Love is in the Hospital by Marianne Johnson.