Ten-year-old Alexis Thompson sometimes tells her parents that the house would be a lot cleaner if only she had a little help with the chores. Take the dishes, for example. “Alexis has trouble believing that a simple task like washing dishes can be too difficult for older sister, Victoria, 12, who has lupus,” says their mom, Kimberly.

In Paducah, Ky., the Harbin family struggles with the occasions when Taylor, 17, has a flare from his polyarticular JRA, causing him and his mother to miss his younger brother Jordan’s basketball game. “We have to work hard to make sure Taylor doesn’t feel guilty for missing the game, and that Jordan doesn’t get the impression he isn’t as important,” says Mary Harbin.

Those are just some of the issues that siblings and their parents deal with when a child in the family has arthritis. Siblings of children with a chronic illness often experience the full gamut of emotions – from guilt and resentment to anger, loneliness and a feeling they never get enough attention. But, experts say, with a little effort and creativity, the family can work through these issues – and even come out stronger as a result.

Staying Positive Together

According to a study published in the Journal of Developmental and Behavioral Pediatrics in 2006, healthy siblings of chronically ill children can be at greater risk for psychological and behavioral problems. But family attitudes played a big role in who had these problems and who didn’t, says Pamela Degotardi, PhD, a psychologist and professor at Queens College in New York City and member of the executive committee of the Association of Rheumatology Health Professionals.

“Kids and their families who had a ‘poor me’ attitude didn’t do very well,” she says. “They were the families who had adjustment problems.” 

One key to warding off ill will is keeping everyone involved. It can be tough to be the brother or sister of a child who has a chronic illness and who requires extra support from the rest of the family. 

“Siblings often feel resentful of all the attention their brothers and sisters get, and because they are asked to do more chores and carry more of the load,” Degotardi says. Make sure all the children have a say in family plans, and try to spread out the chores among all family members, choosing tasks that your child with arthritis can handle successfully.

Changes Bring New Challenges

Long before most families reach the point of deciding who's going to do what chores comes the arthritis diagnosis, and it makes an immediate impact. Routines are quickly altered to fit in doctor’s appointments, therapy sessions and time to take medications. 

“It’s natural and essential, especially with the initial diagnosis, for the family to focus attention on the child with special needs,” says Joanna H. Fanos, PhD, assistant research professor in the Department of Pediatrics at Dartmouth Medical School and director of the Sibling Center at California Pacific Medical Center. “Yet you want all children to feel loved and loveable. There’s a real danger of that not happening if they don’t get a lot of time and attention.”