The Silent Grief When Siblings Are Left Behind

Clinicians sometimes refer to siblings as the “forgotten mourners.” They are children themselves yet suddenly forced to navigate a world reshaped by illness, fear and death. Among the most common and least understood consequences of this bereavement is separation anxiety.

“Historically, siblings have been overlooked,” says Cat, ellenor’s Children’s Services Lead. “Even before a child dies, siblings are often passed from pillar to post while parents focus on treatment, hospital stays and survival. Then, after the death, the impact on siblings can suddenly become very visible.”

Fear of being left behind

Separation anxiety after sibling loss is more than clinginess. It can look like panic at the school gates, refusal to sleep alone or distress whenever a parent leaves the room. For children who have witnessed illness and death up close, the world no longer feels predictable or safe.

“They ask themselves questions adults rarely hear out loud,” explains Cat. “‘If my brother could die, could Mum or Dad die too?’ The worst has already happened once, so they struggle to trust that it won’t happen again.”

Even brief separations can feel unbearable. School drop offs become traumatic. Sleepovers feel impossible. Parents, already exhausted by grief, may find themselves unable to leave the house because their surviving child cannot bear to be apart from them. A painful cycle can develop, where the child’s anxiety feeds the parent’s exhaustion, and vice versa.

The Unseen Impact on Siblings

Research shows that bereaved siblings face higher risks of anxiety disorders, depression and difficulties at school, often long into adulthood. Yet tailored support for siblings remains inconsistent.

Part of the problem is visibility. Siblings are often there throughout a child’s illness, going to hospital appointments and seeing moments of distress, while their own worries and feelings are rarely noticed or spoken about.

“They see far more than we realise,” says Cat. “They may not understand what’s happening, but they feel the fear and tension around them. Without reassurance, that uncertainty can become frightening.”

There can also be complex emotions of resentment and guilt. Siblings may struggle with the attention their brother or sister receives, particularly when well-meaning adults treat the unwell child differently.

Children don’t understand fairness in the way adults do,” Cat explains. “They see one child receiving attention, gifts or special experiences, while they feel invisible. When their own grief goes unrecognised, those feelings can surface as anger, shame, or changes in behaviour.”

Supporting siblings through illness and loss

At ellenor, siblings are included in care wherever possible, from the moment a child is diagnosed. Support is shaped around each child’s age and understanding, through play, memory-making and gentle conversations that help them feel included rather than help them feel included and supported.

Involvement helps siblings feel they matter,” says Cat. “It helps them feel part of the journey, rather than feeling like powerless observers.”

After a death, the focus often shifts to helping siblings feel safe again in their everyday lives. Small, familiar experiences matter such as routines, school days, shared meals, and bedtime rituals that remind them the world is still steady.

“Separation anxiety comes from fear about what might happen next,” Cat explains. “Children feel reassured not by promises, but by seeing that everyday life keeps going.”

ellenor’s Children’s team offers counselling, sibling groups and therapeutic activities that allow children to express grief in their own way. Scrapbooks, photographs and shared memory making help preserve the bond with a brother or sister, while reinforcing a sense of continuity and safety, even after profound loss.

“We’re not trying to take the pain away,” says Cat. “We’re helping children learn how to live alongside it.”

How families can help

Experts recommend several approaches for parents supporting siblings struggling with separation anxiety:

• maintaining clear routines,
• encouraging small steps towards independence,
• answering questions honestly, even when the answers are difficult,
• and involving schools so that children feel safe outside the home.

Most importantly, anxiety should be recognised as a natural part of grief, not misbehaviour.

“Children aren’t being difficult when they cling,” says Cat. “They’re communicating fear. Patience and reassurance go a long way.”

Parents are encouraged to remember that what feels normal to adults living with serious illness can feel overwhelming and unfamiliar to children. Very few children experience the death of a sibling, and many do not yet have the words or support to make sense of it alone.

Separation anxiety, though painful, is also a sign of love. It reflects the depth of the sibling bond and the fear of losing it again.

“With the right support,” says Cat, “most children gradually rebuild trust in their world.

Their grief may be quiet, but it matters. And when it is recognised and supported, children can begin to feel safe again, one day at a time.”