Escape behaviors such as reading for hours, spending inordinate amounts of time alone in his/her room, taking long walks, or plugging in a headset is a means to get away from the demands of being a caregiver. Although not necessarily a negative behavior as it provides the child with an outlet, it can be detrimental if it adversely affects the child’s ability to relate to others or interferes with concrete interactions. Since feelings of isolation can already be present in the situation, self-isolating behaviors may reinforce the feelings of being alone and can potentially lead to significant depression, which compounds the already-present feelings of loss. Most children get through what usually amounts to a brief time of caregiving without lasting, negative effects. Generally resilient, most children adjust adequately to the temporary life change and go on without residual problems. It is important, however, to recognize that children grieve, too, and that grief is not limited to death and divorce; life changes of every kind can elicit a grief response, which is just as powerful in children as in adults, and is generally less understood. Like adults, children grieve in their own ways. Many of the emotional and physical changes that are seen as attributed to adjustment problems or reactions to being a child caregiver are, in fact, indicators of grief. Being unable to effectively express these feelings, or lacking the ability to understand what they are feeling, increases the frustration and isolation.

Former child caregivers have related that once they reached adulthood, they found themselves sometimes emulating caregiving in their personal and professional relationships. Many that I interviewed chose helping professions such as nursing, Teaching or social work. This is consistent with the personality traits required of a caregiver of any age. Knowing the effects of caregiving on a child, we can better understand how to help our children cope with the intense feelings associated with living with someone else’s illness or disability.

First and foremost, communicate with the child. They need to know that they are not responsible for the adult’s or sibling’s condition. Guilt plays a significant role in a child’s desire to step into the caregiving role. Providing simple and understandable information about the condition, and answering their questions, goes a long way to resolving guilt feelings, as well as easing fear based on the “unknown.” Scott said that though he sometimes was afraid that his mother would die, he did not share his feelings with Joel. He explained,”I don’t want him to worry any more than he already does.” Scott was dealing with the “unknown,” while protecting his brother from it; however, he didn’t realize that Joel was doing the same thing. It is OK to talk about the illness or disability, but don’t make it dinner time conversation every day. Children are very aware of changes in their environment and usually know, without being told, that something is “wrong.” Talking about every ache and pain only reinforces that the parent needs “help,” and further engages the child into the caregiving mode. Instead, talk about everyday things. This reassures the child that the life they know is still going to go on, despite the change in health of their family member.

Second, though it is often easy to accept the help of others when we are ill, it is vital for children in this type of household to have the adult remain as independent as possible, and that they rely on available adult help. This diminishes the role-conflict that can arise when children take on adult responsibilities. Utilize the children in performing age-appropriate tasks, such as folding their own clothes, feeding pets, taking out the trash or loading the dishwasher, and save the more adult responsibilities, such as medication administration, dressing changes, and providing personal hygiene, for the adult caregivers. Utilize outside resources to supplement in-home care to keep child caregiving to a minimum.