Parentification of Siblings

When a child becomes seriously ill or has a disability, the family’s daily life often revolves entirely around that child. In this situation, a healthy sibling may take on a role that actually belongs to the parents. Experts call this “parentification” (from the Latin for “to make into a parent”)—a reversal of roles between child and parent.

There are two forms of this. In instrumental parentification, the child takes on practical tasks: they look after their sick sibling, take care of household chores, or organize things that adults would normally handle. In emotional parentification, the child becomes an emotional support—they comfort the mother, worry about the atmosphere at home, and try to keep everyone in good spirits.

A certain amount of responsibility is good for children. It becomes problematic, however, when the responsibility becomes too great for the sibling’s age over the long term and leaves little room for the child to live a normal childhood.

Children who have taken on parental roles rarely stand out because of disruptive behavior. They are often particularly well-adjusted, helpful, and “low-maintenance”—and that, in particular, can be a warning sign. Signs parents can look out for:

• The child seems unusually mature and serious for their age.
• They rarely express their own wishes and tend to withdraw or become quiet.
• They worry deeply about a sick sibling or their parents.
• They complain of fatigue, headaches, or stomachaches for no apparent reason.
• Their performance at school declines—or, conversely, the child overcompensates and strives for perfection in everything.
• The child shows feelings of guilt, sometimes even thinking they are partly to blame for the situation.

Suppressed anger is also part of this. Many siblings don’t dare to feel jealous or angry because, after all, the sick child “can’t help it.” These feelings are normal and should be allowed. Read more about this in the article on sibling rivalry under stress.

Sibling parentification almost never happens on purpose. When a child is seriously ill, the parents’ energy understandably goes where it’s needed most at that moment. The healthy child is inadvertently sidelined—and often steps in on their own because they sense the worry at home and want to help.

Children are sensitive. They notice when their parents are exhausted, and many then try not to be an additional burden. As a result, they take on responsibilities and show consideration that exceed their capabilities. Experts also describe children with ongoing caregiving responsibilities as “young carers”: Estimates for Germany suggest that several hundred thousand minors regularly help care for a sick family member.

It’s important to know: The fact that a child takes on responsibility at an early age says nothing about the parents’ love or effort. It is an understandable reaction of the entire family system to a major strain. However, if the child remains overwhelmed, this can lead to sibling burnout.

Even small changes can make a big difference. Above all, it helps to show the child: You’re allowed to be a child, and you’re just as important.

• Give them exclusive time. Regular, reliable moments spent just with their sibling—even if they’re brief—provide a sense of security.
• Keep tasks age-appropriate. A little help is fine, but long-term caregiving or responsibility isn’t.
• Allow all feelings. Anger, jealousy, and sadness can be expressed without the child feeling guilty.
• Explain things honestly and in an age-appropriate way. Children are less burdened by what they understand than by what they suspect.
• Make sure you have your own space. Friends, hobbies, and free time aren’t a luxury—they’re a form of protection.

Parents’ self-care is just as important. When parents accept support for themselves, they relieve pressure on the entire system—and the child has less to shoulder. External resources such as sibling workshops, support groups, or family support services can provide tangible help.

Professional support is advisable if the stress persists: if the child becomes very withdrawn, seems depressed for weeks on end, experiences a significant decline in school performance, has trouble sleeping, or exhibits unexplained physical symptoms. Even if you, as parents, simply feel that your healthy child is being neglected, that is reason enough to seek advice.

Resources include parenting and family counseling centers, specialized sibling support programs, self-help organizations, and social services at hospitals. Many of these services are free and specifically tailored to the siblings of sick children.

Rückenwind This service is intended to provide support and coaching for families, not as a substitute for diagnosis or therapy. Janike is a social worker and parent coach currently training to become a child and adolescent psychotherapist and does not make diagnoses. If you suspect that your child is experiencing serious emotional distress, the evaluation should be conducted exclusively by a child and adolescent psychiatry (KJP) specialist or a medical or psychotherapeutic professional.