Sibling involvement at the end of life.

When a child is diagnosed with a life-threatening illness, such as cancer, there is much disruption to the family. It is a struggle for parents to divide their time between the hospital, home, and other healthy siblings. Nurses strive to provide family-centered care, which involves siblings in many stages of the treatment process. However, during the terminal phase of a child's disease, the dying child and the parents are often the sole focus of the health care team. Siblings are often left to stay with extended family members or friends so that they are protected from the reality of death. However, previous research has shown that even young children understand death, and some of the protective measures parents take actually hamper the siblings'bereavement process. Nurses are in a position to guide families through the emotional time of a child's death while advocating for sibling involvement at a level appropriate for their developmental stage.