Death of a Sibling
Death of a Sibling
Sibling relationships are unique and may encompass shared history, family roles, traditions, conflict, caregiving, and expectations about growing older together.
Prevalence
Sibling loss affects a significant number of children and young adults in the United States.
Research estimates that approximately 5% to 7% of young adults experienced the death of a sibling during childhood, with longitudinal estimates suggesting that nearly 8% experience a sibling’s death by age 25.
When a sibling dies, grief may encompass not only the relationship with the person who died, but also changes in family roles, identity, daily life, relationships, and expectations for the future.
Sibling Grief Across the Lifespan
Grief is unique to each person and the impact of sibling loss may be shaped by age and developmental stage, the sibling relationship, family dynamics, culture, circumstances of the death, previous experiences with loss, and available support.
Children and adolescents are grieving as their understanding of death, identity, and relationships develops. Young adults may experience the death amid transitions in education, work, independence, and relationships. For adults, the death may mean losing someone connected to decades of shared history and family identity.
When a Child or Adolescent Loses a Sibling
Children and adolescents may not express grief in ways adults expect.
Grief may show up through emotions, questions, behavior, play, physical symptoms, or changes in functioning. Children may move in and out of grief quickly, while adolescents may alternate between seeking support and turning toward peers, activities, or greater independence.
Sibling loss may also raise questions about safety and mortality. Younger children may wonder whether they caused the death or whether someone else will die. Older children and adolescents may understand the permanence of death while grappling with questions about fairness, identity, meaning, or why their sibling died and they survived.
Healthcare professionals can practice grief-sensitive communication by providing clear, developmentally appropriate information, inviting questions, and recognizing that silence or a return to usual activities does not necessarily mean grief is absent.
This video from Child Bereavement UK offers practical guidance for talking with a child when their sibling is not expected to live, including following the child’s lead, addressing concerns, and identifying meaningful ways for them to remain involved.
When a Young Adult Loses a Sibling
Young adulthood often involves transitions in identity, independence, education, work, relationships, and plans for the future. Sibling loss can intersect with these changes and disrupt the future a young person imagined for themselves and their family.
Young adults may also be grieving while supporting parents, younger siblings, or other family members. Expectations that they are old enough to cope independently can make their own support needs less visible.
Grief-sensitive care can include attending to changes in coping and emotional well-being, creating opportunities for open communication, and recognizing when a grieving sibling may benefit from additional support.
When an Adult Loses a Sibling
For adults, the death of a sibling may mean losing someone who shares decades of family history, memories, relationships, and traditions.
The death can also shift family roles and responsibilities. A surviving sibling may become more involved in caring for aging parents, supporting nieces or nephews, managing family responsibilities, or maintaining traditions.
Grief-sensitive care considers the broader impact of sibling loss, including changes in physical, cognitive, and emotional health, family roles, caregiving responsibilities, and a person’s capacity to care for themselves while supporting others.
Grief May Resurface Over Time
The meaning of a sibling’s death may change as life unfolds.
Children and adolescents may revisit the loss as their understanding develops, and an experience understood one way in childhood may take on new meaning in adolescence or adulthood.
Grief may also become more noticeable around birthdays, holidays, graduations, weddings, births, anniversaries, family gatherings, or other milestones.
This does not necessarily mean someone is moving backward. It may reflect a new awareness of the sibling’s absence or experiences that can no longer be shared.
Siblings as “Forgotten Grievers”
Siblings are sometimes described as “forgotten grievers” because attention and concern may understandably center on parents or, in the case of adult siblings, the person’s partner, children, or other family members. As a result, siblings’ own grief experiences and support needs may be less visible.
“The night of Nate's memorial service, we had over 700 people there and I think maybe two people asked how I was doing. Everybody else asked how my parents were doing.’"
In this clip from Speaking Grief, courtesy of WPSU, bereaved sibling Megan Bolich, Cristina M. Chipriano, LCSW, FT, of Dougy Center, and Joyal Mulheron, founder and executive director of Evermore, discuss how surviving siblings can be overlooked.
Siblings may also take on roles that further obscure their own grief, such as supporting grieving parents, caring for other family members, or managing new responsibilities.
Grief-sensitive care recognizes siblings as grievers in their own right by acknowledging the significance of the sibling relationship and making space for their experiences and support needs.
Implications for Health and Well-Being
Grief can affect many aspects of health and functioning. Emotional responses may occur alongside changes in attention, memory, concentration, sleep, appetite, energy, pain, and other physical or cognitive experiences.
Research on sibling loss illustrates how these effects may intersect with healthcare. One longitudinal study of children ages 6–18 found increased illness and healthcare use, particularly during the first six months and around the one-year anniversary, although these patterns may reflect multiple factors and should not automatically be attributed to grief.
Grief-sensitive care considers the potential physical, cognitive, and emotional effects of grief alongside appropriate assessment of health concerns.
After learning of a death in the family, healthcare professionals can proactively ask about siblings, share information about ways grief may show up, and help connect siblings with additional support when needed.
Secondary Losses After the Death of a Sibling
The death is the primary loss, but siblings may also experience secondary losses: the additional losses and changes that follow.
For children and adolescents, these may include changes in caregivers’ availability, routines, family activities, friendships, school experiences, or stability at home. Their role within the family may also change, such as becoming the oldest or only child.
For young adults and adults, secondary losses may involve family roles and responsibilities, relationships, traditions, social connections, identity, and expectations for the future.
Sibling Grief Is Not Exclusive to Death
Grief can also be present in non-death losses, such as when a sibling experiences a serious illness, significant injury, disability, or another major change in health or functioning.
The sibling may still be physically present, while aspects of the relationship, family life, roles, routines, or expected future have changed.
Healthcare professionals can help by recognizing these changes as potential sources of grief and asking how they have affected siblings and family life.
Supporting Siblings Through Grief-Sensitive Care
Healthcare professionals can help ensure that siblings are acknowledged as people who are grieving in their own right. Grief-sensitive care begins with recognizing the sibling relationship and remaining curious about what the loss means to the individual.
Support may include:
- Acknowledging the sibling relationship and its significance
- Providing clear, developmentally appropriate information
- Inviting questions without requiring conversation
- Avoiding assumptions about the sibling relationship
- Recognizing emotional, behavioral, cognitive, physical, and functional responses to grief
- Asking about changes in roles, routines, relationships, and other secondary losses
- Recognizing grief related to significant non-death losses and changes
- Recognizing that grief may resurface as life circumstances change
- Connecting siblings and families with additional support when appropriate
Grief-sensitive care in the context of sibling loss means recognizing and attending to grieving siblings’ experiences and support needs, helping ensure they are not overlooked within the broader context of family grief.