Adopting or fostering a child is a big adjustment for any family, but that adjustment is exacerbated when the foster child has complex medical needs. Foster parents usually receive specialized training to address their child’s unique health requirements, but what happens when the parents aren’t around to treat them?
The responsibility often falls to foster siblings, and despite the integral role they play in caregiving and companionship, they’re overlooked during the formal training process.
BYU College of Nursing professor Dr. Christine Platt, who's had more than 20 foster children come through her own home, recognizes this gap in support. She emphasized the need for additional attention on sibling caregivers: “Everyone assumes foster parents must attend mandatory training,” she explained, “but child advocates and healthcare workers tend to forget about the other children in the home. We’re not giving [those] children an opportunity to ask questions or be supported.”
Motivated by the belief that the whole foster family should be adequately trained, the BYU Family Compassion and Care Lab led by Dr. Platt set out to measure the extent to which siblings care for their foster brothers and sisters. The goal was to quanitify the impact siblings can have on their foster sibling’s’ health and ultimately use the findings to advocate for broader training initiatives that include all family members.
The team performed several studies to better understand the effects of full-family training. In one study, 95 licensed foster families were randomly divided into two groups. One group received additional, full-family intervention training, and the other only received the standard training geared toward the primary caregiver.
A key outcome they tested for was “Family Hardiness,” a measure of how well a family responds to challenges and stressors. The study found that families who received the more inclusive training had higher Hardiness scores, indicating a stronger bond between all involved: the parents, siblings, and foster child.
In a different study, the team surveyed families to determine how much siblings contributed to daily care. Observing the results, the team found that the care provided went far beyond checking a temperature or adjusting medication. One surveyed sibling was reportedly managing their brother’s feeding tube, and another was even entrusted with performing oxygen titration for their sibling!
The team concluded that foster siblings were indeed playing a vital but often invisible role in care.
“It was interesting to see how many of [the foster siblings] downplayed their role. In reality, they were involved in protecting their siblings, helping them get to school, and [taking care] of them.
Put simply, the studies point to a pressing need for more full-family training. The analysis underscored a protective sibling relationship between foster child and sibling, and the data generally highlighted better communication and stronger bonds within families that were given additional training.
The team's research is some of the first of its kind. The work was published in several journals (see below) and even presented at the International Nursing Congress in Singapore!
Dr. Platt anticipates that their work will catalyze change in practice, ensuring that foster siblings are adequately supported to thrive in their role as caregivers. In doing so, families will be better equipped to manage chronic illnesses, disabilities, and other complex medical conditions. Furthermore, the familial bond will be strengthened in the process.
The Family Compassion and Care team will continue working to make life better for foster children and families one project at a time. The full paper published by the team can be viewed here.