Anticipatory Grief

Many people typically think of grief as occurring after the loss, but grief often begins before an actual death. This is known as anticipatory grief, which is the period of approaching death of oneself or their loved one. An example of this involves terminal illness such as end-stage cancer. This post will focus on anticipatory grief experienced by a loved one of a dying patient, although patients can also experience intense grief themselves. When a terminal diagnosis is given, grieving impending loss may occur. The family of a dying patient may begin to imagine what life will be like without their loved one. This is a completely normal phenomenon, though many people may wonder why they are already grieving and even feel guilty for grieving someone who is still alive. Anticipatory grief is not as socially accepted as traditional grief, so it is often ignored. As one’s loved one is dying, there may be a struggle to balance between the two worlds of being present and beginning to let go. Nonetheless, dealing with anticipatory grief can offer opportunities for closure, which can relieve some of the tension in the grief process. In this sense, there are ways to heal relationship ruptures and offer some sense of peace to all members involved. For the person who is dying, this can give them an opportunity to do a life review and have time to look back at what they have done throughout their life. They can share these memories with love ones. Anticipatory grief allows room for completing unfinished business. Examples of this include: asking for and giving forgiveness, saying thank you and goodbye. 

The common symptoms of anticipatory grief are similar to normal grief such as anger, anxiety, forgetfulness, and depression. However, there may also be other complex emotions and thoughts that arise, such as fear of the death and dying process. Watching our loved one suffer can cause trauma symptoms, provoke anxiety, and be physically and emotionally exhausting. It is important to be informed of the dying process and what to expect as well as utilize available resources and support systems.

Here are some things to consider when dealing with anticipatory grief: 

• Anticipatory grief is normal
• Take care of yourself, physically and emotionally
• Communicate/express your feelings
• Make your time together meaningful
• Get the support you need from friends, family and/or a support group
• Seek grief counseling if you feel you need the support

If grief interferes with your ability to cope and overall functioning, seeing a bereavement counselor may be beneficial. 

Here at HNC, we provide anticipatory grief counseling for families of patients on our hospice and palliative services.

Sources: 

Grieving Before A Death: Understanding Anticipatory Grief. (n.d.). Retrieved from https://whatsyourgrief.com/anticipatory-grief/

Eldridge, L. (2019, July 11). Why Am I Already Grieving When My Loved One Is Alive? Retrieved from https://www.verywellhealth.com/understanding-anticipatory-grief-and-symptoms-2248855

Caitlin Mikulicich, MA
Bereavement Counselor Intern

Angeline Baucom
Bereavement Counselor Intern