What is Anticipatory Grief?  

Apr 27, 2021 | Emotional & Spiritual Help, Hospice

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Too often, we think grief follows death. But people can grieve before death as well. When people ask, “what is anticipatory grief?” they are referring to the fear, anxiety, and sadness they experience while coming to terms with impending loss. Not everyone suffers anticipatory grief. Some people do not even recognize it for what it is, which can have devastating consequences. Familiarizing yourself with its symptoms will help you find peace and support your loved ones as they deal with their approaching tragedy.   

What is Anticipatory Grief?

What is Anticipatory Grief: Shock, Sadness, & Guilt

Anticipatory grief moves through several stages. First is the initial shock. People can be angry, perhaps searching for someone to blame. Others may become tearful and despondent. Sometimes the news is so overwhelming, people go numb.  

Once they have had time to process the situation, they move to the second stage, which is more complex. The person can exhibit one or all the grief symptoms.  

  • Denial. Instead of acknowledging their family member and the dying process, the person searches for some shred of hope. They might insist on a second opinion, demand additional testing, or push for more aggressive treatment. Though well-intentioned, this usually makes the process more stressful for the patient and their family.  
  • Depression. The person becomes consumed by feelings of loneliness, fear, or worry. Occasionally, these emotions become so powerful they cause physical symptoms, such as nausea, headaches, or insomnia.  
  • Guilt. Common among caregivers. Looking after a terminally ill person can be exhausting. Caregivers are often on call 24-hours a day to administer medication, assist with basic tasks, and coordinate doctor’s appointments. Because of this, it is easy for them to feel overburdened. At the same time, many are ashamed to ask for time to themselves. After all, their loved one’s needs are so much greater.  
  • Anxiety & Insecurity. The person becomes concerned they are not doing enough or showing their loved one how much they care. These feelings are particularly strong if the person cannot talk to their loved one, either due to the illness or because the family has been forced to isolate. (Learn more about supporting families who cannot see their loved one).  

Finally, the person learns to accept the situation and make peace with their feelings. They might be able to do this on their own, but more often it requires help. 

Acceptance & Healing

Because no two people cope with loss the same way, it is not always easy to recognize when someone needs help. These difficulties are compounded with anticipatory grief. The person might be overwrought, stressed, debilitated, unable to go to work or get out of bed, and yet because their loved one is still alive, the people around them may not recognize the problem for what it is. Even people suffering anticipatory grief may refuse to discuss it, out of a misguided notion they must pack away their feelings because their loved one is sick.  

However, denying your feelings will not resolve them and might even make them worse. So, the first step is to stop hiding and acknowledge your emotions. Be honest with the people around you. Grief requires a support structure: friends, family, counselors, etc. If you do not know who to talk to, you can always reach out to the hospice and palliative care team. Their training will help you understand what anticipatory grief is. But whoever you turn too, it is important to talk through your feelings so you can come to terms with them.   

Finally, it is important to remember that there is nothing wrong with setting aside time to care for yourself. Exercise, pray, or indulge a hobby. Taking your mind off the situation will help break your emotional tension, so you have enough energy to care for your loved one when they need you.   

What is Anticipatory Grief?

Connecting With Your Loved One

Most answers to “what is anticipatory grief?” center on the individual, but they are also opportunities to bond. At its heart, grief is a struggle for closure. Generally, people alleviate feelings of loss by thinking back over old memories. However, with anticipatory grief, you have a chance to create new memories with the person before they pass.  

If they are mobile, go for a walk or a drive. Sit on the porch and watch the sunset together. Look through old photos. Play one of their favorite games. Discuss the pleasant experiences you shared. If they are no longer responsive, read to them. Hold their hand. Tell them you love them. Hearing is the last sense to leave a dying person, so even if they cannot reply, your words will still soothe them.  

Memories are a powerful source of comfort. They frame your experience and add depth to relationships. Taking time to create positive memories will make your loved one’s final days more meaningful.  

What is Anticipatory Grief?

Grief is complicated. It can begin even before a loved one dies and continue long after they pass. Everyone moves through it at a different pace, and it takes many different forms. Regardless, the best response is the same in all cases: patience, compassion, and sympathy.   

Remember that although your loved one may still be alive, their impending loss can be just as heart-wrenching as the loss itself. So do not be afraid to admit your feelings or ask for help. On the other hand, if you know someone dealing with a family member who is terminally ill, do not hesitate to reach out and offer comfort. Knowing they have someone to lean on can make all the difference.  

Anticipatory grief is what we feel when we imagine the death of someone close to us. If you are searching for ways to help, read our practical guide to caring for people who have lost a loved one.  

Jason Graham has been a hospice chaplain with Parentis Health since 2016. He has served churches throughout Orange County as a teaching pastor, outreach pastor, and senior pastor. He counsels hospice patients and their families, offering spiritual comfort and guidance. During the end-of-life process, he works closely with patients, encouraging them to explore their spiritual and emotional needs, as well as providing comfort to their families.  

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