Anticipatory grief: learn the signs and how to deal with them

Grieving a loss that is expected but has not yet happened can be a unique challenge. Here’s how to identify and deal with anticipatory grief.

Sad for what’s to come

“My grief feels like fear,” says Anna Raway, 38, of Lakeville, Minnesota. In recent years, she has watched her beloved mother disappear into the haze of Alzheimer’s disease.

There is some sadness about what is happening now. Her normally patient and loving mother begins to have angry outbursts.

“She would say and do things that hurt my feelings, and I didn’t know how to deal with it,” Raway says. “Besides, she can’t remember a lot of things and that hurts too, because nobody wants to see their parents struggle like that. I cried a lot.”

But there’s another element to her grief, one she’s had a hard time identifying: a sense of deep grief not just for what’s happening now, but for what she knows is bound to come.

“Every time I call or visit, I’m afraid she won’t remember me or my family, she’ll feel lonely because she’s forgotten we visited, and I hate to see her suffer in confusion Because I know it’s only going to get worse until…’ she says.

Alzheimer’s disease lasts until death.

What is Anticipatory Grief?

How do you mourn someone who has not yet died but will soon?

There’s a name for the confusing, frustrating, scary feeling Raway describes — and it’s much more common than you might think, says Gail Trauco, a board-certified oncology nurse and licensed grief counselor who has helped hundreds of patients and their families go through this painful process. navigate .

Anticipatory grief is the process of grieving an expected future tragic event, often the death of a loved one from a terminal illness, explains Ashwini Lal, chief clinical psychologist at the Kaiser Permanente Bernard J. Tyson School of Medicine.

“It is uniquely painful in [that] that which is saddened still exists,” he says.

Grief comes from anticipating the loss, not the loss itself, and that can be confusing, says Abigail Nathanson, a licensed social worker, certified in palliative care, and professor of grief and trauma at New York University.

She adds that there are other ways to feel anticipatory grief. For example, a senior graduating from high school may experience a form of “senioritis” that mourns the imminent unofficial end of childhood and the transition to adulthood.

(Here’s how a young woman copes with anticipatory grief and loss after losing her husband to brain cancer.)

Signs of Anticipatory Grief

All grieving is a form of grieving, and the grieving process – although different for each person – generally follows a similar pattern. There are many different models of grief, but in general people can expect denial, anger, bargaining, depression, and acceptance.


Grieving in general isn’t as easy as it sounds, and when you add in the anticipation of grief, it can feel even more complicated, Nathanson says. People who suffer from this type of grief often feel more guilty.

Mixed feelings

“You can beat yourself up and think, ‘I should enjoy the time I have left with them.’ You may even feel like your grief is ‘giving up’ on your loved one,” Nathanson says. “There can be a lot of self-judgment in anticipatory grief.”


This kind of grief also comes with some uniquely difficult circumstances, Trauco says.

There are the practicalities of knowing someone will die that need to be taken care of, such as end-of-life planning, final wishes, property alienation, and physical adaptations. This can cause anxiety and stress, and it’s not uncommon to see an increase in family conflict during this time — all of which can intensify anticipatory grief, she says.

(Here’s how happy memories of loved ones make you healthier.)

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Symptoms of Anticipatory Grief

While some reactions in the grieving process are similar to general grief, anticipatory grief usually involves a greater risk of depression and anxiety, increased concern for the dying person, and attempts to adapt to the expected consequences of the death, Lal says.

Because of the stressful and sometimes long-lasting nature of this type of grief, you may experience some physical symptoms associated with chronic stress, including stomach problems, eating too much or too little, an increase in addictive behaviors, chest pain, and alcohol abuse, Trauco says. .

Dealing with Anticipatory Grief

“The purpose of sadness is not ‘How do I stop being sad?’ but ‘How do I wear this and still live my life in a meaningful way?’ says Nathanson.

There is no one “right” way to grieve, nor is there a recipe for getting through it. But there are some things that many people find helpful in the process, she says.

You name it

The first step to dealing with this type of grief is to be able to identify it for what it is, Nathanson says.

Knowing that you are grieving the expected loss will help you recognize the source of your feelings and understand them instead of pushing them away or telling yourself you shouldn’t feel that way.

If you feel bad about your negative feelings, you will only feel worse. Identifying your feelings and the cause can help you process them.

Allow yourself to feel it without judging it

“Understand that there is no quota for grief — grieving now doesn’t mean you’ll grieve less later,” Nathanson says.

You may feel guilty or uncomfortable at the thought of grieving someone who is still alive. But your experience is legitimate, and it’s important to acknowledge your sadness, Lal says, adding that feeling relief after someone dies is also normal.

Talk about it

One of the best ways to deal with any kind of grief is to talk about it with others who understand, Lal says. Often that is others close to the person you feel anticipatory grief about, but sometimes not always.

Friends who are more removed from the situation, hospices, and/or support group members are all wonderful people to talk to about your grief. Raway says she has found immense comfort in sharing her feelings with others.

Plan meaningful activities

Depending on the situation, such as how sick your loved one is, you can plan activities that you can do together to create fond memories during this time, Lal says.

Think of playing a favorite game, taking lots of photos, going on an adventure, keeping a diary and making video recordings together.

This type of grieving also offers some special benefits, Trauco says.

“Anticipative grief can be helpful in some ways because it motivates you to prepare for the loss, gives you time to say goodbye, and can lead to peace and a sense of determination and acceptance,” she says.

Take care of yourself

Eat a nutritious meal, take a walk outside, get enough sleep and take a warm bath. All the self-care tasks that were fun before become necessary when you grieve, Trauco says.

(You can also find comfort in quotes about pain and how to deal with it.)

Put it in perspective

Birth and death are the universal experiences of this life, and therefore each person must find a framework to deal with these great problems.

Many people find this perspective and meaning in religion or spirituality, but the most important thing is to find what feels right for you, Lal says.

Cultural or religious traditions can help with this. (Here’s what you can learn about grieving from the Day of the Dead.)

Practice Radical Acceptance

Much anticipatory grief stems from wishing things could be different and mourning the fact that they are not. However, you can hold both thoughts at the same time, allowing you to accept the heartbreaking situation for what it is while still acknowledging your feelings as valid, Nathanson says.

Go to a grief counselor

Grieving is a normal and expected part of life, but you can get stuck in the process. Grieving counselors are trained to help you navigate these complicated feelings and support you through the process.

Be patient with yourself

Grief can be intensely painful and you may want to speed up the process. Unfortunately, there’s no rush, and trying to force yourself to “get over it” can make healing even more difficult, Nathanson says.

Be patient and gentle with yourself in this time of anticipation.

“Grief is not a disease. It’s not a sign that something has gone wrong. It’s actually a sign that something is going well,” Nathanson says. “It’s a sign that you love them.”

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