Anticipatory Grief

Grieving the Loss of a Loved One Long Before They're Gone

Anticipatory grief is common among caregivers and family members of people suffering from Alzheimer’s disease, cancer, and other terminal illnesses. It's real and valid. You may feel that the person you knew is already gone, even if they are still physically there. When your loved one has a decline in physical health or mobility, you may feel anticipatory grief as you lose the opportunity to share life experiences. Learn more about anticipatory grief below and find ways to cope with it.

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Anticipatory grief can also be called preparatory grief. While grief after the death of loved one is described as a range of emotions, this type of grief can be more uneven because it is mixed with hope that your loved one may live even longer than expected. Holding out hope for what still could be can cause the range of emotions to widen.


Emotional Symptoms of Anticipatory Grief:

Depression and Sadness about the situation and changes in your loved one's appearance or personality

Fear and Anxiety about the future

Concern about your loved one, their physical health, and their emotional wellness

Anger at the illness, the situation, or even the ill person

Guilt about thoughts, feelings, or actions related to the situation. Many people feel intense guilt before their loved one’s death. For instance, you may wish for the person’s suffering to end, which would also mean their life would end. You may feel guilty that your life will go on after their death – a feeling called “survivor's guilt.” Or you may have guilt over past behavior or conflicts involving your loved one. You may also have guilt that you can still enjoy things your loved one cannot.

Numbness or Detachment from the situation or person who is ill

Mood Swings and emotional highs and lows

Disbelief that the loss will actually happen


Stages of Anticipatory Grief:

  1. Challenging to accept the reality of the situation
  2. Experiencing intense and fluctuating emotions
  3. Preoccupation with the current situation, the future without your loved one, and the past with your loved one
  4. Finding meaning in the situation and looking for ways to honor your loved one; finding solace and purpose
  5. Adapting to impending change, redefining roles, preparing for new routines


How to Cope and Work Through Anticipatory Grief:

  • Allow yourself to grieve to help you prepare. Take time to examine unresolved issues between you and your loved one. Say what needs to be said. And if your family member is still well enough, settle legal and financial matters and discuss end-of-life wishes.
  • Educate yourself about what to expect. Learn about your loved one's condition; know the symptoms, the side effects from any treatments, and the prognosis. Understanding what is coming may help you to feel in control.
  • Seek support and talk to somebody who is also feeling anticipatory grief. Find a support group of people who are experiencing the same thing, whether it is online, in person, or over the phone. Someone in a similar situation can provide a lot of insight, and it’s okay to be honest about your feelings. You’re not being disrespectful to your family member if you express your frustration.
  • Practice self-care, enlist help, and continue to live your life. Reach out to family and friends or hire someone to help with the care of your loved one. Don’t put your life on hold. Meet with friends and try to have fun when you can. In the long run, it will help both of you. You’ll have more energy to care for your loved one and yourself.
  • Focus on the present and create moments your family member can enjoy. Even though your family member is no longer able to participate in activities as they could before, they can still enjoy pleasurable activities with you.