Coping with anticipatory grief 

Grieving a loved one who is still alive

• Anticipatory grief is the emotional process we go through when we know someone is going to die soon.

• You may feel preoccupied with a sense of the absence of your loved one even as they sit next to you.

• Despite the stigma around these feelings, it is a normal process that is important for your healing.

• Remember that your loved one is also going through anticipatory grief, for the life they will leave behind, and needs space to express what they are going through.

When we know someone we love is going to die soon, it can be a terribly overwhelming time. Many people don’t realize that what they are experiencing during this period is actually grief, even though their loved one is still alive.

This emotional process that we go through when a loved one is diagnosed with a terminal illness, or when they enter hospice care, is sometimes called “anticipatory grief.” It can be just as painful and real as grief for someone who has died, and often comes with some extra challenges as well. But it is a natural and important process, and learning about anticipatory grief and finding constructive ways to express your feelings can be very beneficial. 

What is anticipatory grief? 

Anticipatory grief occurs when a loved one’s death is imminent, whether from a terminal illness or a life-threatening injury, or they are simply nearing death from old age. Anticipatory grief is felt and expressed differently by each family member, friend, and the patient themselves. Like conventional grief, there is no “correct” way to experience it. 

The difference is, of course, that your loved one is still alive while you are grieving their approaching death. This paradox can be difficult to wrap your mind around, and feelings of frustration, confusion, anger, and guilt can often arise. It’s important to allow yourself the space to feel these things, but also to express and communicate your feelings to family and trusted friends.

Sometimes we encounter stigma about the expression of anticipatory grief. Society may tell us that it’s wrong to begin mourning a loved one while they are still alive, and that we should instead be grateful for our time with them—as if you cannot do both at the same time.

Many people report struggling with feeling like they are being selfish, concentrating on their own emotions rather than those of the person who is dying. Others may feel that they are being pulled in opposite directions, trying to both remain hopeful and accept the inevitable. Anything that you might be feeling at this moment is valid and natural; they are all important parts of your grief.

Communicating with your loved one

Working through the difficult feelings of accepting that your loved one will be dying soon can take a long time. You might be preoccupied with a sense of the absence of your loved one even as they sit next to you. Again, this is a completely valid way to feel, but it is also important to keep their emotions in mind as well.

Your loved one is almost certainly coming to terms with their approaching death at the same time that you are. They are themselves grieving for their life and their relationships with the the people they will leave behind.

Allowing channels for open and honest communication with them and others that love them, however painful and uncomfortable it might feel at first, is crucial.

When a loved one is dying, you have the opportunity to say your final goodbyes, and to tell them anything that you need them to hear. This is an important step to healing. When a loved one dies unexpectedly, we often grieve for the things we were not able to tell them—final apologies, words of love or praise, or clearing up a misunderstanding.

In the anticipation of a loved one’s passing, you also have the opportunity to make sure that all of your loved one’s end-of-life wishes are known. As painful as this final time together might be, it can also provide an important opportunity for closure. 

The road to healing 

As with any experience of grief, there is no timeline to anticipatory grief. The road to healing will look different for everyone, and often it does not take a linear path. Keep in mind that your anticipatory grief is entirely separate from and different from the grief that will come with the death of your loved one.

You may expect one to just transition into the other, but often they feel entirely discontinuous and unrelated, with completely different emotional experiences. Just because you have experienced the anticipatory grief, it does not mean you have already done any of the work of the later grief—nor will the fact that you knew it was coming necessarily make this new grief process any less painful or easier to understand.

It is important to be gentle and kind to yourself and your loved ones when you are experiencing anticipatory grief. Remember that you are not alone in this, and it’s OK to ask for help. Counseling, grief support groups, and similar safe spaces are available to you and can help you find useful coping strategies for dealing with what you are going through, so that you can be there for your loved one and the others around them in whatever way you wish ●