The Grief You Feel Before a Loved One Dies

Guest blog by Karen Wyatt MD for The Denver Hospice

We are all familiar with the fact that people experience grief after the death of someone close or following other major losses. But it is also possible to have similar painful feelings before a loved one has died, especially for those providing care to a person at the end of life. Grief therapists refer to this as anticipatory grief and even though it is a normal process, many people don’t recognize it when it occurs.

Anticipatory grief may arise from the awareness that death is near for the loved one and time is slipping away. There are also cumulative daily losses that occur in one’s relationship with a dying person, such as the physical and social activities that are no longer possible to share together. But during the hectic and stressful routine of caregiving the presence of grief may go unnoticed.

The emotional symptoms of anticipatory grief include sadness, tearfulness, anxiety, anger and guilt, among others. There can also be a sense of loneliness even though the loved one is still present. Some people find themselves feeling irritable and resentful, but don’t recognize what is causing those feelings. Anticipatory grief can also cause physical symptoms like headaches, fatigue, loss of sleep and difficulty concentrating.

One of the challenges to coping with anticipatory grief is the fact that there is little support available from others. While friends and family may rally and show up to offer help after a death has occurred, they are not likely to recognize anticipatory grief or to reach out with the same level of concern. So here are some tips for dealing with anticipatory grief if you are experiencing it:

Have compassion for yourself

When you understand why your symptoms are present it can help you stop judging yourself for any negative feelings that may arise, like anger or resentment. Anticipatory grieving comes from the love you feel for the person you are caring for and that love is not diminished even if you feel challenging emotions right now as a caregiver. This is a normal experience so be gentle with yourself.

Talk about it

Find people to talk to who can relate to what you are going through. Seek out a support group for caregivers or talk with a therapist or spiritual counselor about your feelings. If you are working with a hospice team the chaplain or social worker can offer you helpful resources and all other team members are also trained to understand your feelings of grief.

Ask for help

Your need for self-care is extreme during times of anticipatory grief so find ways to get more support from the people in your life. Reach out to people in your close inner circle to let them know that you are going through a difficult time. Ask them to be there for you and let them know some specific things they could do to help like bringing in food, running errands or giving you some respite time.

Work on your relationship

 One hidden aspect of anticipatory grief may be regret or resentment over old issues from the past that have never been addressed. This may be the right time to focus on forgiveness and resolution with your loved one who will also benefit from this type of emotional healing. Process your own emotions first and try to see the conflicts of the past from a bigger vantage point: as part of the path you and your loved one have shared together. Old grievances don’t define who we are right now in the present moment, they are simply stories of things that once happened.

Create meaningful moments

Even though your relationship has changed because of your loved one’s illness you can still find meaningful ways to spend time together. Share stories of favorite times in the past, watch a program together, read poetry or a book aloud, enjoy a simple meal, or record greetings to send to people who are far away. You can also make a photo album or scrapbook together as a keepsake for future generations.

Plan for the future

As difficult as it may seem, talking about what the future holds can bring a great deal of relief to both the patient and caregiver. First you might discuss the healthcare wishes of your loved one and then talk about the funeral or memorial service and disposition after death. In addition you may talk about what life will be like for you and other survivors after the death and make sure that proper estate planning has been done. Many people find new peace of mind once these conversations have taken place.

While anticipatory grief is a normal experience, it is distressing and painful to go through. If you begin talking about it you may find that others close to you are feeling grief too and sharing the journey will be helpful to all of you. In the end anticipatory grief can serve as a reminder that life is short for all of us and we should use our time well while we are here. That is the potential gift that lies within these challenging experiences of life and loss.