“Anticipatory Grief”: Grief Before Death

“Anticipatory Grief”: Grief Before Death

Grieving before someone is gone, anticipatory grief, can happen with many prolonged medical conditions, especially those affecting the mind. It doesn’t follow traditional grief steps and may be more complicated. Here’s what to know about it and how to address this type of grief.

Definition and Understanding of Anticipatory Grief

Anticipatory grief is the grief someone experiences before loss. Typically, this refers to grieving a loss through impending death, but it can also include anticipated loss not involving death. Furthermore, it affects caregivers and those they care for, often simultaneously.

Stages

This type of grief doesn’t necessarily follow grief’s traditional stages (anger, bargaining, denial, depression, and acceptance). Also, some aspects of normal grief’s five stages may occur and shift back and forth.

On the other hand, bereavement experts say that caregivers’ states of grief before death are more likely to involve acceptance that death is inevitable, reflection on feelings about the person dying, anticipating emotions after the death, and envisioning a path forward.

A Way to Process

Grief before death is more than early normal grieving. For this reason, it is often described as a processing experience or a way to deal with issues in the dying person’s life. If you’re experiencing it, the pre-grieving may give you time to come to grips now with feelings about the loss and what happens next so you can be proactive.

  • For some caregivers, going through this process before the actual death helps remove some of the emotional and situational pileups after death occurs.
  • Similarly, the dying person who’s experiencing grief before death may feel somewhat reassured. They have the opportunity to address their impending death with their loved ones.

Still Devastating, But Preemptive Grief May Have Some Benefits

There are some ways this type of grief can be beneficial. These include:

  • It affords those present time to say goodbye.
  • Individuals can clear up misunderstandings, attempt to heal rifts, and say anything they should have told the dying person.
  • Anything unresolved or unfinished can be addressed. This includes practical issues and emotional concerns, such as arranging for hospice.
  • This is the opportunity to face their fears instead of running away or denying them.
  • Finally, grief before a loved one’s death is a time for a person to prepare for their life afterward.

The hope is that this pre-grieving period offers comfort and better prepares the grieving person to cope with grief when death occurs.

Still, everyone’s grief experience is different. There is no single way for grief to look or how to experience it, despite perpetuated myths.

Can Be a Risk Factor for Prolonged Grief Disorder

But not everyone benefits from the grief before death experience. Some find it’s just a stage before the grief they’ll feel after the loss. Neither their ability to weather this painful situation nor their preparedness for the future benefits.

Furthermore, some experiencing unrelenting grief and sadness are at risk for prolonged grief disorder (PGD). According to the American Psychiatric Association (APA), between 7-10 percent of adults in bereavement have symptoms of this psychiatric condition.

Common Emotions and Experiences Associated with Pre-Grieving

Intense emotions are common with all types of grief. However, with anticipatory grief, the feelings and emotions can not only be fierce but can see-saw between normal and distress. For this reason, it’s often referred to as roller-coaster grief.

Common emotions experienced include:

  • Anger, irritability, and fear
  • Anxiety
  • Depression
  • Guilt
  • Intense fixation on the dying individual
  • Isolation and loneliness
  • Loss of emotional control
  • Numbness, disbelief
  • Persistent mood lows
  • Mentally rehearsing the death to come
  • Relief
  • Sadness

How Preemptive Grief Can Affect Both The Person Grieving and The Loved One

The fact that humans are mortal beings with distinct beginnings and endings isn’t something most people think about. When someone faces impending death, whether it’s their death or that of a loved one, the cascade of feelings and emotions about dying comes crashing down. This affects the grieving person and the loved one.

There’s a finite time involved, even when the anticipated death may be days, weeks, or months away. Plus, there may be times when the dying person enjoys a return to near-normalcy, followed by a steep decline. This can be rough for everyone involved.

Tips for Managing Anticipatory Grief with Coping Strategies

No one should try to handle grief alone. Grief is such a powerful emotional experience that it can completely devastate the individual. Besides the immediate physical and psychological effects, trying to go it alone can lead to worsening grief, even to prolonged grief disorder.

If your loved one is dying with Alzheimer’s disease, for example, the anticipated loss may occur suddenly or years from now. The emotional responses associated with incredible grief are normal, yet there are things you can do to cope.

Research shows that every person with advanced cancer goes through this psychological process of grieving past losses, ones happening now and in the future. Psychological counseling and support may help alleviate this grief.

Vital elements of dealing with grief anticipation include:

  • Acknowledge the coming loss.
  • Learn all you can so you know what to expect.
  • Seek counseling and support.
  • Create special connection opportunities.
  • Say what must be said.
  • Redefine what hope means now.

Coping Strategies

Intellectually, knowing that death is coming for a loved one is one thing. Being able to deal with the crush of emotions is another. Coping strategies can prove enormously helpful to get through this trying time.

Put Self-Care First

While taking care of yourself may be far from your thoughts when dealing with so much already, good self-care is essential. Otherwise, the weight of sadness and grief may lead to deteriorating mental and physical health.

  • Recognize that it’s normal to put your dying loved one’s needs ahead of your own. Yet, you still must focus on the essentials of self-care: Get enough sleep, eat healthily, drink plenty of fluids, get some exercise, and be with people you enjoy and who make you happy.

Feel All Your Emotions

Ignoring emotions, especially devastating emotional pain, is unhealthy. While you may think hiding your tears or anger is better, pushing emotions down will harm you. Mental health experts say that this may lead to using unhealthy coping mechanisms like drugs, alcohol, and overeating. That’s because your body needs to do something about those emotions you pushed aside. They’ll come out in other behaviors, not necessarily ones that are good for you.

  • Allow yourself to feel your emotions. Some will be extremely painful, but the intensity will pass. Besides, feeling them makes them go away quicker than ignoring or holding them back.
  • Be aware of the warning signs of a mental health crisis so you can be proactive in seeking help.

Talk About It

What you’re feeling is a normal reaction to unwelcome news. The death of a loved one is one of the most painful emotional experiences. Find someone you trust to talk to about what you’re feeling. Others who have been through this situation may help let you know you’re not alone.

A study in 2020 showed that social support can have a positive influence on the anticipatory griever’s proactive coping and subsequent personal as well as post-traumatic growth.

Support Options

When the grief you feel before your loved one’s death leads to complications in your life, interfering with your job, children, family, or your physical and mental health, you may need professional help. This should be someone experienced in counseling individuals dealing with grief, whether that is anticipatory or normal grief. Options include counseling, virtual therapy, and grief support groups.

Seeking support allows you to talk about what’s happening without judgment or advice from others. You can show and feel your emotions, be validated, and understand that your experience is normal. Besides, counseling and support group participation will reinforce your need to focus on self-care so you can get through the grieving process.

Finding Grief Support Groups

Many hospice organizations have grief support groups and may have grief counseling through hospice care. This helps caregivers and the dying individual before death and the caregiver after the loved one dies.

Other grief support resources are available through hospitals, houses of worship, and funeral homes. You can also check national grief support organizations to find local support groups.

Grief Counseling

When you feel like you need help, especially if you are depressed, anxious, or unable to function due to anticipatory grief, reach out and ask. Our mental health professionals at Restore-Mental Health are always available to discuss your needs and how we may assist you. Contact us for a confidential, free consultation.