How Anticipatory Grief Differs From Grief After Death

Anticipatory grief is grief that occurs before death. It is common among people facing the eventual death of a loved one or their own death. Most people expect to feel grief after a death but fewer are familiar with grief that shows up before a life ends.

Because this kind of grief isn't often discussed, you might worry that it's not socially acceptable to express the deep pain you're feeling. As a result, you may not get the support you need. This article explains what anticipatory grief is, what it can look and feel like, and how you can cope with it during a difficult time.

This article is directed more to someone who is grieving the impending loss of a loved one, but people who are themselves dying can also have preparatory grief.

What Is Anticipatory Grief?

Anticipatory grief is defined as grief that occurs before death or loss. You may be grieving several losses, not just one. These are just a few of the losses you face when someone close to you is near death:

• You may be losing a companion.
• The roles in your family may be changing.
• You may fear losing your financial security.
• You may be losing your dreams about the future.

Grief doesn’t occur in isolation. One loss can bring to light memories of past losses, so that you're not grieving just the present loss, but all the losses that came before it.

Differences From Grief After Death

Anticipatory grief is similar to grief after death. But it's also unique in many ways. Grief before death often involves:

• More anger
• More loss of emotional control
• Atypical grief responses

These unexpected emotions may be because you're in an "in-between place" when a loved one is dying. You might feel mixed up as you try to find the balance between holding on to hope and letting go.

Grieving before someone dies is neither good nor bad. Some people experience little or no grief while a loved one is dying. Some feel grieving in advance might be seen as giving up hope. For others, the grief before the actual loss is even more severe.

Purpose 

For those who are dying, anticipatory grief provides an opportunity for personal growth at the end of life. It can be a way to find meaning and closure. For families, this period is also an opportunity to find closure, reconcile differences, and receive and grant forgiveness. For both, the chance to say goodbye can feel like a gift.

Family members will sometimes avoid visiting a dying loved one. They may say things like, "I want to remember my loved one the way they were before cancer," or "I don’t think I can handle the grief of visiting." Anticipatory grief in this setting can be healing.

Grief before death doesn’t necessarily make the grieving process easier. In some cases, it may make death seem more natural. It’s hard to let our loved ones go. Seeing them when they are weak, failing and tired may make it just a tiny bit easier to say, "It’s OK for you to move on to the next place."

Does It Help Grieving Later On?

Grief before death isn’t a substitute for grief later on. It won’t necessarily shorten the grieving process after death occurs. There is not a fixed amount of grief a person experiences when they lose someone. Even if your loved one’s health has been declining for a long time, nothing can really prepare you for the actual death.

Yet, while anticipatory grieving doesn't give you a head-start on later grieving, it does provide opportunities for closure that people who lose loved ones suddenly never have.

Symptoms

The emotions are similar to those which occur after a loss. In fact, they may be even more like a roller coaster at times. Some days may be really hard. Other days you may not feel grief at all.

Everyone grieves in different ways. Still, these emotions are common ones:

• Sadness and tearfulness: Sadness and tears tend to rise rapidly and often when you least expect them. Something as ordinary as a television commercial could be a sudden and painful reminder your loved one is dying. Coming out of the blue, the surge of emotion may be as powerful as when you first learned that your loved one was dying.
• Fear: Feelings of fear are common. Beyond fearing the death itself, you may fear the changes that will follow losing your loved one.
• Irritability and anger: You may feel anger. You may also have to cope with a dying loved one’s anger.
• Loneliness: Close family caregivers of someone dying from cancer may feel lonely or isolated. If you're concerned about expressing grief before death, it could add to your feelings of isolation.
• A desire to talk: Loneliness can fuel a need to talk to someone—anyone—who might understand how you feel and listen without judgment. If you don’t have a safe place to express your grief, these emotions can lead to social withdrawal or emotional numbness.
• Anxiety: When you are caring for a dying loved one, you may feel you're living in a state of heightened anxiety all of the time. Anxiety can cause trembling, a racing heart, and other symptoms.
• Guilt: The suffering of a loved one can bring feelings of guilt. You long for your loved one to be free of pain, even though that might mean death. You may also feel survivor guilt because you will continue with your life while they will not.
• Intense concern for the person dying: You may have extreme concern for your loved one. Your concern could be about emotional, physical, or spiritual issues.
• Rehearsal of the death: You may be visualizing what it will be like without your loved one. Or if you are dying, you may be imagining how your loved ones will carry on after your death. These thoughts are normal even if you feel guilty about them.
• Physical problems: Grief can cause physical problems such as trouble sleeping and memory issues.
• Fear, compassion, and concern for children: Children and teens can also have anticipatory grief. You may be worried about how they're feeling. One study found that children and teens whose parents had cancer had fears about how they would be cared for after the death of a parent or grandparent.

You may have heard of the stages of grief and the four tasks of grieving. It's important to note that most people do not neatly follow these steps one by one. Most don't wake up one morning feeling they have accepted the death and recovered from the loss.

For some people, the stages overlap. For others, they happen in a different order. You may cycle through the same feelings of shock, questioning, or despair many times over. There is no right way to feel or grieve. 

Treatment and Counseling 

Anticipatory grief is normal. But in some cases, this grief can be so intense that it interferes with your ability to cope. It’s also common for people to develop depression in the midst of profound loss. It can be hard to tell grief and depression apart.

Coping With Anticipatory Grief

It’s important to let yourself grieve. Find a friend or another loved to help you:

• Share your feelings openly
• Maintain hope
• Prepare for death

Some people may wonder why you are grieving before the death has happened. Some may even become angry about it.

Keep in mind that letting go doesn’t mean you have to stop loving the person you're losing. During this stage, you can begin to find a safe place in your heart to hold memories that will never die. 

Summary

If you are facing the end of your life or the death of someone close, grief may come before death does. Anticipatory grief refers to the sorrow and other feelings you experience as you await an impending loss. It has some benefits: It may help you find closure, settle differences, or prepare yourself for the pain of letting go.

This kind of grief can come with lots of other emotions, including anxiety, guilt, fear, and irritability. You may lose sleep, have problems concentrating, making decisions, or remembering things. All of these symptoms are normal.

It's also perfectly normal not to have anticipatory grief. It's a good idea to reach out for emotional and practical support if grief is keeping you from functioning day to day.