Anticipatory grief can occur when a family is expecting a death. Anticipatory grief has many of the same symptoms as those experienced after a death has occurred. It includes all of the thinking, emotions, cultural, and social reactions to an expected death that are felt by family members and friends , including sadness, anger, isolation, forgetfulness, and depression.

These complex emotions are being experienced with the exhaustion that comes with being a caregiver.  This often leads to feelings of overwhelming anxiety and dread, as families struggle to come to an acceptance of losing their loved one.  Anticipatory grief is not only about accepting the imminent death of a loved one, but also the other losses occurring as their illness progresses.  Families grieve the loss of their loved one’s physical abilities and independence, their loss of awareness, loss of stability and security, a loss of hope and future dreams, and many other losses.

Anticipatory grief may include depression, extreme concern for the dying person, preparing for the death, and adjusting to changes caused by the death.  It gives the family and friends more time to slowly get used to the reality of the loss of someone they love.  They have the opportunity to complete unfinished business with the terminally ill loved one such as saying “I forgive you”, “I love you” or simply “Goodbye”.

Caring for a terminally ill loved one as they suffer takes a huge emotional toll, which can become physically and emotionally exhausting.  Also, when a person is nearing the final stages of life, carers are in a constant state of vigilance and feelings of panic arise when things aren’t going well.  These feelings can contribute to a sense of relief for families when their loved one eventually dies, and also a feeling of guilt that can come with that relief.

These feelings are common and totally normal when someone has experienced the prolonged terminal illness of a loved one.  This relief is a confusing feeling, as it seems to indicate a diminished love for the person, and we feel guilty for this relief.  We need to remind ourselves that the relief does not change the deep love we had for the person, rather it is a natural reaction to the illness.

Anticipatory grief does not always occur, and it does not mean that before the death, a person feels the same kind of grief as the grief felt after a death. Some people worry that accepting a loved one’s death while they are still alive, may make them feel as if they are abandoning their loved one.  On the contrary, expecting the loss often makes the attachment to the dying person even stronger.

Anticipatory grief may help the family and friends, however, they should try not to expose their terminally ill loved one to too much grief, as they may become withdrawn.

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