Anticipatory Grief

Here's How to Identify and Cope With Anticipatory Grief

Patients and families facing terminal illness usually begin the grieving process before the actual loss occurs. This is called “anticipatory grief.” Although it may be uncomfortable, anticipatory grief is sometimes helpful and may result in fewer grief complications later. Just as each person experiences grief in his or her own unique way, the same is true for anticipatory grief. It is a natural process that helps individuals prepare for emotional and physical closure. It is also a time when both patient and family prepare for change.

Things to Consider

Emotional and physical symptoms associated with grief may also be associated with anticipatory grieving. You may experience some of the following:

• Loss of appetite
• Tension and irritability
• Fatigue and insomnia
• Tearfulness or crying unexpectedly
• Restlessness
• Indecision about what to do
• Guilt or anger
• Mood changes over small things

Frequently, patients will experience anticipatory grief, too. Some might want to "put their affairs in order” so that their wishes will be honored. This is sometimes referred to as completing “unfinished business.”

Others might be concerned about how their loved ones will cope after they're gone. For example, a dying patient might want to ensure that loved ones obtain practical life skills, such as learning to balance the checkbook or learning how to cook.

The patient may also express a need to withdraw emotionally from others. Caregivers may observe “distancing” behavior, such as the patient becoming less conversational, losing interest in activities that once held meaning, and refusing to allow close friends and family to visit.

What to Do

• Reach out to persons and groups who can offer you support and help.
• Seek help through counseling with a therapist, minister, priest or rabbi.
• Remind yourself that everyone needs adequate time to grieve.
• Utilize spiritual beliefs that bring you comfort or relief.
• Express yourself through art, poetry, music, journaling, or gardening.
• Engage in life review through photographs, music, conversation and writing.
• Identify issues and concerns, which are important to address prior to the loss.
• Talk about your feelings.
• Address legal/financial/funeral issues as appropriate.
• Discuss future plans as appropriate.
• Identify whether your expectations are realistic.