Anticipatory Grief: Preparing for a Loved One's End of Life

If you have a loved one with an advanced cancer, you may already be preparing yourself for their end of life. As your loved one’s illness progresses, you may even feel like you’ve already “lost” them as a person. If this sounds familiar to you, you may be experiencing anticipatory grief.

What is Anticipatory Grief

Grieving is not just something that happens after someone dies. Preparing for a loved one’s end of life or a major loss is what defines anticipatory grief. While it shares some commonalities with conventional grief, some symptoms are unique to anticipatory grief. Anticipatory grief can often be mixed in with hope that your loved one will live longer or survive their illness, while conventional grief signals that a loss has already occurred. The National Cancer Institute defines the most common symptoms of anticipatory grief as:

• Depression
• Heightened concern for the ill person
• Rehearsal of the loved one’s end of life
• Attempts to adjust to the consequences of the loved one’s end of life
• Anxiety and worry
• Increased irritability
• Mourning changes in the loved one’s personality or physical appearance

What Can You Do to Cope?

Redefine hope and focus on quality of life. It is still possible to feel hope for smaller goals while caring for someone who is near the end of life. This may be hoping that your loved one has a “good” day in relation to their health.

Form a community of support. A loved one who is near the end of life is hard for the whole family. Asking for help or leaning on a community of support can strengthen the bonds with other loved ones.

Connect with your loved one. Losing a loved one is always painful but anticipatory grief can function as a way of consciously achieving closure before your loved one passes away. While caregiving, find time to enjoy being with your loved one. This may be through talking or by completing “bucket list” activities. The most effective way of connecting with your loved one, of course, will vary depending on your relationship and your loved one’s physical ability. Read CancerCare’s fact sheet titled, “Caregiving At the End of Life” for more information.

Create a support network. More often than not, there will be others in your family and support network also preparing to mourn the loss of your loved one. Surrounding yourself with people with whom you feel comfortable sharing your sadness and fears for the future can help you cope with both pre- and post-death grief.

Medical and mental health care professionals involved in your loved one’s care, such as a hospice nurse, doctor or social worker, can also provide emotional support and prepare you for this transition period. There is research that suggests counseling for an entire family unit is also effective in coping with anticipatory grief.

Counseling. Oncology social workers are licensed professionals who specialize in individualized counseling people affected by cancer. CancerCare’s oncology social workers can help you in proactive coping, which may help you in adjusting to life after your loved one’s death. CancerCare also offers support groups for those who are bereaved.

Edited by Lucia Fanjul, LMSW