Anticipating a death

When a family member or friend has a life-limiting illness, you may anticipate the loss well before the end of their life.

These four strategies may help you when experiencing anticipatory grief. 

Senior looking into the distance

What is anticipatory grief?

Anticipatory grief is what people experience when they are anticipating the loss of their own life or that of a family member or friend. This anticipation is fueled by the losses that occur as the life-limiting illness progresses.

The person who is ill experiences a progressive loss of energy, mobility, mental functioning, and independence, as well as a loss of dreams, expectations, and plans. These bring about a change in identity as those who are ill lose some of their sense of self.

1. Acknowledging Losses

These losses bring about changes in intimate and social relationships. Caregivers experience a loss of the relationship they once had with the person who is ill and friends may increasingly stay away to try to reduce their own discomfort with illness and death.

As outside caregivers are brought in to help, families also lose a sense of privacy in their own home.

Senior couple walking through garden

This May Help...

Recognize that anticipatory grief is a normal process.

When you anticipate a death, you have time to absorb your loss and acknowledge your new reality ahead of time. This can sometimes make the grief process less intense after the death occurs.

Experiencing anticipatory grief doesn’t mean you won’t also grieve after the death occurs.

Grandson holding grandpa's hands

2. Good days and bad days

The condition of someone with a life-limiting illness will fluctuate from day to day. There will be good days when they have extra energy and can do more. On those days, they seem like their old selves and the degree of loss seems smaller.

There will be other days when the person who is ill has reduced energy and can do less. On those days, caregiving is amplified and the degree of loss seems much larger.

This ambiguity makes it hard to grasp how much has been lost overall, and it becomes difficult to comprehend how much grief to acknowledge.

This May Help...

The ambiguous losses resulting from day-to-day fluctuations in health can give rise to feelings of anxiety and discomfort.  It can be reassuring to share these feelings with a trusted friend or bereavement counsellor.

Try not to look too far ahead.  Focus on the present, making the most of each day's reality.

Try not to over-estimate what has been lost, as you risk avoiding opportunities and experiences that may be possible on a good day.

3. Social support

When you are anticipating the death of someone, you may feel that the type of losses you are experiencing are not acknowledged or recognized by those close to you, and that the depth of your grief is not understood.

Our society recognizes death as a loss and will offer appropriate support when death occurs. However, some may seem insensitive to the losses that happen prior to death.  Anticipatory grief can at times feel like a solitary journey.

When someone has a life-limiting illness, it is often the case that one family member steps forward as the primary caregiver and then others tend to back off. This can lead to resentment.

Woman comforting an elderly man

This May Help...

If friends and family don’t understand or if they minimize your sense of loss, find someone who will listen: a friend, someone who has been through a similar experience, a trained hospice volunteer, a grief counselor, or a therapist.

Tell others what you need. Most people, for example, are happy to mow the lawn, to come and sit with your family member or friend while you go shopping, or to pick up groceries, but they may not generate those ideas themselves. You may need to help others help you.

Acknowledge the losses that are occurring and talk about them.  Sharing anticipatory grief can help reduce its impact if we feel as though we are heard and our reality is understood.

Couple at home

4. Relationship Dynamics & Grief

Patients and caregivers are often in different emotional states at different times, increasing the stress for everyone. Based on these and many other factors, each person will react to the illness differently.

Some will minimize the losses, wanting others to be eternally positive and to keep high levels of hope. They will not want to hear about loss and grief, as they are certain their family member or friend is going to recover and death is not an option.

Some will maximize the losses and may be angry when the person who is ill keeps trying to do things they can no longer do. They may be impatient with others who push treatment options that have little chance of success, and they may irritate others who perceive that they are “giving up” on the person who is ill.

This May Help...

Keep in mind that everyone is doing the best they can in extremely difficult and highly emotional circumstances. Their best may not look like your best, but it’s the best they can do. It’s important for family members to know their own limits and it’s OK to ask for help or support.

It is important for everyone to acknowledge and respect others’ perspectives. Don’t rely on assumptions about why others are doing what they do, ask them.

Anticipatory Grief Guidebook

Download and print the full guide on anticipating the death of a family member or friend.

Strategies for when you anticipate the death of a family member or friend

Document on grief during holidays, celebrations and special days

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