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When You Know a Death Is Coming: How to Cope with Anticipatory Grief

Maybe your best friend has been battling cancer, and the doctors say there’s nothing more they can do. Perhaps you’re seeing your mother’s memory decline as her Alzheimer’s disease advances. Or, possibly, you’ve been diagnosed with a terminal illness, and you’re realizing that your life isn’t going to be as long as you hoped. 

When you’re experiencing grief before a loss occurs, it’s called anticipatory grief. When someone has a terminal illness or dementia, they and their caregivers, family members, friends and loved ones can experience anticipatory grief. 

“Anticipatory grief may look similar or different to conventional grief or what we typically think of as grief,” said Mairead McConnell, PhD, a psychologist with Banner Health in Tucson, AZ. “The main difference is that the loss has not yet occurred.”

Why anticipatory grief can be challenging

With anticipatory grief, you could experience any and all of the emotions of grief — sadness, denial, anger, emotional distress, irritability, anxiety, guilt, physical symptoms and more. “These are all normal parts of the grieving process,” Dr. McConnell said. 

But you might not recognize anticipatory grief since the loss hasn’t occurred yet. And other people might not understand what is happening, so they might not be as supportive. “In some cases, anticipatory grief can seem like you’re giving up hope when it is simply a normal process of coping with an impending loss or inevitable reality,” Dr. McConnell said.

Tips for coping with anticipatory grief

Nothing can prepare you for the loss of a loved one, or for the loss of a future you anticipated. But there are things you can do if you’re experiencing anticipatory grief:

  • Spend time with your loved one. “Anticipatory grief reminds us how much we care about the person we are about to lose,” Dr. McConnell said. So, if possible, find ways to connect with your loved one while you still have time together.
  • Connect with others. “One of the most important factors in coping with the grief of any kind is social support, which simply means having people you can talk to, lean on or ask for help,” Dr. McConnell said. Sometimes it is difficult to talk to loved ones who are also impacted by the loss. If that’s the case, consider reaching out to a more distant friend or a support group.
  • Don’t judge your grief. Some people experience anticipatory grief, and others don’t. Neither way is right or wrong. “Take your feelings as they come, and let them be what they are,” Dr. McConnell said.
  • Don’t compare your grief with other people’s experiences. “Grief can look different for everyone, and it is a messy, painful and human process,” Dr. McConnell said.
  • Take care of yourself. “Remember the basics,” she said. Eat well, move when you can, and make time for rest. These habits will help when you’re grieving after the loss as well.
  • Get professional help if you need it. “Coping with death, whether yours or a loved one’s, is an incredibly difficult task, and you deserve to have support. It’s never too early to seek help from a therapist, counselor or social worker to support your mental health,” Dr. McConnell said. If you cannot perform the basic functions of daily life or are thinking of hurting yourself so you can join your loved one in death, it’s time to reach out for professional support.

If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24/7 across the United States by dialing or texting 988.

How grief may change after the death occurs

For some people who experience anticipatory grief, the loss can bring a sense of relief because the uncertainty, fear and anticipation are over. “This is, of course, not the case for everyone, and anticipatory grief does not ensure that you will experience less grief later on,” Dr. McConnell said. 

However, if you cope with anticipatory grief in healthy ways, you may be able to cope better with the circumstances after the loss. And the opposite is also true: isolation and avoidance before the loss may mean you face more challenges in coping down the road.

The bottom line

Anticipatory grief is the grief you may feel for the impending death of a loved one with a terminal illness or dementia. While they are still a part of your life, you grieve the future where they’re gone. It’s complicated because you’re in an in-between, uncertain state. When you recognize anticipatory grief and take steps to cope with it, you’re better able to deal with it — and the upcoming loss—in a positive way.

Need help dealing with anticipatory grief?

Call the Banner Behavioral Health Appointment Line at (800) 254-4357.

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