Grief is often thought of as something that happens after the death of a loved one. However, for many people, grief begins long before someone dies. As soon as a person becomes aware that death is likely or inevitable, feelings of loss can emerge. When the end of a life is approaching, even if it is months or years away, it is natural for grief to appear.
Anticipatory grief is a form of grief that happens before the actual death. It can carry many of the same symptoms as grief experienced after someone dies. People may feel sadness, anger, anxiety, isolation, forgetfulness, or depression. It can also affect caregivers profoundly, leaving them exhausted and emotionally drained. While these feelings are intense, it is important to remember that anticipatory grief is a normal response, and there are ways to cope and come to terms with it.
If you want to learn more about grief and how it affects us, listen to our interview with grief expert, neuroscientist, professor and psychologist Mary-Frances O’Connor.
What is anticipatory grief?
Anticipatory grief is defined as any grief experienced before a loss, rather than grief that follows after death. It occurs when someone realises that a loved one is declining or facing a terminal illness and there is nothing that can be done to stop the progression. Anticipatory grief allows us to process emotions before the actual loss takes place, but it can also feel confusing, overwhelming, and exhausting.
This type of grief is different from the grief that happens after death, yet it often carries similar emotional and physical effects. Many people feel sadness, anxiety, guilt, or frustration when anticipating a loss. They might also find themselves reflecting on what life will be like when the person has gone and feel a sense of helplessness. Despite these difficult emotions, anticipatory grief can offer a way to prepare mentally, emotionally, and practically for the future.
Grieving an impending loss of a loved one
Anticipatory grief is the private, inner process we go through before a loved one dies. It allows the mind, heart, and soul to start adjusting to the reality of what is coming. Some people call this preparatory grief because it helps them come to terms with an impending loss.
Unlike grief after a death, anticipatory grief often feels less verbal and more internal. People may not openly express their feelings because they worry about seeming disrespectful or premature. It is common to feel guilt for grieving while a loved one is still alive, even though these emotions are completely natural.
During this time, caregivers may find themselves juggling intense emotions alongside the practical demands of supporting a loved one. Feelings of frustration, anger, and sadness can surface, sometimes unexpectedly. Acknowledging these feelings without judgment is an important part of coping.
Facing your own death
Anticipatory grief is not only experienced by those caring for a loved one. It also affects people who know their own death is approaching due to illness or other circumstances. Facing your own mortality can bring fear, sadness, and shock. You may worry about being a burden to your family, about leaving unfinished business, or about how your loved ones will cope.
Other common concerns include fear of the unknown, fear of losing dignity or independence, and fear of experiencing pain or discomfort. Many people also reflect on the meaning of life and their personal relationships during this time.
Talking openly about these fears and emotions can be difficult, but it is vital. It allows you to make practical preparations and emotional arrangements and may ease some of the anxiety surrounding death. Support from loved ones or a professional can help in navigating these feelings.
How anticipatory grief differs from grief after death
Anticipatory grief shares similarities with traditional grief, but it also has unique characteristics. People may feel heightened anger or emotional volatility. There can be confusion as you try to hold onto hope while simultaneously recognising the inevitable.
Some people experience only mild feelings of anticipatory grief, while others feel intense sorrow. Both responses are normal. Mild grief may reflect coping strategies or an attempt to stay strong for the person who is ill. Strong grief is also natural and may intensify as the loss draws closer.
Everyone’s experience is individual, and there is no right or wrong way to feel. Anticipatory grief is a deeply personal process, influenced by personality, past experiences, the relationship with the person who is dying, and the circumstances surrounding the illness or decline.
How can recent events trigger anticipatory grief?
Grief is more than a reaction to death. It can emerge from many forms of loss, even when nothing physical has been lost. The COVID-19 pandemic highlighted this for many people. Even without losing a loved one directly, people experienced grief for the way life had changed.
Losses may include the absence of normal routines, social connections, certainty about the future, and opportunities that were missed. Some have faced bereavement alongside the isolation and anxiety brought about by lockdowns or illness.
Acknowledging anticipatory grief in these situations is essential. Validating your emotions helps you accept them rather than suppressing or judging them. Practical self-care, connection with others, and seeking professional support can all be beneficial during this time.
Symptoms of anticipatory grief
The signs of anticipatory grief are similar to those seen after a death. They can be emotional, cognitive, and physical. You may notice feelings or experiences such as:
- Anxiety or worry
- Anger or frustration
- A need to talk about your feelings
- Depression or sadness
- Fatigue or low energy
- Emotional numbness
- Guilt or self-blame
- Fear of what is to come
- Difficulty concentrating or forgetfulness
- Loneliness or isolation
- Increased concern for the person who is ill
- Thoughts about the future without the loved one
- Addressing unfinished business with the dying person
The five stages of anticipatory grief
The Swiss-American psychiatrist Elisabeth Kübler-Ross developed a model of five stages of grief. These stages were originally described in relation to terminal illness but also apply to anticipatory grief. The stages are not strict rules, and people may experience them in different orders, repeatedly, or not at all.
Denial
In this stage, you may struggle to accept the reality of the impending loss. You might feel disbelief, as though what is happening is not real. Denial can serve as a protective mechanism, giving you time to adjust to overwhelming emotions gradually.
Anger
Anger can be directed at yourself, the person who is dying, a higher power, or the world. It may arise from feelings of helplessness or frustration. Anger can be intense and may challenge your emotional and spiritual beliefs.
Bargaining
During bargaining, people often hope for a different outcome. They may make promises, seek alternative treatments, or reflect on changes they could make to influence the outcome. Bargaining is a way to regain a sense of control when facing uncertainty.
Depression
Once it becomes clear that the situation cannot be changed, feelings of sadness and despair often appear. You may cry more easily, withdraw from social interactions, experience changes in sleep or appetite, and reflect deeply on what is to come. Depression is a natural stage of processing loss and can be accompanied by reflection and emotional release.
Acceptance
Acceptance does not mean being happy about the situation, but rather coming to terms with it. In this stage, you acknowledge what is happening and start to focus on practical matters, spending meaningful time with your loved one, and preparing emotionally for the future.
It is important to remember that these stages are not a fixed path. People often move between stages or experience them simultaneously. Anticipatory grief can feel chaotic and unpredictable, and that is entirely normal.
Anticipatory grief in children
Children can experience anticipatory grief just like adults. They may sense that someone important is unwell or dying and experience shock, confusion, fear, or sadness. Grieving children may struggle with concentration, act differently from their peers, or express emotions through behaviour rather than words.
It can be helpful to explain death in age-appropriate ways and give children space to ask questions. Spending time with the person who is ill, sharing memories, and completing unfinished activities can provide comfort. Children also benefit from reassurance, love, and guidance as they navigate the complex feelings associated with anticipatory grief.
Coping with anticipatory grief
Managing anticipatory grief requires both emotional and practical support. Allow yourself to feel your emotions without judgment and find ways to express your grief. Talking with someone you trust can provide comfort. This may be a friend, family member, or professional counsellor.
Finding a creative outlet can also be valuable. Writing, drawing, music, or other forms of expression help process what is happening and make sense of overwhelming feelings.
Other helpful strategies include:
- Seeking out support groups for caregivers or those experiencing grief
- Learning from others who have navigated similar experiences
- Practising forgiveness and showing love to yourself and others
- Spending meaningful time with your loved one
- Maintaining your own emotional and physical well-being through rest, nutrition, and self-care
Professional support is available for those who need it. Anticipatory grief counselling can help you work through complex emotions, find coping strategies, and prepare for the eventual loss in a healthy and supportive way.
Anticipatory grief is a natural and normal part of preparing for the loss of a loved one or facing your own mortality. It can be overwhelming, exhausting, and emotionally challenging, yet it also offers an opportunity to process emotions, reflect on relationships, and make practical and emotional preparations.
Everyone experiences anticipatory grief differently. There is no right or wrong way to feel, and the intensity of grief varies from person to person. What matters most is acknowledging your feelings, seeking support when needed, and finding healthy ways to cope.
Whether you are a caregiver, family member, or someone facing the end of life yourself, understanding anticipatory grief can help you navigate this difficult time with compassion for yourself and others.
