Anticipatory grief refers to a grief reaction that occurs with the anticipation of an impending loss. It may be felt by the person dying or their loved ones. Anticipatory grief includes many of the same symptoms of grief after a loss, but it can help family members prepare emotionally and spend time with the dying person. A misconception is that anticipatory grief is the same as post-death grief. However, with anticipatory grief, emotions and actions are largely proactive and the experience can be somewhat of an emotional rollercoaster because one can shift from distress to hope to normalcy and back again. With conventional or post-death grief, a person's emotions and actions are reactive.
For the patient, anticipatory grief may be too much to handle and may cause them to withdraw from others. Studies show that when anticipatory grief needs are met for family members, the individuals are less likely to experience negative outcomes at the end of life. It is important to remember that grief felt before death will not decrease the grief felt afterward or make it last a shorter time. It is not like there is a sum of grief and experiencing before the loss will make the feelings lessen after the loss.
Triggers of anticipatory grief
These are just some of the reasons people may have anticipatory grief:
Receiving a terminal diagnosis, such as stage 4 cancer
Being diagnosed with a progressive disease like Alzheimer's disease, cystic fibrosis, muscular dystrophy or macular degeneration
Caring for a child with a chronic disease or a developmental disorder
Learning an unborn baby may have a congenital disorder
Impending divorce or break up
Deterioration and impending death of a pet
Having to move from your home
Children going to college
Signs
Emotions prior to an expected loss can fluctuate unexpectedly and may include:
Loss of control of one's emotions such as intense sadness, fear, anger and irritability
Loneliness and isolation
Anxiety that may also manifest physically with trembling, a racing heart or other symptoms
Guilt
Intense preoccupation with the loss that makes it difficult to manage your health, work or daily living
Rehearsal of the death, including they dying person imagining how loved ones will carry on
Not everyone who learns of a pending experience will have anticipatory grief, but approximately 25% of patients with incurable cancer experience it.
Anticipatory grief is more likely to occur among individuals with dependent relationships, limited external social support or even discomfort with close relationships. Additionally, studies show people undergoing a spiritual crisis are also more likely to be at risk of developing anticipatory grief.
Source: National Cancer Institute
