Anticipatory grief, which is linked to caregiver burden, is when you grieve a loss before it happens.
Learn how you can cope
Everyone will lose someone in their lifetime and grief is the natural response. Anticipatory grief, however, is grieving ahead of time before your loved one has passed.
It can be felt by patients, friends, family and caregivers and can be triggered during the different phases of the end-of-life journey.
Although anticipatory grief is quite common, it’s often not understood or discussed. It can have a significant impact on your mental health and quality of life, especially if you’re not getting the support you need.
So, let’s take a look at what can cause it, the potential consequences and what you can do about it.
A Strong Link to Caregiving
A study published in the journal BMC Palliative Care found that excessive caregiving burden is linked to high levels of anticipatory grief. It also revealed that illness uncertainty is a critical factor in anticipatory grief.
With illness uncertainty, you are unable to figure out the meaning of illness-related events. The inconsistencies and unpredictability of these events, and unclear causes all contribute to a cognitive state that can impair your ability to adjust and cope. Illness uncertainty takes a huge toll on the quality of life for your loved one and for you as a family caregiver.
Causes of Anticipatory Grief
It’s not just the impending death of a loved one that can cause anticipatory grief. Other triggers include:
- Diagnosis of a disease
- Hospice or end-of-life care
- A loved one losing their memory or mobility
- Changes in your loved one’s personality
- A child moving out
- Amputation
- Divorce or end of a relationship
- Loss of a pet
- A geographic move
- Job loss or starting a new job
It’s possible you may be grieving several losses at the same time. Also, a loved one dying can cause you to experience several losses all in one. For example, you are facing the end of a relationship, plans you had together, your sense of place in your life and society, or even your financial stability. At each stage of the relationship changing, you feel a sense of loss.
For family caregivers who look after their loved ones daily, the distress of anticipatory grief can make it difficult to regulate emotions. You’re also likely to experience strong emotions you’ve never had before.
Common Feelings During Anticipatory Grief
- Anger or irritability
- Anxiety
- An intense preoccupation with the dying person
- Denial
- Desire to withdraw from social situations
- Desperation
- Dread
- Guilt
- Lethargy or lack of motivation
- Loneliness
- Sadness
- Tearfulness
While these feelings can occur when you’re grieving the loss of a loved one, during anticipatory grief they can be more intense.
Stages of Grief
Several theories on the stages of grief abound, and some have gained widespread acceptance. For instance, in her book On Death and Dying, Elisabeth Kubler-Ross identifies five stages of grief:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
During each of these stages, you can experience many of the feelings listed above. However, one of the key differences between anticipatory grief and grief after death is hope — hoping that some treatment or even a miracle might prevent your loved one from dying.
Sources
BMC Palliative Care: The relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer: a cross-sectional study
https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-022-00925-4
Oncology Nursing Forum: Illness Uncertainty and Its Antecedents for Patients With Prostate Cancer and Their Partners
