Grief and Bereavement Part 2: Anticipatory Grief and Expected Loss

Coping with the loss of a loved one is a devastating experience. Those who have encountered this type of pain can attest to the emotional trauma that comes along with it. As you begin to grieve, it’s important to note first and foremost that there is no right or wrong way to process the pain of your loss. This is why there are five distinct phases of grief that can take days, weeks, and even years to undergo before reaching a point of acceptance.

While the process of grief takes on different phases, there are two distinct forms of loss that can alter the course of your grief immensely. The first is known as traumatic or unexpected loss. This type of loss expresses a conventional version of grief that takes place immediately after the death of a loved one. The second form is known as expected loss. This type of loss is non-conventional as it brings about anticipatory grief in the weeks or months before the actual loss of a loved one.

Throughout this article, we will be discussing the anticipatory grief that occurs from expected loss in terms of what it is, how it affects your emotional state, and strategies to help you cope with your loss.

What is Anticipatory Grief?

Anticipatory grief is the grief that evolves before the actual death occurs. It’s a version of grief that can occur in the elderly population, after a palliative diagnosis of a terminal illness, or in some cases following a poor medical prognosis. In the moments after taking in this information of your loved one’s fate, the anticipatory grief will begin to take its course.

Unlike traumatic grief, anticipatory grief is something that is being processed during the time spent with this person. For this reason, it is very normal for your grieving process to feel quite confusing. Because you're able to spend quality time with your loved one now, many people find it socially unacceptable to express the deep emotional pain they are experiencing. For this reason, you may fail to reach out and receive the support needed to cope with your grief.

Common Symptoms of Anticipatory Grief

For most people experiencing grief both before and after an expected loss of a loved one, there are several common symptoms that may arise. That being said, it’s important to keep in mind that everyone experiences anticipatory grief very differently, so these symptoms may vary from one person to another.

• Sadness: emotions of sadness are commonly associated with anticipatory grief and often happen when you least expect. Random reminders in your everyday life may trigger you to feel extreme sadness or tearfulness.

• Fear: because you’re aware of the approaching loss of a loved one, feelings of fear can come up. Not only a fear of death, but also fearing all the changes that will come once this person passes.

• Guilt: feelings of guilt are common to arise as the time of your loved one's death approaches — especially if they are suffering from a terminal illness. You may feel like you want to take away their pain and put it onto yourself instead. With this, you may feel guilty for finding yourself anticipating feelings of relief when they pass as it indicates an end to their suffering.

• Anxiety: in the days, weeks, or months of experiencing anticipatory grief, you may be living in a state of immense anxiety. This anxiety is often intensified if you’re the sole caretaker for your loved one.

• Concern: as the time approaches, you may experience intense feelings of concern for your loved one. In some cases, this concern can be worsened due to certain uncertainties or questions about life after death.

• Loneliness: you may be experiencing a sense of loneliness during anticipatory grief. As mentioned previously, the feeling that it’s not socially acceptable to express your grief before the loss of a loved one can add to these feelings of isolation.

• Thinking about death: in some instances, you may find yourself visualizing or rehearsing life after they pass over and over again in your head. It’s important to recognize that these thoughts are very normal and not to feel guilty for this. Instead, it’s a part of the process towards gaining acceptance of the inevitability of your loss.

Expected Loss

An expected loss is generally seen in the older population, especially those affected by a form of dementia. Expected loss is also commonly seen in those who have been diagnosed with a terminal illness or chronic disease. In terms of any medical diagnosis, your loved one and their family can decide what the end of life care looks like for them. Some people choose to spend their final days in a palliative care facility, such as a Hospice, while others prefer the comfort of their own home.

While these circumstances help you understand the ‘why’ factor around your loved one’s death, it doesn’t make your grieving process any easier. For this reason, it’s more than necessary to begin practicing healthy coping strategies to deal with anticipatory grief both before and after the death of your loved one.

Coping with Anticipatory Grief

The first step towards coping with anticipatory grief is to express your pain and allow yourself to grieve. It’s helpful to find a trusted friend or family member to share your feelings in an open, vulnerable manner. Give yourself the permission to feel the many emotions that come with anticipatory grief. Not only are they all very normal, but they are necessary to experience. Without this expression, you risk becoming numb to any feelings surrounding your loved one — both the good and the bad. Be sad, happy, reflective, concerned or anything you feel in that moment.

Next, it’s incredibly important to spend quality time with your loved one in a stress-free, light-hearted way. Rather than closing yourself off to the inevitability of their diagnosis, your presence in their life right now can be helpful for the both of you. Offering an ear for listening, a shoulder to cry on, or simply a friend to laugh with is especially meaningful. 

Lastly, there are certain “tasks” to address prior to the time your loved one passes.

1. Coming to terms with loss

This can be accomplished through means of counselling, speaking to a loved one, or journaling your thoughts and feelings as they come. Remember, there is no timeline to your grief. The process of acceptance can be a winding road, and that’s okay.

2. Take time to say goodbye

Saying goodbye to your loved one is both one of the most important things to do and the hardest. In most circumstances, when your loved one is nearing the end of their life they may appear to be sleeping blissfully. Remain present in the moment and continue talking to them even if you’re unsure whether they hear you or not.

3. Making amends

In addition to saying goodbye, it is important to make amends with your loved one if necessary. Putting the past in the past and letting them know you’re open to forgiveness can be a cathartic and relieving experience.

4. Discussing their will, power of attorney, and upholding final wishes

Lastly, it’s important to take the time to discuss the logistics surrounding your loved one’s death. Although making plans for a will, designating a power of attorney, and upholding final wishes can elicit a considerable amount of stress, it is something that must be discussed in detail with your loved one. 

Counselling for Anticipatory Grief and Expected Loss

Fortunately, there is support in your community if you’re struggling to cope with the anticipated loss of a loved one. Reaching out for help is especially beneficial for those who are managing grief that has become so intense that it interferes with your daily living.

At On Your Mind Counselling, we understand that grief and bereavement is a unique experience and can differ from person to person. Our counsellors are specially trained in this area to provide a framework of coping strategies that work for you. Reach out today by visiting our website to book an online consultation. Gaining more control over your grief is a courageous first step in the process. We are available to support your journey when you’re ready.

Taking It One Step at a Time

Anticipatory grief and expected loss bring about an array of emotions and feelings no one can truly prepare for in advance. It’s important to remember that grief before death isn’t a substitute for the grief you will experience later on. Instead, there are helpful strategies that can get you onto the path of coping earlier.

No matter your grieving journey, take it one day at a time. We are here when you need to reach out.

Coming soon: Grief and Bereavement Part 3: Traumatic and Unexpected Loss

Written by Laura Anderson BA, MA, MSW, RSW