What Is Anticipatory Grief?
It might be the hardest part of caregiving — watching your loved one slip away step by terrible step, knowing you can’t stop the decline and grieving the loss, long before they’re actually gone. Psychologists call this process anticipatory grief, and it’s common among caregivers and family members of people suffering from Alzheimer’s disease, cancer, and other terminal illnesses.
Coping with Anticipatory Grief
“As a disease progresses, there is so much frustration and sadness associated with watching the person you once knew go away,” says Vince Corso, MDiv, LCSW, CT. “ It can be overwhelming.”
Corso provided care to his mother, who suffered from Alzheimer’s. One of the painful milestones of the disease was the point at which she no longer recognized him. “My mom didn’t recognize us, and she confused us with other people. As a son and a caregiver, that was really hard. I had to leave the room.” But after a period of time, he became acclimated to his new reality and began to accept it. He found that sharing the sense of loss with family members was helpful. “It’s so crucial that family members talk about the loss.”
If your loved one’s condition has advanced, consider asking their physician whether it may be time to transition to hospice care. In addition to providing the right level of care for patients whose illness has progressed, hospice also provides emotional support to families and caregivers, beginning when their loved one enrolls in hospice.
Five Ways to Work Through Anticipatory Grief
- Allow feelings of grief to help you prepare. Take time to examine unresolved issues between you and your loved one. “Say what needs to be said,” Corso advises. And if your family member is still well enough, settle legal and financial matters and discuss end-of-life wishes.
How can you make sure you will get the care you want when you aren’t able to speak or make decisions? Learn how in our Guide to Advance Care Planning.
- Educate yourself about what to expect. Learn about your family member’s condition — know the symptoms, the side effects from any treatments, and the prognosis. Understanding what is coming down the pike may help you to feel in control.
- Talk to somebody who is also feeling anticipatory grief. Find a support group of people who are experiencing the same thing, whether it is online, in person, or over the phone. “Someone in a similar situation can provide a lot of insight,” says Corso. “And it’s okay to be honest about your feelings. You’re not being disrespectful to your family member if you express your frustration.”
- Enlist help and continue to live your life. Reach out to family and friends or hire someone to help with the care of your loved one. Don’t put your life on hold. Meet with friends and try to have fun when you can. “In the long run, it will help the patient and yourself,” says Corso. “You’ll have more energy to care for your loved one and to do what you need to do.”
- Create moments your family member can enjoy. Even though your family member is no longer able to participate in activities as they could before, they can still enjoy pleasurable activities with you. Take mom outside for some fresh air, play music for her, do simple puzzles if she is able. In the end, these moments might be what you cherish most.
Helping Your Loved One Adjust
When illness or injury robs your loved one of the ability to remember things about themselves, it can be scary and profoundly difficult. How do you help them cope with the changes in memory and identity?
Look for ways to add new activities to your loved one’s life, or think about how you might incorporate elements of a favorite pastime. If your mother was an avid golfer, she may have no interest in taking up knitting if her doctor tells her to stay off the links. However, if you ask her what she misses about golf, you may discover that she misses the camaraderie more than the activity itself. Would she be able to meet her foursome for lunch after they’ve finished their round?
Remember too that this is a type of loss. Feelings associated with the grieving process, including denial, anger, and depression, are normal. Talking to a social worker, therapist, clergyperson, or even a sympathetic friend may help you or your loved one manage the emotions and come to terms with the loss. If there’s a support group in your area, attending a meeting and hearing how others have coped with the changes you’re experiencing can provide insight and concrete steps, and learning that you aren’t alone in your feelings of anticipatory grief can be reassuring.