Anticipatory Grief

When we think of grief, we generally think of the process and feelings we experience after someone dies. In reality we begin this process on the day someone we love is diagnosed with a life threatening illness. This process of mourning before someone we love has died is called anticipatory grief. According to noted grief expert, Dr. Therese Rando, anticipatory grief refers to the process in which we begin to mourn past, present and future losses.

Anticipatory grief is experienced by care recipient and caregiver from different perspectives. For instance, the care recipient mourns the loss of their previous body image, changes in their physical and mental abilities and possibly career loss. The role of the care recipient in the family may change. A breadwinner may no longer provide for the family or a homemaker may no longer be able to manage the home independently.

The caregiver frequently takes on these additional roles, while caring for their loved one and dealing with their own feelings. Both loved ones and caregivers are grieving for the way life was and mourn the deterioration of the care recipient’s health. Frequently, the inability of friends and family members to manage their own discomfort with illness and death may cause the care recipient and the caregiver to be isolated.

During the course of the illness there will be many losses for the care recipient and primary caregiver. These may include; intimacy, sex, privacy, independence, dreams, partnership, dignity, money, control, intellectual stimulation, friendship and family position. These losses will produce accompanying feelings of anger, sadness, depression, and abandonment. It is common for both the care recipient and caregiver to feel isolated, invisible and numb.

A long term illness leaves a person with a "mixed bag" of feelings. As you watch someone you love in pain, you may wish them to be out of their misery. This feeling can be followed feelings of guilt and remorse, that we "wished" this person to die. Discussing these feelings is a survival necessity. Care recipients and caregivers need someone to hear and validate their feelings. Both parties require information about the illness, support and the means to maintain control over their lives, as they make the arduous journey towards death. Family members and close friends can be good sources of support, but if they are either physically or emotionally unavailable, support groups and mental health professionals can be a great source of support.