When You Grieve Loss Even Before Death

You are mourning a loss that hasn’t happened yet.   You feel anxiety, sadness, fear and the emotional pain of bereavement. Anticipatory grief, also known as preparatory grief, comes when you foresee the loss before it occurs.  This is a complex reaction to any significant life change including the loss of a job, marriage, or an impending death. It is particularly common among caregivers of terminally ill family members, and the patient themselves, and it can be debilitating.

Anticipatory grief is a common concern addressed by spiritual care and bereavement support professionals. “Grief is grief no matter what the loss is,” explained NJHealth Hospice Spiritual Care Coordinator Denise Davis, noting that this pain can steal the time you have left with your loved one. 

Providing support to caregivers is also part of the hospice mission. Davis has been a spiritual care and bereavement professional for more than 40 years, finds it helpful to focus on the caregiver apart from the patient, to see how they are doing.

“I acknowledge that they are going through a tough time and that I’m here for them too. I remind them that these are sacred moments as they care for someone they love,” she said. “It is important for the patient to know they are given the opportunity to invest in someone who has invested in them.”

Denise Davis, NJHealth Hospice Spiritual Care

Davis brings with her a keen understanding of the caregiver experience having care for her own family members. Her father had long-term dementia, and she lost both her parents and in-laws.  She encourages conversations, noting that they too are loved, and self-care is as important as caring for another.  “It is very hard to stay upbeat and encouraging if they are at the end of themselves.”

For hospice patients their grief is many times centered on unfinished business, things not done, said or completed. They are often concerned about leaving loved ones, and but are less fearful of death than some may believe.

“I remind them that dying is part of life, and it is okay,” she said noting that spiritual support isn’t always religious in nature.   But when accepted, she offers Bible verses and prayer for comfort. “Sometimes I can share Bible verses such as Psalm 23, Psalm 139.”

 The team at NJHealth Hospice and Palliative Care provides physical, emotional and spiritual support throughout their hospice journey and after the patient has passed. If you are struggling with grief and need support, call us at 856-696-5340.

Signs of Anticipatory Grief

These feelings can be just as intense as those experienced after an actual loss, making anticipatory grief a significant emotional challenge. 

Sadness and Anxiety: Feelings of deep sorrow and worry about the future 

without the loved one.

Irritability and Withdrawal: Increased irritability and a tendency to 

withdraw social interactions.

Preoccupation with Loss: An intense focus on the impending loss and its

implication for the future.

Coping Strategies

Coping with anticipatory grief involves several strategies that can help individuals manage their emotions and prepare for the impending loss:

Acknowledge Your Feelings: Recognizing and accepting your feelings of grief is critical.  Understand that these emotions are valid and part of the grieving process.

·Seek Support: Talking to friends, family, or a therapist can provide emotional relief and help 

you process your feelings. 

Prepare for the Future: Use this time to address any unfinished business with your loved one.  Have important conversations or make necessary arrangements. 

Engage in Self-Care: Prioritize your physical and emotional well-being by engaging in activities that bring you joy and comfort.

Davis shares this poem by Hank Dunn,

a renowned author and speaker on healthcare, grief and dying.

Giving Up, Letting Go, and Letting Be, By Hank Dunn

Giving up implies a struggle…

Letting go implies a partnership…

Letting be implies, in reality, there is nothing that separates.

Giving up says there is something to lose…

Letting go says there is something to gain…

Letting be says it doesn’t matter.

Giving up dreads the future…

Letting go looks forward to the future…

Letting be accepts the present as the only moment I ever have.

Giving up lives out of fear…

Letting go lives out of grace and trust…

Letting be just lives.

Giving up is defeat at the hands of suffering…

Letting go is victory over suffering…

Letting be knows suffering is often in my own mind in the first place.

Giving up is unwillingly yielding control to forces beyond myself…

Letting go is choosing to yield to forces beyond myself…

Letting be acknowledges that control and choices can be illusions.

Giving up believes that God is to be feared…

Letting go trusts in God to care for me…

Letting be never asks the question.