Managing Anticipatory Grief

Many of us are aware that grief is a normal part of every loss we experience, but does grief only occur after the loss? Anticipatory grief is the form of grief that occurs when one is confronted with a chronic or life threatening illness or when one anticipates the death of a loved one (or oneself). Anticipatory grief does not substitute, or necessarily lessen, grief that occurs after the death. It is not simply grief pushed ahead in time. Please utilize this discussion group to share your thoughts and feelings.

Managing Anticipatory Grief

Postby dscowan » Mon Jun 04, 2012 8:32 am

Anticipatory grief is not a way to complete your grief prior to the death of the individual. Rather, it is a response to losses of both the person who is ill as well as caregivers and others who are close to him or her. Each experiences anticipatory grief from their own unique frame of reference.

Many times when we think of a loss we think about the death of a person, but there are many other losses. These include tangible losses such as physical limitations and intangible losses such as the loss of hopes, dreams, dignity, motivation and many others. With life limiting and chronic illnesses, both the patient and the caregiver experience anticipatory grief. Anticipatory grief not only includes future losses but also past and present losses.

Here are some considerations for managing anticipatory grief:

Adapting to the new and ever changing environment can be very difficult for many individuals depending on their expectations and cognitive abilities. Understanding the loss and finding ways to adapt can bring meaning and fulfillment back into the griever’s life. For example, a person with memory loss may no longer be able to drive to the store, but he still can shop independently once at the store. It is important to focus on the remaining strengths or the capabilities.

Communication between individuals can be difficult even when things are good. Many things impact effective communication such as individual characteristics, family systems, style and cultural norms. Learning how to communicate feelings is very important. It is through communication that we can learn what is meaningful for an individual and why they are responding in a certain way. It is important to communicate without hurting those you care about.

Other ways of managing anticipatory grief are through legacy and reflection techniques. Remembering and telling old stories, old pictures and music can often touch the person who is ill. Long term memories, significant events and feelings of significance can be triggered. Good memories can be fuel for conversation, and stories can be passed on from generation to generation, keeping the spirit of the person alive for future generations. In addition, reminiscence can provide feelings of meaning and purpose for both patients and their loved ones. These reflections and legacies are a gift to those left behind.
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Re: Managing Anticipatory Grief

Postby d_butler » Fri Jul 26, 2013 2:12 pm

I agree that each person experiences anticipatory grief from their own unique frame of reference, especially children. In my practice I have noticed that many parents try to shield their children from death and the reality that their loved one is dying. I have learned that children want to be involved and are better prepared when they are given accurate information and the opportunity to do grief work prior to their loved one's death. There is no easy way to tell your child that someone very special to them has a terminal illness and is dying. My experience has shown me that it is best to be honest, share your feelings, fears with them and use simple words that they can understand. Reassure your child that the feelings they are experiencing are normal, it's not their fault that their loved one is sick and they are loved.
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Re: Managing Anticipatory Grief

Postby lee1986 » Wed Nov 20, 2013 9:47 am

I met with a young woman whose husband died--she talked about "how she is handling" her grief now", but then started talking about her feelings of grief before her husband died. She asked if there was a name for "the pre-death grief" and I said that it is referred to as anticipatory grief. Therese Rando, an expert in the field, states, "anticipatory grief refers to the process in which we begin to mourn past, present and future losses."

This woman was with her husband every step of his illness and verbalized that she did alot of grief work everyday seeing his declining health, as well as, the loss "for what should have been". She said that it was extremely important that her feelings of loss were accepted before her husband's death, just as her feelings are being accepted now. Please feel free to respond and discuss your experience.
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Re: Managing Anticipatory Grief

Postby BobB » Mon Jan 20, 2014 11:44 am

Unfortunately, with anticipatory grief there is not a thermometer or litmus test that one can take to indicate that one is experiencing anticipatory grief. What generally are experienced are the distressing symptoms of anticipatory grief. These symptoms are generally felt as feelings of anxiety, depression, anger…. To address anticipatory grief one needs to identify what the loss is and to validate and normalize the loss. Then, we need to understand what the loss means to the individual who is experiencing it. From there, an intervention can be put in place to address the issue. What have you been experiencing?
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Re: Managing Anticipatory Grief

Postby kincaid59 » Fri May 30, 2014 2:49 pm

Anticipatory grief sometimes happens when we are preparing for the eventual death of a loved one. It is not only experienced by the family and friends but can also be felt by the patient. A person is often thinking of all the losses associated with the eventual death, such as friendship, companionship, dreams and plans for the future, or financial needs while watching the loved one decline. It can often look like post death grief, i.e. sadness, depression, longing, feeling overwhelmed, etc. So what can you do? Stay connected with a support system who you can trust and rely on. Talk to those who have experienced the same journey you are traveling. Exercise, eat right, get enough sleep. Prioritize your life, attending to those things that need to be done and letting go of the rest. Say the things you need to say, experience the things you need to experience. Create memories while you can. Have no regrets. Remember there are no rules to grieving. Grief is a consequence of loving someone. So be kind to yourself and in doing so you will be better able to help others.
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Re: Managing Anticipatory Grief

Postby kitkat5 » Thu Sep 25, 2014 1:52 pm

I agree with the previous posts that said anticipatory grief does not eliminate the actual grief felt after a death. But knowing that a loved one is at the end of his/her life also affords the opportunity for the dying person and the family/friends to share precious time together sharing feelings, thoughts, fears and joys. Often family will have "the talk" in which they tell the person what he/she has meant to them and reassure him/her that they will be okay but will miss them. The patient has that same opportunity. Another aspect of anticipatory grief is the chance to mend damaged relationships and ask/receive forgiveness for either real or imagined situations that have happened. Just as the changing colors of autumn are beautiful but a harbinger of a cold, harsh winter to come, anticipatory grief is a special time for sharing but usually means that death will occur in the near future. If you are experiencing anticipatory grief, use this opportunity to talk with your loved one and give them the chance to talk about their own feelings related to their impending death. It is an invaluable gift for both of you.
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Re: Managing Anticipatory Grief

Postby dscowan » Mon Feb 09, 2015 10:57 am

Great suggestions! This is also a good time to do an ethical will or legacy project. Legacy work is a collection of personal values and family history that can be passed on to loved ones. Some see it as a way to learn about one’s self, reflect on life and to affirm the importance of others in their life.
An ethical will is not a legal document. With an ethical will we bequeath our values, not our valuables. It is a way to pass on or share beliefs, histories, blessings, hopes and dreams for the future, and advice to future generations.
One doesn’t need to have a lot of money or property or to have done something truly extraordinary to create an ethical will. Each of us is unique with our own family history and tradition, life experiences, lessons learned and obstacles overcome. An ethical will is a way to pass on our personal legacies and can reflect how we want to be remembered. Ethical wills can be written – in the form of letters, poems, recipes, and journals. They can be digital recordings or song compositions. They can be in the form of art – such as a quilt, jewelry, paintings. They can be almost anything.

If you have a created such a project, please share here.
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Re: Managing Anticipatory Grief

Postby kincaid59 » Wed Jun 03, 2015 12:31 pm

You’ve received the news…your loved one is terminal. Fear and anxiety envelope you like a blanket. What do you do now? Ask yourself what are you worrying about? What are your concerns for the present and the future?
Do you have any regrets or something that needs to be said?
Attempting to resolve these concerns can help ease some of the anxiety. Be honest with yourself. There is no right or wrong, just “what it is.” When we address the fears, the fear becomes less powerful over us. Find people who will allow you to speak openly with out fear of being judged. Come up with a plan. Identify your needs and desires. Know there is nothing you can do that will fully take away the pain but you may be able to alleviate some of the stress and worry.
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