Losing a Loved One – Anticipatory Grief

One of the hardest things in life is dealing with the death of a loved one but what happens when you find out someone you love has a terminal illness? Often individuals will go through the process of ‘Anticipatory Grief.’  This describes the mourning a person may go through before their loved one has passed away.

Anticipatory grief involves both the dying person and those around them, such as relatives, children, friends etc. Anticipatory grief brings in to focus all the things that will be lost by death. The loss of the loved one, the loss of a future with them in it, the loss of dreams and the loss of life itself.

Anticipatory grief forces a person to look at every aspect of life. The relationship with the person they are losing is examined over and over again, the closeness of the relationship is looked at in detail, the meaning of the relationship is dissected as the person contemplates the past, present and future. The anticipation of the future, of family events, of future accomplishments are all brought under the spot light as the person contemplates a life without their loved one in it.

Anticipatory grief involves confusing, intense emotions that can swing back and forth. The emotions can become overwhelming and make little sense at all. The feelings of guilt, anxiety and hopelessness can rise to the surface as the person feels a sense of overwhelming helplessness.

Knowing a loved one has a limited time to live allows time for reconciliation and gives time for both parties to say the things they need to say. Anticipatory grief can strengthen the bond between the dying person and their loved ones. The impending loss often increases the attachment to the dying person. The increased hopelessness of the situation, the inability to comfort the dying person can lead to increased feelings of helplessness and frustration.

This period of grief before death has an advantage over sudden death in that it allows the person to prepare emotionally and mentally and also allows unresolved issues between themselves and the dying person to be addressed and resolved.

The five stages of grief as proposed by Elisabeth Kubler-Ross are often present in anticipatory grief but it is not simply a case of a person starting the grief process early. A person may go through stages of:

These stages may also be revisited once the person’s loved one has passed away, as part of the grieving process (Not everyone will necessarily go through each stage and individuals may go through the stages in a different order.)

Stages identified specifically with anticipatory grief as opposed to grief experienced after a death include an increased concern for the dying person, rehearsal of the death and attempts to adjust to the consequences of the death.

The following shows how a person may go through anticipatory grief:

Stage One
After initial feelings of shock a person comes to terms with the fact that death is inevitable. There is a realisation that a cure will not be found and their loved one will die. Deep sadness and depression are often associated with this first stage of grief. Loved ones and the dying person  may go through phases of denial, anger, or calmness and acceptance.

Stage Two
During this phase the focus is on the dying person. Loved ones may feel the need to resolve differences or address past arguments. There may be a concern for the dying person’s fear of death which may result in the dying person becoming withdrawn. This can lead to an eagerness to comfort the dying person and support them through this difficult stage of life. Being close to the person dying is important during this stage and provides great comfort and support.

Stage Three
During this stage the actual death is “rehearsed” by both the dying person and the loved ones. The dying person may request their wants and preferences for their funeral plans. Loved ones may start helping the dying person put things into place. For example, the dying person’s financial affairs may be organised and a last will and testament may be drawn up.

Stage Four
During this last stage, loved ones may start to imagine what their lives will be like without the dying person in it, they will start to visualise a future different to the one they had previously imagined. At this stage, people will ponder on what life will be like on birthdays, Christmases, weddings etc. without the dying person there.

Grief before the death has occurred can present many issues in an individual as the dying person is still alive and therefore, feelings of anger and depression may bring with it a sense of survivor’s guilt. Often grief is not recognised and supported by others when the individual in question is still alive and therefore individuals can often feel isolated in their grief.

It is important to remember that no two people are the same, the way one person will go through the grieving process will be different to the next. There is no right or wrong way. It is also important that an individual has support when going through the grieving process. Talking to a counsellor, psychotherapist, priest, family, friends etc. may help during this most difficult time of life.

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