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Photo by Judith R. Sands

Anticipatory Grief: The Space Between

Anticipatory grief is the set of feelings associated with an impending loss. Anticipatory grief: the space between what happens when a death is expected, but before it actually happens. It can last for a long time, especially when caring for a loved one with a chronic illness. Caregivers, family members, and friends recognize the decline in the loved one condition and the associated loss and change in the relationship. Change in itself can produce anxiety, worry, and anticipatory grief just from fear of the “unknown.”

Who Else Experiences This?

Many loved ones, especially those who are alert and oriented, realize that they are in a declining physical state and experience anticipatory grief. They perceive a lost sense of self-value and worth and often express that they feeling like a “burden” to family.

Your loved one may be worried about you, as much as you are worrying about them. Common concerns relate to how the survivors will manage their daily routine, and who will take over those activities and responsibilities that the loved one usually performed. Often, they think about and may even express thoughts relating to:

  • Expectations in the coming days
  • Worrying about getting you through this time
  • Concerns about care and comfort measures

Using Anticipatory Grief

Anticipatory grief can help caregivers, family members, and friends prepare emotionally for the loss. It can be a time to take care of unfinished business with the loved one, sharing final thoughts such as saying “I love you” or “I forgive you.”

Anticipatory grief involves mental, emotional, cultural, and social responses. Each individual responds uniquely. Symptoms of anticipatory grief may include the following:

  • Depression
  • Feeling a greater than usual concern for the loved one
  • Imagining what the loved one’s death will be like
  • Preparing emotionally for what will happen after the death

Does Everyone Experience Anticipatory Grief?

Not everyone experiences anticipatory grief. Caregivers, Family, and friends of the loved one trying to accept the future loss may make it seem that the one dying has been abandoned. Grief experienced before death does not lessen the grief experienced after death or shorten the grief duration.

Photo by Judith R. Sands

Dealing with Anticipatory Grief

Feelings of depression, anxiety, or discomfort are normal, when they interfere with the ability to carry out routine activities or cope, then obtaining assistance in addressing those feelings is important. Supportive counseling can be obtained from clergy, hospice entities, social workers, or mental health counselors. Culture and religion can influence how individuals address anticipatory grief.

Action Steps

  • Acknowledge your feelings
  • Journal. Write about your feelings so you can reflect and notice how they change over time. Focus on including things that went well that day, pleasant surprises no matter how small they may be
  • Take time to recharge. Do something that will bring you some pleasure; listen to music, take a bath, exercise, sit quietly with a book. Remember that you cannot care for someone else when you are “running on empty.”


Medical Definition of Anticipatory grief

Your Grief Journey is Unique

Anticipatory Grief: Preparing for a Loved One’s End of Life

SAMHSA’s (Treatment Referral Routing Service) National Helpline, 1-800-662-HELP (4357), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service (part of HHS) provides referrals to local treatment facilities, support groups, and community-based organizations. SAMHSA’s