You sit beside your mother’s bed and catch yourself thinking about her funeral. You sort your husband’s pills and feel a wave of sadness for the man he was two years ago. Then the guilt hits, because they are still here. What you are feeling has a name: anticipatory grief. It is grief that starts before a loss happens, and it is one of the most common and least talked-about experiences of caring for someone who is dying or declining.
This piece explains what anticipatory grief is, why it brings so much guilt, and what actually helps.
What is anticipatory grief?
Anticipatory grief is the sadness, fear and sense of loss a person feels when they expect someone they love to die or to change in a lasting way. It begins before the loss itself, often after a terminal diagnosis or during a long decline.
Psychiatrist Erich Lindemann first described it in 1944, after noticing that some wives of soldiers at war had grieved so fully in advance that reunions felt distant. Psychologist Therese Rando later expanded the idea, pointing out that this kind of grief is not only about the death ahead. It is also about the losses already happening: conversations you can no longer have, roles that have changed, plans that will not happen.
It can be felt by family members, close friends, and the person who is ill.
What does anticipatory grief feel like?
Anticipatory grief can feel like ordinary grief, mixed with dread and exhaustion. Common experiences include:
- Sadness that comes in waves, often at unexpected moments
- Anxiety about the death itself, and about the time just after
- Picturing the funeral or life afterwards, then feeling ashamed of it
- Irritability or a short temper, especially with the person you’re caring for
- Trouble sleeping, poor appetite, constant tiredness
- Pulling away emotionally to protect yourself
- An urge to hold on tightly and not miss a single moment
- Loneliness, because friends assume grief starts after a death
Those last two can happen in the same week. That push and pull is normal.
Why do I feel guilty for grieving someone who is still alive?
Guilt shows up because anticipatory grief feels like giving up on someone. It is not. Grieving ahead of time is your mind trying to prepare for something it cannot stop.
The hardest version of this guilt comes with relief, or with moments of wishing it were over. People rarely say this out loud. In counselling, we hear it often, usually from the most devoted caregivers. Wishing for an end to suffering, theirs or yours, does not mean you love them less. It usually means you have watched someone you love struggle for a long time.
This kind of grief is also hard to share, which is part of why it hurts so much. It falls into what researchers call disenfranchised grief: grief that the people around you do not see or know how to support.
Anticipatory grief and dementia: the long goodbye
Dementia brings a particular form of anticipatory grief. The person is physically present but slowly becomes someone different. Some days they recognise you. Some days they don’t.
Family therapist Pauline Boss calls this “ambiguous loss.” There is no clear moment of loss and no ritual to mark it, so the grief has nowhere to land. Families often grieve the same person many times, as each ability fades.
If this is your situation, it helps to name each loss as it happens. “Mom can’t cook anymore, and I miss Sunday dinners.” Small acknowledgements stop grief from piling up unspoken.
Anticipatory grief vs caregiver burnout
They often overlap, but they are different problems with different fixes.
| Anticipatory grief | Caregiver burnout | |
|---|---|---|
| What it is | Mourning a loss that is coming or happening | Exhaustion from ongoing care demands |
| Core feeling | Sadness, longing, dread | Depletion, resentment, numbness |
| What helps most | Space to feel and talk about the loss | Practical relief: respite, shared tasks, rest |
If you mostly feel empty and overwhelmed rather than sad, burnout may be the bigger issue. Respite care and asking others to take specific tasks matter as much as emotional support. Our piece on emotional burnout covers the signs.
Does anticipatory grief make the loss easier later?
Not necessarily. Many people expect that grieving early will mean less grief afterwards. Research does not support that as a rule. Grief is not a fixed amount that gets used up.
Some people do find the time before a death lets them say important things, make peace, or plan in a way that helps afterwards. Others feel blindsided by how intense the grief still is after months of preparing. Both are normal. If grief after the death feels stuck, bereavement counselling can help.
How to cope with anticipatory grief
Coping with anticipatory grief is less about feeling better and more about making room for the feelings while still living your life. What tends to help:
- Say what matters now. Thank you, I’m sorry, I love you, I’ll be okay. If the person can’t respond, say it anyway, or write it.
- Talk to someone who isn’t also grieving. Family members are often too close to hold your feelings.
- Accept practical help. Meals, rides, a few hours of respite. Name a specific task when people offer.
- Let mixed feelings exist. You can laugh at the bedside and cry in the car the same day.
- Keep one small thing that is just yours. A walk, a class, a weekly coffee. It isn’t selfish. It keeps you going.
- Use local supports. In BC, the BC Bereavement Helpline, local hospice societies, and the Alzheimer Society of BC’s caregiver programs offer support for families.
If you feel unable to cope or have thoughts of harming yourself, call or text 9-8-8 any time, day or night.
When counselling can help
Counselling helps when anticipatory grief is affecting your sleep, health, work or relationships, or when you have no one you can be fully honest with. A counsellor gives you a place to say the things you can’t say at the bedside, including the guilt and the relief.
It also helps with practical emotional questions: how to talk to children, how to handle conflict between siblings about care decisions, and how to stay connected to the person while letting go.
Our Registered Clinical Counsellors offer grief and loss counselling in New Westminster and online across BC, with culturally sensitive care for families from many backgrounds. You can read more about how grief counselling helps, or get in touch to book a session.
Frequently asked questions
Is anticipatory grief normal?
Yes. Anticipatory grief is a common response to an expected loss, especially among caregivers of people with terminal illness or dementia. Feeling it does not mean you are giving up on the person.
How long does anticipatory grief last?
It can last as long as the illness or decline does, sometimes months or years. It often rises and falls with changes in the person’s health, such as a new diagnosis or a hospital stay.
Can you have anticipatory grief for a pet or a relationship?
Yes. Anticipatory grief can come with any expected loss, including an aging pet, a divorce in progress, or a friend moving away.
Is it wrong to feel relief when someone is dying?
No. Relief usually reflects the end of suffering, both the person’s and your own. Many loving caregivers feel it, and it often sits right beside deep sadness.
References
- Lindemann, E. (1944). Symptomatology and Management of Acute Grief. American Journal of Psychiatry.
- Rando, T. (1986). Loss and Anticipatory Grief.
- Boss, P. (1999). Ambiguous Loss.
