Anticipatory Grief – An Early On-Ramp to One’s Grief Journey

Loss of a spouse or a life-partner can occur suddenly as in the case of a drug overdose, an auto accident, or someone falling down a flight of stairs. Some spouses are lost to their families following a prolonged illness such as cancer, dementia, or Multiple Sclerosis, leaving the door open for survivors to experience anticipatory grief. As the founder of the Widowers Support Network, I have witnessed members frequently debate which scenario is more comfortable with the survivors. The jury is still out.

            Sudden death may deprive loved ones of the opportunity to say good-bye, to reconcile a long-standing dispute, or to say “I love you” to the deceased.  Conversely, anticipatory grief has its own set of pluses and minuses. Writing for the Journal of Palliative Care, Therese A. Rando wrote: “… in the area of anticipatory grief, the caregiver has the golden opportunity to use primary prevention strategies and to make therapeutic interventions that may facilitate appropriate grief work and a more positive post-death bereavement experience for the survivor-to-be.” A period of anticipatory grief provides family and loved ones the time to get used to the reality of the impending death gradually.

            Perhaps this is why, after serving as a caregiver for thirty-nine months, I did not shed a tear while attending my deceased wife’s Celebration of Life. After all, I had been experiencing anticipatory grief for thirty-nine months. Each morning, and before I would even open my eyes, I would think to myself, my wife is dying, and I need to give her another good day.

Dr. William C. Shiel (MedicineNet) cautions: “Although anticipatory grief may help the family, the dying person may experience too much grief, causing the patient to become withdrawn.”

            The view of some soon-to-be mourners is that anticipatory grief is a sign of abandonment of the dying patient, leaving in the aftermath of the patient’s passing, a sense of unwarranted guilt by the survivor, perhaps for years to come.  Moreover, one shouldn’t assume that by their experiencing anticipatory grief, they will automatically experience a lessen amount of pain following the eventual passing of their loved one, as each survivor’s grief journey is unique. Anticipatory grief entrenches itself into a caregiver’s daily life, absence of any fanfare, or noted entry. The soon to be survivor will be burned with having to carry any fear associated with their anticipatory grief as well as its emotional weight each day, each hour, each minute.

One occasion I experienced anticipatory grief occurred about two months before my wife died, as I was sitting at a traffic light at the corner of 1604 and Blanco Rd., in San Antonio, Texas. As I glanced to my right, I noticed a grey-haired elderly couple in the car next to me. As I gazed upon them, it struck me how lucky they were to have been able to enjoy their senior years together, and how I was not going to be so fortunate. At the time, I felt cheated. Little did I realize that the human heart is capable of loving again and that I would discover love and marry years later.         

            Commenting on his experience with anticipatory grief, widower Joe Netzel of Cincinnati, Ohio, said, “My

mind tended to drift toward the possibility Tracey might not win her battle with breast cancer when I had  “alone time,” which usually took place in the car during my weekly trip to and from the grocery store, and when I had a private moment to think/ponder/wonder/tremble about life without her.”

Widower Mike Simons of Cleburne, Texas, lost his wife Amy in May of 2019, self-discovered he was “pre-grieving” when he found himself needing to visit with a financial advisor, a lawyer, and ministers. 

“I cried in the shower or the car when running errands so I could be strong for the family.”           

Dr. Shiel adds, “Expecting the loss often makes the attachment to the dying person stronger.” A feeling I can personally attest to as the thirty-nine months I served as a caregiver for my deceased wife were among the best years of our sixteen-year marriage.  

Working with hundreds of widowers from around the world, I have found that the degree of anticipatory grief or pre-grief experienced by a survivor may not only influence the severity and duration of their grief journey, it is also likely to accelerate their desire to rebuild what remains of their own life following the passing of their loved one. This may include their romantic involvement with another woman or life-partner soon after their spouse passes, an action that may risk alienating family and friends that may view such conduct as disrespectful to the deceased, if not worse.  

Caregiver Nathan Siefert of Wauwatosa, Wisconsin, wife Becca is currently fighting cancer. “I’m slowly taking on more and more around the house and in our family,” said Nathan as he describes the current state of his anticipatory grief journey. “Faith has helped.  I chose at the moment to evict any intrusive worries.  I chose to focus on what is in front of me.”

To help combat the onset of anticipatory grief, Nathan remains proactive. He works out three days each week, and he runs to keep depression at bay. He shares his fears with friends, a little bit at a time to not scare anyone away because he will need them to listen to his concerns during the dark days ahead. Nathan encourages caregivers who believe in a higher power to read Matthew 6:25-34, which reads in part, “Therefore do not worry about tomorrow, for tomorrow will worry about its own things.”

Those dealing with anticipatory grief are encouraged to see a mental health professional. During my caregiver days, I knew I needed to be on top of my game. I also knew I would be ill-advised to evaluate my mental state, yet I needed to know that I was capable of dealing with my anticipatory grief for as long as my wife needed me to do so. For her sake, as well as my own, I decided to visit with a psychologist at Vanderbilt University Medical Center, where I was pleased to learn a trained professional thought, I was handling the rigors of being a caregiver pretty well. Nathan’s doctor prescribed a medication for anxiety for him, something just to taken some of the edge off.   

Writing for the Visiting Nurse Service of New York, Vince Corso suggests caregivers work through their feelings of anticipatory grief and to take time to examine unresolved issues between their loved and themselves. “Say what needs to be said,” Corso advises. Moreover, if your spouse or life partner is still well enough, settle legal and financial matters and discuss end-of-life wishes.

Anticipatory grief or pre-grief is a condition that ebbs and flows and should not be ignored; sufferers should seek medical attention. For those who think seeing a doctor is not manly, I’m here to tell you; you're mistaken.  Seeing a doctor for a legitimate medical condition is a smart move, especially if you genuinely care about being able to serve your ailing spouse or a life partner better.

“Some days are better than others when dealing with my anticipatory grief; the denial, the depression the bargaining and the pain,” said Nathan. “Today is a good day. Tomorrow I may be on the edge of tears as I can’t stop thinking about life without Becca.”