What is Anticipatory Grief?

Family Health, Featured Article, Healthy Living
on July 24, 2013

QUESTION: Could I be suffering from something called anticipatory grief? I am the sole caregiver of my 75-year-old father who is terminally ill with lung cancer. My caregiving tasks keep me very busy at this stage of his illness and it will most likely be several months before he needs hospice care. My problem, and I think it’s a problem, is that I am experiencing both feelings and behaviors I would normally attribute to grief. I have times when I feel empty, confused and disconnected to everything around me. I find myself denying my father is really ill even though the truth is right before my eyes. I’ve lost weight, can’t sleep and feel fatigued much of the time. My moods shift between anger and acceptance. And I cry all the time. My biggest challenge in caring for my father is not meeting his daily needs, it’s keeping this roller coaster ride under wraps so he isn’t affected. I’ve heard of anticipatory grief—is that what I have? Can you help?—Christopher

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ANSWER: Christopher, you sound like such a reasonable, intelligent man. Your father is fortunate to have you at his side. From what you have explained, it does sound as if you may be suffering from anticipatory grief or pre-grief. These two terms are making their way into caregiving circles at a rapid rate due to the number of caregivers who seem to be experiencing similar symptoms to yours. Given that you are the sole caregiver for your father, and you didn’t mention any other siblings or close family members, you could be a prime target for anticipatory grief. According to author Edward Myers in his book, When Parents Die, he says this burden comes with special difficulties. While an early or quick death is a shock, he explains a slow death “arrives more like a glacier, massive and unstoppable, grinding you down.” And what this means is you are preparing yourself for the subsequent loss in a unique way. As with most challenges in caregiving, the best way to deal with all of this is to accept what you are feeling and thinking as a natural part of this process. Self-care is at the heart of staying healthy, and this includes allowing yourself to cry, when necessary. Crying not only removes toxins from your body, it also serves to release stress and worry. If you don’t have a close relationship with another person to share your feelings and concerns, you might find solace in reaching out to other caregivers at Heartache to Healing.  You can also find additional information on handling grief on the American Hospice Foundation website. But in the end, if your symptoms worsen or you feel you need additional support, contact a mental health professional who can see you through this process. My best to you as you travel this path.

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Patricia Smith is a certified Compassion Fatigue Specialist with 20 years of training experience. As founder of the Compassion Fatigue Awareness Project© (www.compassionfatigue.org), the outreach division of Healthy Caregiving, LLC, she writes, speaks and facilities workshops nationwide in service of those who care for others. She has authored several books including To Weep for a Stranger: Compassion Fatigue in Caregiving, which is available at www.healthycaregiving.com or Amazon.com.