Anticipatory Grief
A handout for adults and families facing the expected death of someone they love. It explains anticipatory grief, why grieving in advance does not mean giving up, and how to stay present with the person while the loss approaches.
About this resource
Anticipatory grief describes the grieving that begins before a death, when a terminal diagnosis or a progressive illness makes the loss foreseeable. Lindemann first described the phenomenon in the 1940s, and Rando's later work on anticipatory mourning emphasised that it involves not one loss but many: the loss of the person's health, roles, personality or memory, of shared plans, and of the relationship as it was, all while the person is still alive. Families often find themselves grieving and caregiving at the same time, which can be exhausting and confusing.
This handout normalises the mix of sadness, dread, guilt, relief and love that families describe, and draws on acceptance and commitment principles to help readers make room for painful feelings while continuing to act on what matters to them in the time that remains. It gently addresses the belief that grieving early is a betrayal, and the fear of 'wishing it was over'.
The professional version adds notes on the differences between anticipatory grief and the grief that follows the death (the former does not reliably shorten the latter), on carer burnout, and on working with families where members are at different points of acceptance.
How to use it
- Offer this to family members or to the person who is ill, adapting your language to who is reading. Ask first what they already understand about the prognosis.
- Use the section on mixed feelings to give explicit permission for relief, anger and impatience, which clients often will not volunteer.
- Draw out what the client wants the remaining time to contain, and translate that into small, specific actions. This is the values work at the centre of the handout.
- Check the client's own sleep, health and support. Carers frequently neglect these and may need help giving themselves permission to rest.
- Do not suggest that grieving now will make the death easier. Prepare the client instead for the possibility that the death will still bring a new and different grief.
References
- Lindemann, E. (1944). Symptomatology and management of acute grief. American Journal of Psychiatry, 101(2), 141-148.
- Rando, T. A. (Ed.). (2000). Clinical dimensions of anticipatory mourning: Theory and practice in working with the dying, their loved ones, and their caregivers. Research Press.
- Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.
- Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner (5th ed.). Springer.
