• Jill


By Jill S. Cohen, NYC family grief counselor

In my grief counseling practice, I am getting inquiries more and more from men and women (sometimes children too) who come to me prior to the death of a loved one. They’re surprised when I say: Yup, that’s anticipatory grief. It’s a “thing”.

They come to me because they can’t wrap their head around what’s going on either right in front of them or around them, as a loved one declines, and life’s routines, certainties, and comforts seem to unravel.

A smart way to handle an upcoming death, if your goal is to stay afloat as much as you can, is to seek support, and often that means outside expert advice from a professional. This does not mean that you’ll get “so good at grief” that you’ll be ready when it happens.

No. What it means is that you will be able to learn how to feel grounded when you need to be, how to handle some decision-making rationally, how to continue with life/work/career/parenting situations without feeling like you’re going to “lose it” every five minutes.

Here are some thoughts about Anticipatory Grief that you may find relevant or helpful.

  • Grief does not always wait for death to come. Grief can start at the point in which you learn that your loved one will be dying sooner rather than later. In other words, you know intuitively that nobody lives forever, but there may come a time in which you are told that a diagnosis is terminal or a condition cannot be cured, and that the end is inevitable and likely within an estimated timeframe.

  • Grief affects everyone around the ill person. It’s not just you that is grieving the eventual loss of that loved one. The person who is dying may be grieving for his/her self, family members and those whom they are leaving behind. Caregivers may feel fatigued and perhaps even defeated as they anticipate the loss of their role as caregiver.

  • Anticipatory mourning can take on a heavier tone than actual post-death mourning sometimes. Why? While someone is still physically present, there is extra anxiety because you are trying to keep your loved one comfortable, stay involved in decision-making, interacting with doctors, nurses and medical people -- all while trying to absorb what’s going on internally for you. The grieving that comes with death can feel lighter, sometimes with relief knowing that your person is out of discomfort, and done with the illness which took its toll. What remains is the knowledge that there is no more that you can do to try to prolong or prevent death or ease their life. The grieving after death belongs solely to your emotions and the task at hand is that of your own adjustment to the “new normal”. It is not as charged with activity and drama or trauma as it is when the dying person is still alive and in the process of dying. The worst that could happen has already happened, when you are grieving post-death. You are not living on high alert anymore, in a sense.

  • Anticipatory grief can also be more emotional if you feel daunted by the need to take on the job of unfinished business with your loved one or witnessing your loved one’s “life review” in real-time.

  • If you don’t quite know what to do or how to act, follow the lead of the person who is dying. Try to notice how he/she is handling it and how he/she wants the remaining time together to be used. It may be that around-the-clock company is not the most desired situation, and your loved one wants you to participate in your own life as fully as usual, even during this time.

  • You may wake up and realize you haven’t done anything for yourself in a while. If that’s the case, remedy it right now. If you don’t take time out for a walk, a yoga class, a movie, a workout, or a night out with friends, a massage ... or whatever makes you feel renewed ... you won’t have the energy to keep going and you’ll end up with a short fuse when you’re around others.

  • Don’t be a perfectionist during this period. As you anticipate a death, you won’t have the extra energy to carry on your usual tasks with the same output as you like to. If you have to get prepared meals for your family, or hire a house cleaning service to help out, do it. You can let some of the details of your life slide, and hand the tasks over to others.

  • Everyone mourns differently – both with anticipatory grief and after-death grief. Cut your friends and family members some slack if they’re doing it differently from the way you are. Changes in family dynamics will happen, whether invited or not. The same goes for friendships.

  • THE SYMPTOMS OF GRIEF – sadness, anger, depression, anxiety, loss of appetite, overeating, forgetfulness, exhaustion, isolation, lethargy – can be the same in anticipatory grief as well as the grief that follows a death. Understand that and allow them to exist. Anticipatory grief adds the symptoms of panic, hyper-alert state, intense emotions, and guilt.


  1. Anticipatory grief is normal. You’re allowed to have it. You’re not alone with it.

  2. Don’t be upset if people say things at this time like, “At least he or she is still alive .” Don’t let that minimize your feelings of grief.

  3. Consider caregiver support groups when the exhaustion is too overwhelming and there’s a need to connect to others who are living a similar caregiving lifestyle as you are.

  4. Use your support system. Friends and family members who have expressed that they are there for you, mean it. So, take advantage of their offers.


  6. Understand that when the post-death grief comes, and you feel a sense of relief, that too is normal. RELIEF is a normal response after the constant level of stress and overwhelm and exhaustion that you experienced. Take a look back at what you’ve been through in the lead-up to the death. You might surprise yourself that you made it through.

If you’d like to talk to me about grief counseling in anticipation of a loved one’s death, feel free to reach out. Sometimes it can be very helpful to have support, advice, a new way of looking at situations, and I can give you that, for sure.

Schedule a 30-minute free consultation with me HERE!

I look forward to guiding you through this unique kind of grief.



© 2020 by Anthony Walker Designs

New York City Metro Area

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