Tips for Caregivers

Manage Anticipatory Grief

Grief can start as soon as you realize death is possible. This can be when someone is diagnosed, admitted to hospice or any point in the journey.

Though it is different than grief that follows a death, anticipatory grief can exhibit many of the same symptoms—sadness, anger, isolation, forgetfulness and depression. These complicated emotions are often coupled with the exhaustion that comes with being a caregiver or the stress of being left alone. Even if you are accepting of the coming death, knowing it is imminent can bring an overwhelming anxiety and dread.

This grief is not just about accepting the future death, but of the many losses already occurring as an illness progresses. We grieve the loss of a person’s abilities, independence, cognition, hope, future dreams, stability, security, identity and countless other things. Anticipatory grief doesn’t diminish the need to grieve after the death. It may change the intensity of grief.

Use these helpful tips to better understand the anticipatory grief process:

TAKES ITS OWN TIME

Grieving before a loved one dies may or may not lessen grief experienced after the death. Working through it allows you to gain meaning or closure.

DOESN’T MEAN YOU ARE GIVING UP

Focus on what you are doing—still supporting, caring, loving and creating meaningful time together. You are shifting your energy from hope for recovery to hope for meaningful, comfortable time together.

YOU FEEL SORROW AND HOPE AT THE SAME TIME

Hope may be the most unique aspect of anticipatory grief. While you are grieving you hope a new drug will be invented, new surgery will be developed or your loved one will experience a miraculous turn-around.

TIME CAN GRIND YOU DOWN

Since you don’t know when the end will come, you are on constant alert.

RELIEF IS NORMAL

In the case of anticipated losses, there can be months, years and even decades of caregiving that can be overwhelming and exhausting. When someone dies there can be a sense of relief that is completely normal, but that can also create feelings of guilt. Remember that feeling relief after an anticipated death does not mean you loved the person any less. It is a normal reaction after a stressful and overwhelming time in your life.

FINAL CONVERSATIONS

Final conversations can include saying goodbye, hearing and saying I love you, sharing memories, planning the funeral or your loved one saying, “When I am gone remember…” Giving or receiving forgiveness may also be part of the final conversation and can be healing. This can be a gift for the one who is dying. Don’t cheat them out of the opportunity to prepare you for their death. Let them talk about their funeral arrangements even if you don’t want to. Some people have multiple final conversations while others are short. Use thought prompts such as, “If I had one more chance to talk to them I would say…”

LIFE IS A CYCLE

Many cultures consider death not as the opposite of life but the opposite of birth. It is part of the circle of life. At the time of death, consider ways to mark this life transition:

  • Sing a favorite song or hymn around the bedside
  • Light a candle near the bed to symbolize illumination and clarity
  • Place a passage quilt on the body, a favorite blanket or special covering to bury with the person or use during the memorial service
  • Toast the one who has passed on by gathering around the bed to share a prayer with the toast – the drink symbolizes a new life
  • Place a flower on the person’s bed after the body has been removed –a favorite flower is comforting as a symbol of new life

(Groves, R., Klauser, H., 2009, The American Book of Living and Dying)

Learn more, contact Tabitha Hospice at 402.486.8506 or a Bereavement Coordinator today.

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