Anticipatory Grief

Caring for a loved one with dementia is often compared to running a marathon. After being diagnosed, the life expectancy ranges from 5 to 10 years, depending on the type of dementia. This makes caregiving particularly challenging, as you witness a gradual decline without the ability to halt it. The emotional journey of caring 24/7 for someone living

with dementia is raw and intense. Care partners experience a unique form of grief, mourning the gradual loss of their loved one while they are still alive. Unlike traditional grief, there is no final closure; the grief is ongoing and relentless.

This weekend, I read an article that could be beneficial for care partners experiencing what is known as anticipatory grief. While there is no easy solution, understanding your emotions can prevent a downward spiral of despair. Recognising the process and finding small moments of hope can provide support and help you navigate each day.

Is it healthy to grieve before a loss?

By Jancee Dunn

Published in the New York Times on. 17/10/2025

https://www.nytimes.com/2025/10/17/well/anticipatory-grief.html

When Alan Wolfelt’s mother, Virgene, died from Alzheimer’s disease, he wasn’t

surprised by what he felt. As the director of the Center for Loss and Life Transition in

Fort Collins, Colo., he knew the symptoms of grief all too well. But he realized that he

was mourning her for a second time. He had begun to grieve several years earlier,

he said, “when she entered the transition into dementia.” Typically, we experience

grief as a reaction to loss. But sometimes it crops up before a life transition or a

death that we’re expecting. We can feel grief while a parent is sick, when we’re

contemplating divorce, or before moving, retirement or an empty nest. What we feel

in this “in-between time,” as Dr. Wolfelt calls it, is known as “anticipatory grief.”

Because we’re not primed to expect it, he said, our reactions can be unsettling,

confusing and painful. During this time, people will try to mentally “rehearse” for a

major loss, Dr. Wolfelt explained. And because many big life changes and losses

aren’t instantaneous, he added, this period can be long. While immersing yourself in

anticipatory grief doesn’t mean that a loss will be less painful, experts say it can help

you prepare. Here’s how to navigate these feelings.

Recognise that this is grief.

Like conventional grief, anticipatory grief looks different for everyone, Dr. Wolfelt

said. If you find you are experiencing heightened emotions such as sorrow or fear,

acknowledge that you’re grieving, and that a loss is coming and you can’t control it,

he said. Naming what you’re experiencing helps you better understand your current

circumstances and be more compassionate toward yourself, he added. That honesty

may help your overall healing process, added Mary-Frances O’Connor, a professor

of psychology at the University of Arizona who studies grief and is the author of “The

Grieving Body.” Research on late-stage cancer patients found that when the people

around these patients worked to accept the loss of their loved one, they adjusted

better to bereavement after the death. So, it’s wise to be open about your feelings

and ask other people for support, said Peggy Morton, a clinical associate professor

at the Silver School of Social Work at New York University. Talk to friends who have

been through similar situations and seek their advice, she said.

Deal with unfinished business.

You can use a period of anticipatory grief as an opportunity to figure out if there are

any issues you need to work through, such as things that have gone unsaid, Dr.

O’Connor said. When someone is in hospice care, Dr. O’Connor said, “they are

encouraged to have closure conversations, getting a chance to say: ‘I love you,

thank you, I’m sorry, please forgive me, I forgive you, goodbye.’” Research suggests

that survivors experience less depression after a death when they have these types

of meaningful communication. If you’re expecting a death, Dr Wolfelt said, you might

use this time to gather mementoes and archive memories. Follow the person’s lead,

he said, but if they are up for reminiscing, ask them questions and give them

prompts such as photographs.

Stay in the present.

Constantly worrying about the future can be demoralising, Dr. Wolfelt said. “Don’t

spend more time and energy in your imagination than in the present.” Dr. O’Connor

agreed, adding: “It’s in the present moment that we get to have connection and

compassion and joy and love.” While you’re in the midst of anticipatory grief, try to

cultivate hope by looking for interests, activities and people that make you feel

optimistic, Dr. Wolfelt said. Then put an activity on your schedule every day —

whether it’s phoning a friend, sharing a home-cooked meal with a loved one, or

praying. Hope keeps you going, and it balances the darkness and confusion.

Know that the loss will still be hard.

Some anticipatory grievers imagine that by the time their loss takes place, “they will

have ‘used up’ all their grief, or that it will be easier when the loss happens,” Dr.

Wolfelt said. “That’s a misconception,” he added. “It’s still hard. You’re not all done.”

All the experts warned that you can never fully predict what a loss will be like. “My

mother was quite ill for a protracted period of time,” Dr. Morton said. “And every time

there was a close call, my sister and I rehearsed and thought about what we would

do and what would life be like without her.” But when her mother died “rather

suddenly,” Dr. Morton said, “I was very overwhelmed and upset. And I would never

have anticipated that, because we had rehearsed it so many times.” If you’re

ruminating about your upcoming loss or change, or if your worrying affects your daily

functioning, consider seeking help, whether it’s peer support or a therapist, Dr.

Morton said. And yes, it’s OK to join a support group before your loss has happened,

she said. “Find people to talk to,” Dr. Morton said. “Don’t keep it all inside.”