Anticipatory Grief: Grieving Someone Who Is Still Here

Grief doesn’t always begin after someone dies.

Sometimes it starts with a diagnosis. Sometimes it comes with watching someone lose their independence or realizing that the relationship you have with them is beginning to change. Sometimes it’s knowing what is coming, even when you don’t know exactly when. This is often called anticipatory grief, and it can begin weeks, months, or even years before a death.

It can also be confusing. How do you grieve someone who is still sitting beside you? How can you feel heartbroken about losing someone while also being grateful that they’re still here? The truth is, both can exist at the same time.

What Is Anticipatory Grief?

Anticipatory grief is grief that happens before an expected loss.

It may happen after a terminal diagnosis, while caring for someone with a progressive illness, or as someone you love becomes more dependent on others for their care. But you aren’t only grieving the death that may eventually come. You may already be grieving things that have changed along the way. Maybe your spouse can no longer do the things you used to enjoy together. Maybe your parent needs help with things they once did independently. Maybe conversations don't look the way they used to. Maybe plans you thought you'd have years to make together suddenly feel uncertain. These are losses too… and you don't have to wait until someone dies for them to hurt.

Anticipatory Grief Doesn't Always Look Like Sadness

We tend to picture grief as crying and sadness, but grief can show up in a lot of different ways.

You might feel anxious about what is coming. You might be angry that this is happening at all. You might feel numb. You may have trouble concentrating or find yourself thinking about things you normally wouldn't. You may feel guilty for enjoying yourself when your loved one is sick. And sometimes, especially after a long period of caregiving, you may even find yourself wishing the difficult part would just be over.

That last one can carry a lot of guilt. But wishing for an end to suffering or feeling exhausted by an incredibly difficult situation doesn't mean you stopped loving the person you're caring for. Sometimes it just means you're tired.

You Can Be Grateful They're Here and Still Grieve

I think this is one of the hardest parts of anticipatory grief.

There can be this feeling that because your loved one is still here, you should only be grateful for the time you have. And of course, there may be gratitude. But gratitude doesn't erase grief. You can be grateful for another day and still miss the way things used to be. You can hope for more time and also feel exhausted. You can enjoy a good day together and still cry when you're alone later. You can love someone deeply and wish none of this was happening. Those feelings don't cancel each other out. There can be room for both.

Caregivers Experience Loss Along the Way, Too

When someone becomes seriously ill, life often changes for the people caring for them as well. Roles within a relationship may shift. A spouse becomes a caregiver. An adult child begins making decisions for a parent. Daily routines begin revolving around medications, appointments, symptoms, equipment, or simply making sure someone is safe.

You may have less time for yourself. You may be sleeping differently. Your work or family responsibilities may change. And sometimes, without even realizing it, your world becomes much smaller. Acknowledging those losses does not mean you're making your loved one's illness about you. It means you're a person going through something difficult too.

Caregivers need care, too.

You Don't Have to “Make the Most” of Every Moment

When someone is nearing the end of life, there can be a lot of pressure to make every moment meaningful.

Have the important conversations. Take the pictures. Make the memories. Say everything you've ever wanted to say. Those things can absolutely be meaningful. But every moment doesn't have to become a memory. Sometimes you're going to sit together and watch TV. Sometimes you're going to talk about what you want for dinner. Sometimes your loved one won't feel like talking at all. Sometimes you're going to be tired and need a break. You don't have to create a perfect ending. Being there counts too.

Anticipatory Grief Can Also Change From Day to Day

There may be days when you feel like you're handling everything surprisingly well. Then something small happens and suddenly you aren't. A song. An old photograph. Something your loved one used to do without help. A future event you realize they may not be there for. Grief doesn't always arrive in big, obvious moments… Sometimes it sneaks into completely ordinary ones. Give yourself space for that. There isn't a correct way to feel while preparing for the loss of someone you love.

You Don't Have to Wait Until After the Death to Get Support

Support for grief doesn't have to begin after someone dies.

If your loved one is receiving hospice care, ask what emotional, spiritual, caregiver, or social work support is available to your family.

Counseling, support groups, trusted friends and family, faith or spiritual communities, respite support, and other resources can also provide somewhere to put some of what you're carrying.

An end-of-life doula can be another layer of support. End-of-life doulas provide non-medical support to individuals and families throughout the dying process. That may include education about what to expect, caregiver support, helping families prepare for the final days, creating space for difficult conversations, vigil planning, or simply being present with a family during a time that can feel incredibly uncertain.

You don't have to wait until everything becomes unbearable before asking for help.

There Can Be Room for Both

Anticipatory grief is complicated because you're grieving while you're still loving someone in the present.

There may be sadness and laughter in the same day. Fear and gratitude. Exhaustion and love. Hope and grief. You don't have to choose one feeling and decide that's the only feeling you can feel.

You can be grateful they're still here and still grieve what has already changed.

There can be space for both gratitude ad grief at the same time.

At Blooming Transitions, I provide non-medical end-of-life support for individuals and families throughout the Tampa Bay area and virtual support for families beyond Tampa Bay. My role is to help families feel more informed, supported, and less alone as they navigate the changes that can come with serious illness, caregiving, dying, and loss.

About the Author

Brittanny Clervil is an end-of-life doula and Licensed Practical Nurse serving the Tampa Bay area through Blooming Transitions. She provides compassionate, non-medical support for individuals facing serious illness, those at the end of life, and the families caring for them. Through education, guidance, and a calming presence, Brittanny helps individuals and families navigate end-of-life with greater understanding, confidence, and support.