Understanding Anticipatory Grief

Document created by kbass on Dec 30, 2016Last modified by mcunningham on Mar 8, 2017
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What is anticipatory grief and what are the symptoms?

The thoughts and feelings that come from knowing that the death of your loved one is close are called anticipatory grief. People may respond to anticipatory grief by an increased need to hold on to their loved one. Others may withdraw from the dying person. Both responses are normal and common reactions.


anticipatory griefOther normal thoughts and feelings associated with anticipatory grief may include:

  • sadness
  • extreme concern
  • worry about the future (unmanaged symptoms, end-of-life “business,” financial burdens)
  • uncertainty
  • anger
  • being overwhelmed





What helps anticipatory grief?

  • Family and friends may be a great source of comfort.
  • Sharing your concerns with your hospice team may help identify the source of your worry and assist you to make a plan.
  • If you are feeling angry or overwhelmed you might try:
    • asking for a break
    • identifying the cause of your anger
    • doing something physical like walking, squeezing a stress ball, stretching
    • talking to someone.
  • You may also try keeping a journal, gardening or other hobbies to help you deal with anticipatory grief.
  • If you are feeling overwhelmed it helps to focus on what you can do today.


Conversations at the end of life may be some of the most difficult conversations you ever have. However, they may also be some of the more meaningful and rewarding. 

We recommend the following:

  • Spend time with the person who is dying.
  • Engage in open communication.
  • Even though it hurts, let yourself experience feelings of grief.


Dr. Ira Byock identified five things that patients and families should try to say to each other during this time:*

  • Forgive me
  • I forgive you
  • Thank you
  • I love you
  • Goodbye



* Byock, Ira.: Dying Well: The Prospect for Growth at the End-of Life, East Rutherford, N.J., Putnam-Reverhead, 1997.



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