Understanding Anticipatory Grief: Navigating Emotions in Hospice Care

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If you or a loved one has recently entered hospice, you are likely familiar with anticipatory grief, although you might not have heard this exact term before. Anticipatory grief is a painful, deep sadness that occurs before an unavoidable loss. Anticipatory grief is helpful in that it can help you prepare for a loss. It can help you navigate the grieving process. However, anticipatory grief can lead to a condition known as prolonged grief disorder (PGD). This condition can make it hard to function in relationships, at work, or at school. 

This article will take a closer look at anticipatory grief, what it looks like, and how hospice care can help you cope and prevent PGD. 
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What Is Anticipatory Grief?

Anticipatory grief, sometimes called preparatory grief, is a term that is used to describe grief that occurs before an impending death, rather than just after. A person may also experience anticipatory grieving upon receiving a terminal illness diagnosis or upon being diagnosed with a progressive illness like Alzheimer's disease or pancreatic cancer. Anticipatory grief may occur for the first time when having to address hospice or end-of-life care. 

This type of grief is common both among the person who is facing death and caregivers. A close family member living with someone receiving hospice care, for instance, may experience anticipatory grief. 

It’s important to note that not everyone experiences anticipatory grief and that is normal too. 
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Signs of Anticipatory Grief

Essentially, anticipatory grief is marked by feelings of sadness, despair, and physical symptoms like trouble sleeping. Expanding on the above, anticipatory grief may also include the following:   

• Sorrow, tearfulness, or guilt 
• Anger
• Anxiety or fear 
• Loss of appetite 
• Being preoccupied with death 
• Social withdrawal and loneliness 
• Trouble sleeping 

Everyone experiences grief differently so the signs of anticipatory grief may vary, as well. 
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Can Anticipatory Grief Be Beneficial?

Anticipatory grief is a natural part of loss and it’s adaptive in many ways. It can help you proactively deal with grief so that it isn’t so overwhelming later. Anticipatory grief prompts you to deal with practical things like setting up funeral arrangements early. It also allows you to say your goodbyes. 
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Anticipatory Grief Vs. Prolonged Grief Disorder 

Up to 10 percent of adults who experience any type of grief (both anticipatory and traditional) later meet the diagnostic criteria for PGD. The symptoms of this disorder are the same as for grief, however, they are more severe and persist for six months or more. 

• Avoiding reminders of the death 
• Intrusive thoughts about the loss 
• Feeling emotionally numb 
• Inability to accept that the loss has occurred 
• Intense emotional pain and suffering 

Typically, the symptoms are so severe that they interfere with important areas of life, such as your work or relationships. PDG is a risk factor for major depressive disorder if not dealt with. PGD can also lead to suicidal thoughts or behaviors. 

Important: If you are experiencing suicidal thoughts, it's important to call or text 988 (in the U.S.). This is the Suicide and Crisis Lifeline. Trained counselors are available 24 hours a day, including all major holidays. 
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How to Cope With Anticipatory Grief 

So, how do you calm anticipatory grief? There are ways to cope with this type of grief and support services are available, as well. 

• Don’t ignore your emotions - If you have been taught to push your emotions down, this is not the way. It’s not healthy and can lead to other issues like using alcohol excessively to cope. Instead, feel your emotions. It’s okay to cry and talk about how you are feeling with others. 
• Take care of yourself - It’s easy to lose sight of your own needs when you are in the process of grieving an impending loss. However, this can negatively affect your physical and emotional health, making the loss that much harder to cope with. Make sure you are getting the recommended seven to nine hours of sleep a night, exercising, and eating healthy. 
• Find support- Hospice services can be a great source of support for those experiencing anticipatory grief. Patients have access to spiritual, social, and emotional support workers. In addition, grief and loss counseling can also be provided for the patient’s loved ones up to a year after the death. Counseling can be a major help when it comes to caregiver grief. 
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Summary

If you or someone you love is facing death, you may experience trouble sleeping, sadness, and other symptoms. It’s important to get the support that you need to cope with anticipatory grief. Hospice care can be part of that support. 

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