Anticipatory Grief

What is anticipatory grief? Anticipatory grief is defined as grief that occurs before death in contrast to grief after death (conventional grief). Rather than the death alone, this type of grief includes many losses and may occur over an extended time period before death occurs. Anticipatory grief is the normal mourning a person feels when she is anticipating the death of a loved one. Anticipatory grief includes sadness, concern for the dying person, preparing for the death, and adjusting to changes that have happened and will happen when death occurs.


It started with the skin grafting surgery on her leg because of a wound that would not heal. My mother-in-law was still in the hospital, a couple of days post-op from that surgery when she had her heart attack. Tests showed she needed heart by-pass surgery, which was scheduled for the end of the week.


She tolerated that surgery well and was about ten days post-op, recovering at home, when we tried calling to ask how she was doing. There was no answer. We called several times. No answer. Finally, we decided to drive over to her house.


We found that she had suffered a massive stroke from a blot clot caused by afibrillation of her heart. The stroke caused paralysis of the right side of her body. The doctors were not optimistic about her prognosis. The first 48 hours were critical to her recovery. As those hours passed and then as the days passed, we saw very little improvement. We began the long process of anticipatory grieving as we realized that our Mom would never be the same.


She could not feed herself, bathe herself, or dress herself. She would require total care for the rest of her life. She would never return home to stay but would become a permanent resident of the care facility. We gave away her household items, much of her clothing, so many things that had been meaningful to her.


We grieved that she would never care for herself again.

We grieved that we would never “go home” for Sunday dinner or for

           holiday gatherings.


We grieved her loss of independence. She could no longer stand or walk. She was confined to bed or to a wheelchair. In fact, after the therapist tried to teach her to “drive” her power wheelchair, she kept crashing into the walls and into other residents and was banned from using that chair!


We grieved that loss of her independence, and of course, we grieved when her car was sold because she would never drive again.



Immediately following her stroke, we took turns feeding Mom. Some weeks later she struggled to use her left hand to raise a fork to her mouth to feed herself. But we realized it was easiest for her to use her fingers to eat, just like a little child.


We grieved the reality that she was now more “child” than “mom” to us.



My mother-in-law had the most bubbly, out-going personality and loved to talk. She had many friends and family members who dearly loved her. But the stroke also affected her ability to speak. She would never talk or laugh or joke with her family or friends again.


We grieved the loss of her ability to communicate with us.


One result of this anticipatory grieving was that when she died thirteen years later, so much grieving had already been done, so many tears had already been shed, we really just felt relief and gratitude that her difficult journey was over. We experienced the loss of our precious mom and grandma, but our grief was not raw, there was no shock at the loss.


I have talked to others who have had this same experience of anticipatory grieving. They, along with my family, felt guilty about the absence of tears and sadness at the time of death. They felt guilty about the relief of no longer having to see their loved one suffering with limitations.


After learning about anticipatory grief, I now can better understand the experience my family had with my dear mother-in-law. In my work with MKD Family  Aftercare Services, I can share with others who are going through the same things and feeling the same emotions. The MKD Grief Support Group can offer help to those who have gone through this experience as well.