The Long Goodbye
July 31, 2022 was the last time we ever went out. We met with one of Wendy’s students who had become quite successful in her dream job. I capured Wendy’s gaze, knowing then that her mind was racing with anticipatory thoughts I was having as well.
We often hear that death is as natural as birth. Yet while expectant parents have countless resources to guide them through bringing life into the world, there’s very little that prepares us for the experience of losing someone we love.
When a loved one is facing a life-limiting illness or decline, many people begin grieving before the loss actually occurs. Mental health professionals call this anticipatory grief. This complex emotional response was one I never knew about before Wendy was diagnosed with her Stage 4 colon cancer. Anticipatory grief can begin days, months, or even years before death.
In retrospect, it likely began for me the second day Wendy was in the hospital and the doctor pulled me into the hallway and told me to “get my affairs in order.” How does one get their head back into the game after that?
While this kind of grief can feel confusing and overwhelming, understanding it can help you navigate both the practical realities and emotional weight of what lies ahead.
What Is It?
Anticipatory grief is the emotional process that occurs when a loss is expected. It can be experienced by both the person who is dying and those who love them.
While it shares similarities with grief after death—such as sadness, anxiety, or anger—it is different in one important way: it is proactive rather than reactive. Emotions may shift rapidly, moving between hope, fear, acceptance, and even moments of normalcy. This unpredictability can make the experience feel like an emotional rollercoaster.
Through it all, it’s vital to understand that having anticipatory grief before a loss does not mean that there will be a reduction in the grief that comes afterward. Sadly, there is no “prepaid” emotional balance. Feeling your feelings before the death of a loved is as necessary as processing the grief after death. And it takes as long as it takes.
It’s Not Just About Death
Of course, anticipatory grief can arise in many situations such as:
A terminal diagnosis such as advanced cancer
Progressive illnesses like Alzheimer’s or muscular dystrophy
Caring for a child with chronic or developmental conditions
The declining health of a beloved pet
What surprises many people is that because grief is the natural response to any loss, other events may trigger anticipatory grief, including:
Divorce
Children heading to college or moving out
Business restructuring that may result in layoffs
Retirement
Moving to a new city or country
Forced displacement due to community rezoning or natural disaster
Financial instability and loss of income
In each of these cases, people begin mourning the future they imagined.
What I Wish Someone Had Told Me at the Time
As difficult as it may be to navigate anticipatory grief, it’s essential to address some practical, emotional, and psychological things to make an otherwise chaotic time a little more manageable.
Understand your loved one’s health: One of the best ways to prepare is to become educated about what your loved one is facing. Talk to their doctors or other medical professionals. Learn about their physical condition and what to expect as they deteriorate. Are there limitations, suggested exercises, food restrictions, medication regimens, or other necessary steps for care? Ask what will make your loved one most comfortable during this time.
Get your affairs in order: As cliched as the phrase has become, it’s necessary to organize legal and financial paperwork. Time is of the essence. You can’t put your head in the sand and decide to deal with it all later. See if there is a will and advance directives. If not, meet with financial or legal experts to see what can be created. If that is not practical, explore the protocol of what to do when someone dies without a will. Review all household and financial accounts such as utilities and credit cards and ensure they’re not solely in your loved one’s name. It’s also important to securely document login information for computers and online accounts so access isn’t lost.
Know your loved ones wishes: Ask if they’d like a funeral or memorial service. These are delicate conversations to have with someone but explain that you want to be sure arrangements are made according to their desires. Be respectful of any choices, even if they differ from yours. For LGBTQ folk, I found it to be essential to have these wishes in writing and notarized if possible. Death impacts surviving loved ones, and they often want to take control of the uncontrollable. Thus, they may want to make decisions that are far from what your spouse wished. Having paperwork in order that explicitly details desires can be helpful during these chaotic moments.
Say everything: This is the time to express thoughts and feelings. Say, “I love you.” Harriet Beecher-Stowe said, “The bitterest tears shed over graves are for words left unsaid and deeds left undone.” You cannot get time back. Do your best to have no regrets.
Build a support network: Reach out to friends or family members. Consider joining a support group. Asking for help before your loved one dies gives you a network to tap when that moment comes.
Prepare the kids: Children know when something is up. Explain the situation in ways appropriate for their age. Seek out a counselor or therapist if necessary.
Be mindful: Far too many of us get lost in the days ahead of us instead of recognizing today. We are never promised tomorrow. When a loved one faces death, it’s crucial to get grounded and stay present. Enjoy this minute, this hour, and this day. Concentrate on being grateful. Spend quality time looking at photos, sharing stories, playing favorite music, or watching favorite movies. Listen to your loved one in a non-judgmentally way to help them cope.
Take time for self-care: Being a caregiver is difficult and preparing for a loved one’s death is exhausting. Set time aside for physical and emotional health. This includes eating, sleeping, exercising, and tending to your needs.
Could This Feeling Be Anticipatory Grief?
If you’re in this place as you read this blog, know this: what you’re feeling is valid. The emotions can be wide-ranging and often unpredictable, but there are signs to look for. You may experience:
Intense sadness, fear, anger, or irritability
Anxiety, sometimes with physical symptoms like a racing heart
Guilt or regret
Loneliness or isolation
Difficulty concentrating on daily responsibilities
Emotional numbness
A sense of losing control
Mentally “rehearsing” what life will look like after the loss
It’s also common to feel conflicting emotions at the same time. While still holding on to hope, it can stride alongside despair. Moments of acceptance may also change to denial. These shifts are normal. You may think you’re crazy. You’re not crazy. This is grief.
Anticipatory grief is a deeply human response to the awareness that loss is coming. It can be painful, disorienting, and exhausting. But it can also create space for connection, reflection, and meaningful closure.
And while you cannot control what lies ahead, you can choose how you show up in the time you have now. Treasure it.