Your gain: Gain a better understanding of what anticipatory grief is, the effects it can have on a griever, and how to cope with it.

I wanted to write about this particular kind of grief because it’s a grief I know well. It’s a kind that many, many people have and will experience, particularly if there’s a prolonged illness or watching a decline in some way. I experienced it with both of my parents’ deaths. Looking back on it now, I actually don’t know how I got through it as well as I did some days. More on that below, though.

What is Anticipatory Grief?

So what is anticipatory grief, anyway? Let’s dive right in.

As you probably gleaned from my context above, it usually affects caregivers and family, friends. It’s a type of grief that begins before—sometimes long before, even—a person passes away. This anticipation can venture through diagnosis, deteriorating health, and imminent death. Truthfully, I feel like it’s one of the most brutal kinds of grief.

It’s actually sort of wild, if you think about it, how humans can even cope with anticipatory grief. Knowing the fate of someone you care so deeply for, and still having to function every day. When you really think about that, how do we move from day to day with that looming? Kind of crazy, right?

My Experience with Anticipatory Grief

When I say I know this well, I want to give you some quick context as to why I say that. My mom was diagnosed with esophageal cancer around May of 2019, and was gone by that December—so roughly seven or eight months. While my dad had a six-year journey with prostate cancer, his more significant decline with it was about six months.

In both of these timeframes there was chaos of doctor and hospital visits, bouts of pneumonia (both of them at the same time once), and my mom having to cope with her tracheotomy. New, more limited lifestyles from what they were used to, not having the appetite or diet they once did. On my end, watching all of this with there being little to nothing I could do about bodies that were failing them. It was absolutely awful and I felt helpless. And, very alone, especially being an only child.

But my mom’s decline felt different to me than my dad’s in some ways. Why? Because with my mom, I hadn’t been through anything like that before. It was so scarring on all of us, and we were all flying by the seat of our pants, in a way. For a very, very long time I think I had my head in the clouds about what her fate really was.

How Anticipatory Grief Can Manifest Itself

Truthfully there are a lot of ways that anticipatory grief can manifest itself, but the ones I’ll cover here are, I think, some of the most prevalent and impactful ways. The ways that we probably need to pay the closest attention to and cope with the most intentionally.


For me (and many others), anticipatory grief can involve denial. Especially for a usual optimist and “glass half full” kind of girl like me, thoughts that things will be okay. They just have to be. 

Denial Example #1

My mom was—is—the strongest person I know. A true Taurus to the bitter end. The woman didn’t know fear, and there was nothing, NOTHING that could bring her down. She didn’t know the word weakness, either. But whether the person who’s in the process of dying is one of the strongest we know or not, we can still have some semblance of denial that what’s happening is really happening, you feel me?

Because of that—and also because I had no idea how huge the tumor in her esophagus was until much later on—there was no wrapping my mind around the severity of it all. I thought she would go through the necessary treatments, we’d all figure it out together as a family, and it might be a rough road but she WOULD get through it. There was no way around it. Death simply wasn’t an option. Amongst her persona simply not matching a fate like that, she was only 62. So, so young still. You couldn’t convince me of anything else for most of her 7-to-8-month decline.

Because I had never witnessed anything like this before, I was both painfully unaware and unprepared. I was also in great denial that anything could possibly go so wrong. This wrong. I’m not joking, I still had hope (or maybe it was just denial, I don’t even know) within a month or two of her death.

Denial Example #2

With my dad’s decline, which began more or less around March or April of 2020 (he passed in July 2020), it honestly still pains me to say this but to put it simply: I knew what to expect. I mean, generally speaking. I had just been through this with my mom. Of course not in the same exact way, there were differences in their types of cancer and health issues and all the things. Not to put too fine a point on it—I knew what it was like to have a dying parent in front of me. But this did not come right away. In fact, this came pretty late. Because again, I feel like I was in some pretty deep denial. 

A part of this was certainly because I didn’t actually know his cancer was metastatic (moved from the prostate to his back and brain) until much later on, so I didn’t actually know how bad it was, technically speaking. But emotionally, I was like… “In what world am I about to lose my dad THIS soon after losing my mom?! No freaking way. This is surreal. This isn’t happening.” 

It wasn’t until I came over to their condo where my dad was living alone—mind you I had JUST broken up with my then-boyfriend probably an hour or two before this, not even kidding—to find him almost non-responsive on the bed. Anything he said to me made little sense, he was very dehydrated, and more.

I called the ambulance for him, and before I knew it he was in the ICU. From there, he never came home. Even in the ICU I don’t think I could comprehend the fact that the cancer had spread. I couldn’t accept or wrap my head around a very sweet nurse telling me he was very depressed, and that he was “on his way out”, if you will.

I just knew, in the moment, things were bad. Putting it mildly, of course.

Denial Coming in Waves

Denial would continue to go and come. It still does. There are days where I’ll have a moment to myself, or a moment where I’m speaking with someone, and a wave of denial hits—as do many aspects of grief. If denial is something you have or continue to struggle with, please know this:

It’s completely, entirely normal. Like fear, I feel like this is a coping mechanism of our brain that’s trying to protect us from getting hurt. At least more than we already are. It’s something that is entirely natural to experience, and we often can’t help it, so please never feel like it’s the “wrong” thing to think or feel. Your body is doing all it can to understand what’s happening around you, and that takes time.

Stress & Anxiety

Stress and anxiety around a looming death… you’re probably like, “tell me something I don’t know, Tara”. To which I would say, “I know! But I’m going to touch on this anyway, because we’re going to talk about coping mechanisms for this further down in this post.”

Calling Mr. Wonka

Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. Think of it as this scene from Willy Wonka.

Willy Wonka going through colorful tunnel with the text "Yes! The danger must be growing"

That crazy, ridiculous tunnel they’re all traveling through, do you remember it? Wonka is singing that creepy song, it starts going faster and faster, there are those absolutely horrible images that flash on the walls. None of it is logical or makes any sense, it’s just frightening and confusing as the maniacal Mr. Wonka (gotta love Gene Wilder, though) is just reciting his poem and having a grand old time.

Anyway, what am I getting at here? I’m saying that this is kind of what anxiety is like. Loss of control, worst case scenario thinking and imagery to boot, and complete uncertainty. Meanwhile, if you’re in this Willy Wonka ride from hell, you’re like… “let me off this boat now please!” Right? Yeah, I get it.

If you’re someone who knows anxiety well and perhaps this has only gotten worse with an impending loss, I want to acknowledge that and please know I see you right now. It can be so, so scary and not being in control of what’s happening to a loved one, your emotions, and your thoughts. It’s one of the worst feelings we humans can experience. 


I want to also quickly address dread, because this is another common emotion a lot of us grievers might feel when anticipating a loss. Dread occurs in response to high probability negative events, and its intensity increases as the dreaded event draws nearer. I think of my parents as examples here, because they both had slower deaths due to their illnesses. I knew, at some point, death was coming. That is an event that I dreaded every damn day.

Because dread makes an anticipated negative event even worse, we often prefer to get unpleasant things over with quickly, even if doing them sooner means they will be more unpleasant. This almost reminds me of someone being on life support, for example. Especially if we know they’re not getting better, belaboring it is really only going to make it worse, but doing it now or sooner versus waiting one could certainly argue is an unpleasant idea to ponder.

Dread can look like a lot of different things. I’ll include some examples below, even outside of any death-related losses (i.e. a friendship, job, etc.)

What Dread Can Look Like

  • Feeling unsure or nervous about financial responsibilities.
  • What could happen to you or the rest of your family upon their passing.
  • How children might take the news, or how it could affect them long term.
  • Feeling uncertainty around your own future, and what this death or loss could mean for you.
  • An impending loss of identity (i.e. If I lose my child, am I no longer a mother? If I lose my parents, am I no longer a daughter? If I lose this job, am I a [insert a still a career/job here]?)
  • Having to travel or go to certain places without a person.
  • Move to a different space, city, country, etc.
  • Being in/around different surroundings (outside of needing to move anywhere). This could mean being in your current space, just without a significant person.

Really the list could go on, but I hope at least one of these resonated. Bottom line, dread is an extremely common and natural (and often unavoidable) thing to feel when we know a loss could be coming.

Feeling Lost and Hopeless

Feeling lost during anticipatory grief (and certainly after) is probably one of the most frequent emotions grievers move through. To begin to “find” ourselves or our bearings, or feel more hopeful again, requires us to reorient ourselves physically, emotionally, and even socially. 

We could feel lost in our own skin half the time! Examples of this (other than what I just mean might be:

  • Feeling unsure of what to do next (whether in your own life, a more immediate decision in front of you, etc.)
  • Feeling unsure about how to handle a certain situation in front of you.
    • This could be a medical decision, deciding on whether to keep something or not (i.e. belongings of loved ones, more on that here), and so much more.
  • Feeling confused about how we even got here to this dark place. 
  • Feeling confused and lost about why a certain illness or situation or thing could be happening to someone you love, and even feelings of “why me”.
  • Unsure how to feel, perhaps because we’re feeling so many things that it’s overwhelming.
  • Hopelessness about ever feeling happy or fulfilled again.
  • Hopelessness and mourning a future you thought you were going to have, that is now being taken away from you.
  • Hopelessness about never finding another partner or friend after what you’ll lost.
  • Hopelessness or feeling lost about the notion of never being able to communicate or speak to a loved one once they pass.
  • Hopelessness in terms of feeling powerless in being able to help your loved one (or even yourself!).
  • Hopelessness around feeling abandoned or having to “go it alone” in life (this has DEFINITELY been me!).
  • Feeling uninspired.
  • Hopeless about how you might be viewed or treated with this impending loss.
  • Feeling lost or hopeless about how you might be able to stand up for yourself moving forward, once you’ve lost this person or thing.

That was a whole bunch of examples, but the list is really endless here. And, you might be feeling a LOT of these at once! That’s so normal, I want you to know that. It’s more than okay to worry about these things, it’s a very human response to a threat—the threat being what we’re about to lose.

How to Cope with Anticipatory Grief

The gut-wrenching pain and the agony of getting accustomed to a life without them. The denial, shock, stress, dread, hopeless thoughts and every emotion we’ve talked about so far. Anticipation of having to live and relive all of this is AWFUL. It makes sense that we might be a little anxiety ridden over all of it! 

But here’s the thing that we must always come back to. I want to preface this by saying this is NOT a concept I need or want you to understand right now, but with due time.

We can’t live in this space. Any day could be our last day and we don’t even know it, right? If the reality is that a loss or a death is on the horizon, turn this anxiety on its head and take your power back. You can do this in a few ways, and this is what I would recommend based on my own experience.

Spend Time

Spend as MUCH time with that person as possible. I know, all too well, that the stress of work, school, a family, and countless other things might prevent us from being able to do this fully. When my dad was declining, COVID was rearing its ugly head and I could barely see him. Most days I simply had to call and was given no other options, which I HATED. But I would do my best with it. Our conversations didn’t always last long or even make sense due to the cancer spreading to his brain, but the effort was there.

The point is, we have to try and make this less about ourselves and more about them. Give their legacy the light and attention it deserves. Be so painfully present with them. Remember every inflection in their voice. Remember the marks on their skin and the warmth of their touch. There’s no going back and experiencing those again once they’re gone. Soak it all in. You’ll be so happy you did.

Cope in a Healthy Way

Let’s talk about coping mechanisms for a moment. Anxiety especially often leads to one of two coping mechanisms: worry or avoidance. Unfortunately, neither of these strategies are very effective.

Addressing Worry

Worrying and anxiety go together, but worry is not an emotion, it’s the thinking part of anxiety. Worry can be described as a chain of negative thoughts about bad things that might/will happen in the future.

Research also shows that those of us with the tendency to worry believe it’s helpful for coping. Which, by the way, it is not. And, many believe it is uncontrollable, which means we don’t try to stop worrying and try to suppress worrying thoughts, which actually strengthens and reinforces worry. See how vicious of a cycle that is? 

The suggestion here isn’t to worry about worry, but it’s helpful to recognize that worrying is not a helpful coping mechanism. That we absolutely can learn how to control it, and that rather than suppressing worry, we need to dig in and address the emotion driving the thinking.

Addressing Avoidance

Avoidance is the second coping mechanism for anxiety (but this also applies to the denial and dread we talked about), and that involves not showing up and often spending a lot of energy zigzagging around and away from that thing that already feels like it’s consuming us. Avoidance can hurt us, hurt other people, and lead to increased and mounting anxiety. 

To summarize a quote from Dr. Harriet Lerner’s book The Dance of Fear, and this is what I really want you to take away here…

“People want to feel comfortable, so we may avoid doing or saying the thing that will evoke fear and other difficult emotions. Avoidance ultimately makes you feel less vulnerable in the short run, but it will never make you feel less afraid.”

A huge part of anxiety, denial, and dread for grievers is the idea that they could go through another major loss. I mean the impending one, but then god forbid another one on top of that someday. I’d be lying if I said I wasn’t a little nervous about the day where I lose someone else near and dear to me. That’s a terrifying thing to think about!

The thought of losing yet another loved one or someone significant could be anxiety inducing to anyone. But it’s more than just the loss, right? It’s everything that comes along with it! Hi, secondary losses.That leads me to my next couple of points.

Give Yourself Grace

Remember to give yourself grace. On a related note to the above, I want to acknowledge how emotionally taxing it could be to be around someone we know is, ultimately, dying. Please remember to take care of yourself. I get into self-care more below, but be selfless in remembering that their life is the one coming to an end and they need support. But be just selfish enough to know when you need a break. When you need space and time and an outlet to process what is happening and what’s in front of you.

Talk To Someone

I can’t stress this enough. Don’t burn yourself out, and don’t burn the candle at both ends as much as you can avoid it. I KNOW this can be hard. And in being a difficult thing, that means you need to take care of your heart and mind. As difficult as it is for your loved one to be on decline, watching that as someone who loves them so fiercely is excruciating. 

Give yourself permission to take time outs and talk to someone. Perhaps someone not even in your inner circle. A Grief Coach such as myself, a therapist, counselor, what have you can be such a beneficial outlet for you to talk about what you’re thinking and feeling, your fears about their impending death, planning for the future and figuring out what that looks like… everything. Use it to your advantage!

Self Care with Anticipatory Grief

When it comes to anticipatory grief, I can’t stress enough how important it is to take care of yourself and your soul. A really unfortunate comment I’ve heard when someone is going through anticipatory grief (myself included) is, “you’re putting them in the grave already and they’re not even dead!”. 

It’s so painfully unfair to put this back on a griever like that. If you’re the one grieving and experiencing anticipatory grief right now, maybe you’ve had this said to you. Or you could imagine, at least, how awful it would feel to have someone say this to you. Especially when that isn’t at ALL the intention!

With comments or judgements like that, we often end up holding our broken hearts and our grief in silence. That’s the last thing, the LAST method grievers should be using to cope with an impending death. Grievers need compassion, love, support, hugs, cuddles, food made for us maybe (or delivered, who’s being picky here, amirite?!), to simply be listened to, validated, seen… I could go on. So, without further ado, some self-care recommendations.

Ways to Practice Self Care

In your self care, make sure you’re getting as many of these as you can from somewhere.

Some of my favorite ways to practice self care in a situation like this are:

  • A warm bath with some lavender involved.
    • If you can, avoid being on your phone or watching TV as you do this. Just close your eyes, breathe, and let out any emotions that come.
  • Treat yourself to a massage (this doesn’t have to be at a fancy place!) to release some of the tension from your body.
  • Practice meditation (more on that here).
  • Practice ways to relax and calm your mind (more on that here).
  • Hugs and/or cuddles from a partner or friend.
  • Cuddling up with a book.
    • I want to note here: make sure it’s a book that inspires you in some way. Whether it’s a fun fiction, an autobiography of someone you admire, a non-fiction on changing up your mindset (I love Untamed by Glennon Doyle, that got me through some very dark times), be sure it’s something that leaves you feeling better than when you started.
  • Lots of sleep.
    • I’ll have a blog post all about this particular topic coming! But if sleep is difficult right now, make sure you’re:
      • Getting enough exercise each day to wear yourself out.
      • Consider taking Melatonin (but please research this before you do to make sure it’s right for you).
      • Practice breathing as you lay down and try to sleep.
      • Make to-do lists if your mind runs at night, have a notepad you can write down any other thoughts or ideas that are keeping you up.
  • Journal your thoughts, emotions, and feelings to get them out.
    • I have a journal prompt for this if you need it! Click here to access that. 
  • Practice breathing exercises. I have a whole blog on this subject if you need help, just click here!

In many instances, anxiety, stress, and feeling hopeless is due to the anticipation and fear of your future without your loved one. The pain and the absence you might feel again is natural and normal. And, can happen over and over again even years after they’re gone. (Grief is really fun, right?)

However, focusing only on these feelings creates more anxiety. To begin wrapping up this blog, I want to share an analogy about why coping with all of this properly is so important.

The Food Poisoning Analogy

Since I love analogies, I’d like to use a food poisoning analogy I once heard. Bear with me on this one, it has a good point I promise. 

Let’s say you and a friend are out having a meal at a restaurant and soon you realize that something’s not right. You both feel like garbage all of the sudden, you’ve eaten something bad and… let’s just say, there come the repercussions. Your friend immediately excuses themself from the table, and they go and do what they need to do in the restroom. But you don’t want to embarrass yourself or make a scene in public—or at least the bathroom. You sit there and you hold it all in. Meanwhile, your friend comes back to the table feeling somewhat better. At the same time, you’re feeling worse. Your friend has “let it go”, so to speak, and is able to move on. Maybe not to continue with that same meal, but the point is: you holding it in actually could have a fatal reaction.

It’s the same thing with your grief. Holding it in and not letting it go, not addressing it, not taking care of it, creates more anxiety and more stress which can create other harmful conditions. We don’t want that, right? Whether it’s anticipatory grief, or when you’re in the thick of it after the loss actually happens, this applies.

A Very Important Question

I want for you to acknowledge that your heart is broken, but ponder this for a moment and answer this question: Would you trade in your broken heart and all the pain and the sadness that you’re feeling right now for never having the wonderful times shared with your loved one? The answer to that is usually—well, almost always—no.

The Takeaway

The takeaway from this post today is this: let the pain and the hurt out so that you can make room for the hope, the love, and the gratitude that wants and so desperately needs to enter.

Use the coping tools and self care methods I mentioned above to do one thing, and one thing only: take it one moment, one day at a time. That’s it. Just put one foot in front of the other. Be there, and be present for your person. Give them your full and undivided attention while you’re with them, do your best not to think about all of the weight and responsibilities that are being dangled in front of you, because you won’t get that time back. You’ll have plenty of time to deal with them later. And, allow yourself to be cared for. Take the actions to care for yourself, too. Anticipatory grief is too significant to ignore.

Get Your Freebie From Me

I have THREE free tools you can take advantage of if you’re ready to step up your grief work. I’m so excited to share these with you! My Gratitude in Grief Journal Prompt, From Grief to Grinning Toolkit, and A Practice in Presence Toolkit are ready and waiting for you to download, all you have to do is click here or the button below.

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  1. Josie Facca says:

    You totally get it! I finally feel like I can look back at the last year and take a breath. I too lost both parents in the last year and everything you have described is so dead on! Parden the pun. I just wanted to reach out and say thank you for your writings on such a complex emotional rollercoaster of this grief.

    • Tara Accardo says:

      Thank you so much for your kind words, Josie! I’m so glad this resonated with you, and I truly appreciate the compliment so much. I appreciate the pun, too 😉 It’s absolutely my pleasure to bring this topic to fellow grievers, and I’m SO happy you’re at a point where you feel you can take a bit of a breath from everything that has happened. I’m so, so sorry you’ve lost both of your parents, too – I don’t wish this on anyone. I remember when I began feeling like some of the pressure was finally being alleviated a little bit and it really helped me feel like a light at the end of this very long tunnel was possible. Keep hanging in there!