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At The Holidays: Coping with Anticipatory Grief

Updated: Dec 24, 2019



Those familiar colors and songs mean holiday season is here again. For many, the beginning of the season brings memories of family traditions and sparks anticipation for this year’s get-togethers and shopping lists.


You probably know a variety of people who approach the season differently – some who love this time of year, some who are stressed out the entire season, and those who don’t really concern themselves much with the season.


Yet there are others for whom this season is bittersweet; those who struggle between a desire to celebrate and overwhelming sadness from a loss of a loved one or caring for one that is experiencing terminal illness.


Realizations At The Holidays

For families and caregivers of someone who is terminally ill, the sparkling lights, festive decorations, scents and sounds bring a somber realization that this may be their final holiday season with their loved one, triggering a period of anticipatory grief.


While grief and mourning are feelings typically experienced after a loved one’s death, it’s also possible to experience the feelings beforehand. When a loved one will be passing soon, the end-of-life experience is enough to trigger an anticipatory grief stage, before a death occurs.


Experiencing Anticipatory Grief

During the time of anticipatory grief, you may begin to feel like you’ve already lost your loved one, even though the person is still alive.


The overwhelming feeling of loss looms over you, and unlike those whose loved ones have passed suddenly, providing care for someone who is terminally ill often means you have an extended opportunity to work through your feelings, reflect on your grief, and explore what this loss will mean.


Intense reflection often occurs because providing care for a loved one likely puts your personal life on pause, as you add new time consuming and/or emotionally demanding tasks to your daily routine.


Care-giving’s Emotional Rollercoaster

There is an emotional roller-coaster during your time of care-giving. At times, your loved-one’s lack of sharpness or independence can test your patience. At others, the deteriorated state you see every day, causes you to mourn the person you remember before the illness occurred.


The flood of emotions can be too much to bear, but you keep going because you know your burden is temporary and because simply, you love them.


You set your thoughts aside and choose to focus only on your jam-packed weekly routine. Before you know it, you become used to living in this state of limbo, replacing thoughts of the future with medication schedules, pick-ups and drop-offs, and calls with social workers and nurses.


Unfortunately, even the busiest schedule won’t allow escape from inevitable reflections. Whether it is an especially frustrating moment or a quiet one between tasks, you can’t help but think of the day when all of this will change.


You may continue to mourn your loved one in advance, hoping that the person can stay with you for as long as possible. You may also dread the thought of losing this person and fear the life that comes after they pass on.


At the same time, the laborious or emotional challenges you face daily might make you secretly wish for the freedom of your old life.


This mix of fear, sadness, and guilt can be the most difficult time for family members or caregivers who experience anticipatory grief, and it is important to be aware of events that trigger these feelings.


Heightened Reflections

For those who celebrate, the holidays are arguably the biggest annual break in routine. Just having time-off from work allows the sad reflections to creep in more often. In addition, holiday preparations can also foster new, difficult thoughts.


The memories of holidays passed with your loved one can make you realize next holiday season this person may not be with you.


You may try to savor this time with your loved one and have “one last holiday,” but this can be hard if your loved one is not the person he or she once was.


This realization can be even more emotionally taxing than daily routine struggles if you cherish memories of spending the holidays with your loved one and now cannot have this time as you once did.


Emotional Planning Options

To avoid being caught unaware of anticipatory grief during the holidays, first, take a moment to process what the holidays will mean for you during this difficult time.


Coping involves understanding your new reality and determining how you will need to adjust in order to accept it. The caregiver first needs to accept that these holidays will be different, as the loved one is at different stage of life. And that this is okay.


Family members and caregivers also have a say in what the holiday will mean to them. What thoughts or actions can bring joy during this time? What thoughts or actions should be avoided? How will everyone work together to make this holiday a peaceful time?


Answers to these questions can help to relieve organize some of the anticipatory grief through planning.


Meaningful Conversations

Today, you are able to hug and kiss your loved one. Will you make an effort to do this more, focusing on the joy of that moment only and dismissing any thoughts of the future? Or will you let your displays of affection happen naturally, allowing you to feel like things are the same as they were before the illness?


Ask yourself what traditions will bring you joy, and which ones might be too painful to experience right now. While this level of emotional planning is not how you would regularly manage loss, the alternative of ignoring the feelings may prove futile to escape anticipatory grief.


Instead, think of anticipatory grief as a guide to facilitate meaningful conversations between family members that bring people together and help all cope with the situation at hand.


An example I’ve witnessed recently was when a family member whose mother was receiving hospice care shared with me that she was able to use this time to ask her mother questions she had never asked before.


Questions like, “What are you most proud of in your life?” and “What did it feel like to be one of the only female lawyers in your time?” Reflecting back, she later shared that she views that time as a gift. A gift to have intimate conversations with her mother and share things with her she never had. If anything, she recalls, it was “an opportunity to pour out all my love for her so she knew every minute of every day, that she was loved.”


Making It Through

Whether you are experiencing anticipatory grief during the holidays or supporting someone who is, it’s important to focus first on awareness and then action. Remember, it is human to mourn and to feel grief when caring for a terminally ill loved-one.


When you are able to identify these feelings and know they are normal, you can then begin taking an active role in how you will process this year’s holidays.


While during this time we can’t assume the holidays will be nothing but happiness, it’s good to remember that joy is still possible for those who foster a mindful perspective.

And if joy isn’t possible, that is okay too, as long as there is understanding and support between loved ones, as this brings peace, in even the most difficult times.




About the Author

Joelle Purdy, LICSW, is a program manager at The Washington Home. In her role, she oversees the development of charitable programming that aims to connect social and community resources for the elderly and/or terminally ill residents in the Washington D.C. metropolitan area.


Joelle has spent her professional career serving the geriatric community in hospice, hospital, P.A.C.E. and nursing home settings. 

Joelle earned her Master’s in Social Work from the University of Denver. She is a licensed independent clinical social worker in Washington, DC.

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