Sinking Into Illness

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Anticipatory Grief

A couple months ago I posted on my Facebook page for people to send me suggestions for my Scarred Joy blog. I received a great one from a writer friend, Sally Meadows. Here is what Sally had to say.

“Having experienced it myself a couple of years ago, I would like to see a blog about “anticipatory grief”–when you start grieving about something/someone sometimes long before it might happen. You just know it down in your soul that something/someone is going to end/leave…it could be a relationship, a job you love, or perhaps someone is dying. Have you had experience with that, Alan?”

In this post I will give a definition of “anticipatory grief,” unpack it a bit, then offer a short story to illustrate this grief.

Here is a definition of anticipatory grief from the writing one of the main people I turn to as a resource for issues regarding grief.

Anticipatory grief” is a term that referred to the grief felt about someone with a life-limiting illness; friends, family, and caregivers felt it in anticipation of an eventual death. We now understand anticipatory grief or what Dr. Rando, a prominent grief therapist and author, prefers—anticipatory mourning—as a reaction to all the losses experienced in an illness.” (“Grief, Loss, and Caregiving”, Kenneth Doka, page 200, Caregiving and Loss: Family Needs, Professional Responses, Edited by Ken Doka and Joyce D. Davidson, Hospice Foundation of America, 2001.)

Notice the progressive step in defining anticipatory grief. It has been used to refer to grief associated with feelings family, friends, etc. experience related to a loved one’s eventual death. The definition has been expanded to where it includes grief expressed over all the different losses a person experiences in the context of an illness, not just the grief due to impending death.

In “anticipatory grief” we mourn plans that will never come to pass. Grieving that this past Christmas was the last one to be celebrated with your loved one. There may be a loss of living “at home” and now being confined to a care facility. A primary caregiver or family members may be trying to imagine what life will be like after the death of their loved one.

Some people may experience anticipatory grief on a deeper level than the death of their loved one. Such things as when our ill loved one loses the ability to speak. This may be accompanied with a number of issues adding to one’s suffering. The sick person and family members may be frustrated as to how to now communicate with each other. The possibilities of having meaningful conversations with the loved one are now remote.

Family members may grieve times together that will never be. The holidays they wanted to plan, the special celebrations they wanted to enjoy, die with the loved one. Vacations will never be the same without the loved one. This is what Dr. Ken Doka refers to as a loss of the “assumptive world” (Doka, page 200). The life together they hoped for will never be realized. All of one’s life is altered with the death.

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A Story of Jim and June (not their real names): An Illustration of Anticipatory Grief

Jim and June were looking forward to putting their plans in action as soon as he retired. For the past five years they had planned a road trip in their RV to drive all over Canada and the United States. It would be a trip of a lifetime. Jim worked a couple years longer than he intended but now the time had come. Working longer allowed them to save enough money to pay for their RV in cash.

After retirement they were both excited at the prospect of putting their travel plans into action! The RV was insured and they had mapped out the route for their trip. They gave copies of their plans to their children so the kids could know estimations as to when they would be at certain places on their trip.

It was soon after Jim’s retirement that June began to not be feeling well. After some coaxing Jim convinced her to make a doctor appointment. He accompanied her to see the doc and it was good he did. After his initial assessment the doctor referred June to an oncologist. The result of the oncologist’s examination was conclusive. June had pancreatic cancer. To make matters worse the cancer was spreading to the point the oncologist was not hopeful June would recover.

As time progressed so did the cancer. The plans June and Jim had for travelling gave way to doctor appointments. In fact, they decided to only have short trips on the occasional weekend. June couldn’t face being away from home for too long. As she became weaker from cancer treatments as well as the illness Jim and June decided to sell their RV. The dream of travelling around North America was shattered.

The couple would have quiet moments at home where they would talk about their lives together. The cancer was slowing June down to the point that even short walks with Jim around their neighbourhood were too much. She bemoaned the reality that she was dying.

Jim recognized he was experiencing a profound sense of grief at the prospect of losing June. It would keep him awake at night. He would have periods during the day that he would cry at the thought of life without June. He may be doing something like puttering in their back yard but his thoughts were consumed by June’s illness. One time, he went into his workshop just to be alone as he cried bitter tears. He didn’t know if he was crying because of June’s cancer or his own grief. Life wasn’t the same anymore and he dreaded what it would be like after June died.

Anticipatory grief is real and common when things take a major turn in life. It is something you may have experienced. If not, you will.

Perhaps you are experiencing anticipatory grief right now. You don’t have to be alone in this part of your grief journey. Please feel free to share some of your thoughts with me if you like.

Love your life as much as you can. Put aside the petty things that really don’t matter. Be happy rather than always wanting to be right. Remember to never take life for granted.

Until next time, bless you all.

 

14 thoughts on “Sinking Into Illness

  1. Alan,
    Very interesting. Never thought of that definition but I can see how some people might live that way. I had a friend who was dying in AZ before I left – she decided to live all the things together with her hubby that they could. They did their favourite things.
    It’s not easy to look at the blessings during a time of upheaval.
    Blessings on your writing
    Janis

    Liked by 1 person

  2. Great post, Alan. I did not know this kind of grief had a name. I know it is an actual grief, though, as I have lived it. Even this grief has various levels of intensity as time goes by. All seems better, and then a thought will strike. Conversations during this time give a deeper intimacy to relationships, though. Thanks for posting!

    Liked by 1 person

    1. Hi Marnie! Yes, anticipatory grief applies to other losses. My posts are usually in the context of death and dying etc. but people certainly grieve over other aspects in life. Thank you the comments Marnie. 🙂

      Liked by 1 person

  3. My mother had cancer for twelve years before she died. I was only 16 when she first got sick and she was only 36. So there were twelve years (although I was young) where I must have felt some of this anticipatory grief…and yet it eludes me for the most part. Is it because she just kept on living and doing everything she always did even though she was sick? Was I in denial? I think we all were as she would rarely speak of dying and the last real time I had with her, when she did briefly speak of it, I basically shut it down. We had been taught to say positive things about her recovery so I didn’t really even know how to speak about her possible death, even though she looked very ill and she died only two months later…I simply couldn’t see it. In reading your post, as painful as anticipatory grief sounds, I think it would have been healthier for us all to have gone through it rather than denied it and then being hit in the face with the shock of her death. Grief and death are profound in their affect on us. But I can also say that in my sisters suicide it was very anticipatory….I know that sounds strange and even awful but she had attempted so many times, been in so many psychiatric wards…that none of us knew how to help anymore and we felt so guilty that we all seemed to know that one day she was going to do it for real, but nothing we tried worked, including the professionals. It was an excruciating time of anticipatory grief that I wouldn’t want anyone to go through. (I’ve never told anyone about this other than close family members. I feel most would only heap more guilt on as we are told all the things we can do to help a suicidal person. I notice however that they usually offer no advice if you have a family member who is chronically suicidal and you’ve already tried all that stuff.) Thanks for listening. And thanks for your post.

    Liked by 1 person

    1. Hi Gloria! Your family has experienced a lot of grief. There may have hints of anticipatory grief through the yearsdue to the sorrowful situations with your mom and sister. To use a couple other terms, it sounds like there were “compounded grief” or even “complicated grief” that invaded your life. Life itself becomes more complicated when serious and life threatening situations enter a family.

      Thank you for being so brave as to share some of your story here. I’m open to listening to you anytime my friend.

      Liked by 1 person

  4. Thanks for this post, Alan! It was very informative and the use of a real-life example enhanced the narrative. It is interesting that in your post, anticipatory grief is exclusively defined in the context of someone dying or with a serious illness. Is the term not appropriate then to refer to grief in a relationship ending, or a job ending? I have experienced both of these. Thanks.

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    1. Hi Sally! Yes, anticipatory grief is indeed appropriate to relationship or job endings etc. My Scarred Joy posts are pretty well always in the context of death & dying or serious illness etc. My apologies for not referring to anticipatory grief in other contexts. Losses stemming from experiences with divorce or job lay-offs are indeed painful and diverse. In the context of divorce for instance, there are losses experienced by the couple but also their children when children are involved. Anticipatory losses in such situations may break off into complicated grief situations long after the divorce. Grief is something that can certainly leave emotional scars for years to come. I’ve heard people who experienced the divorce of their parents say how they were aware of things leading to the divorce. This we can include as being anticipatory grief because the children sensed how things were changing and not the same at home prior to the divorce. Perhaps I can leave it there for now. Sally, if you have any other comments to add please feel free to do so and we can carry on our discussion. Thank you for your comments and your question my friend.

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  5. “Love your life as much as you can. Put aside the petty things that really don’t matter. Be happy rather than always wanting to be right. Remember to never take life for granted.”

    An excellent reminder. Thank you for another thoughtful post.

    Like

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