Coping with ANTICIPATORY GRIEF in Cancer

Most people think of grief as a process experienced after a loved one's death. But grief can also occur before death. This experience is known as anticipatory grief or anticipatory sorrow because it arises in expectation of death or another kind of loss, such as loss of ability. It may be experienced by a patient's loved ones as well as by the patient or person who is dying.

The emotions may be comparable in both kinds of grief, but anticipatory grief can involve more ups and downs. Some days you may feel very sad, while on others you may feel no sadness. As a result, you may feel guilty about your changing emotions. This is very normal and does not mean you love the person any less. Everyone grieves differently. There is no right or wrong way to grieve.

If you are grieving someone who is still here, a number of things may help you cope. Let us review what anticipatory grief involves and then discuss what may help during this process.

What Is Anticipatory Grief?

Anticipatory grief is the deep sadness often felt in the final days of life.

It is often experienced both by those close to someone approaching death and by the person who is ill and dying.

Grief before death offers an opportunity to say goodbye that sudden death cannot give us, but it does not replace grieving after death.

This article is written for people whose loved one is approaching death and who are experiencing anticipatory grief. We hope the following coping suggestions help both those who are dying and their loved ones.

A study found that 40% of people who lost a spouse found anticipatory grief more stressful than grief after death in their experience.

Tips for Coping with Anticipatory Grief

The following tips have helped others work through difficult emotions. We hope they will help you too.

Allow Yourself to Feel and Grieve

Giving yourself permission to feel the pain in your heart helps you be honest with yourself. Anticipatory grief is not only sorrow over a loved one's approaching death, but also all the other losses accompanying it: loss of a friend, shared memories and dreams for the future.

Denying the pain you feel may prolong grieving later in your journey. Whether grief occurs before or after death, it serves a purpose.

The tasks of grief begin with acknowledging the approaching loss, dealing with sorrow and eventually letting go in a way that allows you to move your emotional bond with your loved one to a different place. This does not mean giving up on or forgetting them. Completing these tasks instead allows you to hold on to the joy and love you once shared.

Do Not Walk This Path Alone: Express Your Feelings

Do not keep your sorrow inside. Sharing feelings with a close friend or relatives is important during this process. Nobody needs to face anticipatory sorrow alone. Keeping feelings to yourself can create deep loneliness and isolation.

Whom you share your feelings with also matters. If possible, share with a friend who cannot judge you and with whom you feel comfortable expressing your pain and emotions.

If the friend you speak to has not faced the same situation, being advised on what to do or how to feel may be irritating.

Speak to your friend in such situations. Let them know that you only want them to listen and that you are not trying to fix things. There is no easy solution to the feelings you experience. Still, finding someone to listen lets you walk this path feeling less alone.

• Related Topic: What Should and Should Not Be Said to Cancer Patients?

Spend Time Together

We often hear how difficult relatives find spending time with a dying loved one. They do not want to remember the person as they are at the end, preferring to remember healthier days.

Spending time together matters not only for the ill person but also for their loved ones. Avoiding visits to a dying loved one can often lead to regret later.

If you are anxious about how to spend time with someone who is dying, the following examples may offer ideas.

Think of meaningful ways to be together. Bringing out old photo albums is one example. The laughter and tears brought by remembering can be cleansing.

You may ask your loved one to talk about childhood memories and stories they enjoy telling. You may also want to make video recordings while they tell them.

Another activity some people find special is finding a suitable paraffin bath and massaging their loved one's hands and feet. This may serve a dual purpose, reducing pain and stiffness from arthritis and providing needed touch.

You may also want to read aloud about a subject that interests your loved one or from a favorite novel.

If they enjoy fishing, you can ask about their memories and invite them to share fishing stories. The list could go on… Everyone differs in what might be meaningful, and the specific activities you choose are not what matters. It is spending time together, even in silence.

Do Not Underestimate Time Together, Even in Silence

Finally, many people fear breaking down when they see a dying relative and making the person's pain harder to bear, which may make you anxious about visiting. Remember that your loved one usually prefers you to visit, even in tears, even if you lose them completely.

Do Not Overlook Children!

Children also experience anticipatory grief. Working through grief is just as important for them, yet they are often given fewer opportunities than adults to express themselves.

Research shows that children not given the opportunity to grieve are more likely to struggle with anxiety and depression later in life.

Children need to be included and have a safe space to express emotions. If a parent or older relative is dying, choosing someone other than these people may help because children may try to be strong for the person who is dying.

There are several myths about grief in children and adolescents, including the myth that children do not deeply feel an approaching loss. Contrary to these myths, one study highlighted that parents with advanced cancer were unaware of how distressed their children were.

On a more positive note, the same study found that children with a parent with advanced cancer valued family members and important things in life much more than children without a parent with cancer.

Open communication about death has been shown to help reduce anxiety, depression and behavioral problems in children with a seriously ill parent. Children need reassurance that they will be cared for after the death and will not be abandoned.

Play and art therapy may help children cope with death and dying. You may also want to look at our article, Children Whose Parent Has Cancer Should Receive Psychological Support.

Consider Keeping a Journal

Many people find journaling healing. It can offer emotional release by letting you express even things you may hesitate to share with a friend.

In addition to journaling, some people find that writing letters helps with sorrow over an approaching death. For example, a letter can express things you want to tell your dying relative but find difficult to say.

If you are the person who is ill, writing letters to your children — perhaps letters they can open later — provides a place to express tender feelings and leaves an enormous gift for those who remain.

Use Holistic Coping Methods

A holistic approach may help both the patient and loved ones. Many of these therapies have been found to help with emotions such as anxiety.

Some of These Practices Include:

• Meditation
• Art Therapy
• Massage Therapy
• Music Therapy

Nurture Your Spirituality

Spirituality matters for both ill people and their loved ones. It may take the form of religion and prayer, meditation, connecting with nature or even listening to music that is meaningful to you.

Studies have shown that dying people have better quality of life if they maintain an active spiritual life in their final days. Research also highlights less depression among their relatives when their loved one has an active spiritual life.

Forgiving and Being Forgiven

Forgiveness is healing, and learning to forgive yourself is as important as forgiving others.

Listening is a good first step toward forgiveness. The person you need to listen to may be a loved one or yourself. Looking back, the person you need to forgive may not be far away. You can begin with the closest person: yourself.

Someone once said that resentment is a poison you prepare for someone else and drink yourself. Letting go of resentment and pain from the past is freedom.

Remember

Talking about anticipatory grief and ways to cope can be tiring and difficult. Although the tips above may ease some pain, grief is something each of us must move through in our own way and time.

Do not underestimate its effect on you. You are running a marathon full of emotional miles. Be kind to yourself and treat yourself gently. Allow yourself to do nothing sometimes, or to do only things that serve you.

Making sacrifices to support someone at the end of life is among the most important things you will do. Just take care not to sacrifice your own health and well-being along the way.

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