Grief and loss
Anticipatory grief is the mourning that starts before the loss. It is grief without a grave, and it is almost impossible to explain.
When someone you love is dying — slowly, from illness or age — you begin grieving while they are still here. This is anticipatory grief. It is not a rehearsal for the real thing. It is real grief. And it is profoundly lonely, because the world does not yet have a name for what you are losing.
You can grieve someone who has not yet died. The grief is not a prediction — it is a response to the loss that is already happening.
The term was first used by psychiatrist Erich Lindemann in 1944, when he noticed that wives of soldiers deployed overseas were already experiencing grief symptoms before receiving any news of death or loss. The concept was developed significantly by Therese Rando, whose 1986 research defined anticipatory grief as grief that encompasses all the losses that occur before the actual death — not just mourning the anticipated death itself.
Anticipatory grief occurs when we become aware that we are going to lose someone important, and we begin mourning alongside managing the present. It includes grief for what has already been lost (their former self, their health, the relationship you used to have), grief for what is being lost now (their capacity to recognise you, their ability to have a conversation, their independence), and grief for the future that will not now exist (the grandchildren they will not see grow up, the trip you planned together).
It can also include feelings that are harder to acknowledge: relief that a long illness will eventually end, guilt about that relief, anger at the person for dying, guilt about the anger. The complexity of anticipatory grief is immense, and very little of it is socially sanctioned to express.
Anticipatory grief is not one grief — it is several, happening at once.
Rando's framework distinguishes three temporal dimensions of loss in anticipatory grief:
What has already been lost
The person you knew before the illness. Their personality before the dementia changed them. The relationship you had before their capacity diminished. These losses are real and complete — they have already happened — even though the person is still alive.
What is being lost right now
Their ongoing deterioration. Each new symptom, each new limitation, each appointment that brings worse news. You are not anticipating this — you are living it. The grief is happening in real time alongside the caregiving.
What will be lost in the future
The death itself. The absence. The future you will not share. This is what most people mean when they think of anticipatory grief — but it is actually only one part of what is being grieved.
Understanding which layer you are grieving at any given moment can help you locate the feeling — and explain it to others who may not see why you are so affected by something that has not yet happened.
Anticipatory grief includes feelings you are not supposed to have.
Relief is one of them. When someone has been ill for a long time — when their suffering is visible and ongoing, when caregiving has consumed your life, when each day brings new losses — a part of you may be relieved that the end is approaching. This does not mean you want them to die. It means you are human, and you are exhausted, and you recognise that their suffering will also end.
Anger is another. Anger at the illness. Anger at the person, even — for leaving, for getting sick, for the changes their condition has forced upon the relationship. Anger at the unfairness of the situation. Anger at other people who do not understand or do not show up in the way you need them to.
Detachment is common too. After sustained anticipatory grief, some people experience a pulling-away from the person who is ill — a kind of emotional preparation for the absence. This can be deeply painful and guilt-inducing, but it is a recognised response to prolonged anticipatory grieving.
None of these feelings mean you love the person less. They mean you are carrying more than a person can comfortably carry, and your emotional system is doing its best to cope with an impossible situation.
When the person is still alive, the world often does not recognise the grief that is already happening.
Friends and family tend to focus on the person who is ill and the logistics of care. The emotional experience of the person anticipating the loss — watching it approach, managing it daily, carrying it quietly — is often secondary. You may find that when you try to express your grief before the loss, people redirect to optimism or practical matters. You are told to stay positive. You are told to focus on the time that remains. Your grief has not yet been licensed by death.
Socially, there are rituals for post-death grief: funerals, condolences, casseroles left on doorsteps. There are almost no rituals for anticipatory grief. No one sends flowers to the adult child watching their parent disappear to dementia. No one offers condolences for the loss of who a person used to be.
This invisibility can add a layer of profound loneliness to what is already an extremely difficult experience. The grief is real. You deserve space to express it.
Seven common signs — many of which are rarely discussed.
- 01
Persistent sadness that comes in waves
You may find yourself crying at unexpected moments, or feeling a heaviness that lifts briefly and then returns. The sadness may not always feel directly attached to the coming loss — but it is.
- 02
Difficulty being present with the person who is ill
You love them and want to be with them, but sitting beside them is painful in a way that is hard to articulate. You may find yourself pulling away slightly — emotionally, if not physically.
- 03
Rehearsing the loss
You find yourself imagining what life will look like after. You plan the funeral in your head. You think about how you will tell people. This is not morbid; it is anticipatory grief doing its work.
- 04
Guilt about living your own life
Going to a film, enjoying a meal, laughing at something — these ordinary activities can feel wrong when someone you love is dying. You may feel guilty for experiencing pleasure.
- 05
Exhaustion that sleep does not fix
The emotional labour of watching someone decline — and managing your feelings about it — is physiologically taxing. Grief is not just psychological; it places real demands on the body.
- 06
Feeling relieved and then guilty about the relief
You may catch yourself thinking that when it is over, at least the waiting will end. Then you feel guilty for thinking that. This cycle is extraordinarily common in anticipatory grief.
- 07
Social withdrawal
You may find that ordinary social situations feel impossibly far from where you actually are. Other people seem to be living in a different world. You may stop reaching out.
Five evidence-informed approaches to coping with anticipatory grief.
- 01
Let yourself grieve now — you do not need permission
The most important thing about anticipatory grief is recognising it as real grief. You are not being morbid or premature. You are experiencing a genuine response to a genuine loss. The grief does not need to wait for the death.
- 02
Distinguish between the person they were and the person they are now
One of the most painful aspects of anticipatory grief is watching someone change — losing their memory, their personality, their capacity for the relationship you once had. Naming this explicitly — "I am grieving who they were" — can help locate the feeling.
- 03
Find at least one person who can hold the complexity
Well-meaning people often redirect to optimism. You need at least one person — a therapist, a grief counsellor, a close friend, or a stranger on a platform like Mindfuse — who can sit with the grief as it is, without rushing you toward resolution.
- 04
Do not suppress the difficult emotions
Relief, anger, guilt, detachment — these are normal. Research by Therese Rando and others shows that the emotional complexity of anticipatory grief is part of what makes it so hard to talk about. Suppressing these feelings tends to compound them.
- 05
Create intentional moments with the person who is still here
Anticipatory grief can paradoxically make it harder to be present with the person you are about to lose. Intentional, low-pressure moments — listening to music together, sitting in the same room, looking at photographs — can coexist with grief without requiring you to perform normalcy.
You do not need someone who fully understands. You need someone who is genuinely present.
Therapy is valuable if you can access it. Grief support groups exist and are worth finding — particularly those specifically for people supporting someone with a terminal illness or dementia. But sometimes, in the moment when the weight is heaviest, what you need is simply a real voice on the other end of a call — someone who is there, listening, without an agenda or a clock ticking.
Mindfuse is an anonymous voice call app. Tap once. Talk to a real person. No scheduling, no commuting, no explanation of context required. First conversation free. €4 a month after that.
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My mum has Alzheimer's. She doesn't know my name anymore. Everyone asks how she's doing — nobody asks how I'm doing. Talking to a stranger on Mindfuse at 11pm was the first time I said out loud that I'm already grieving her.
— Mindfuse user, 47, Ireland
Questions about anticipatory grief.
Is anticipatory grief the same as pre-grief or grieving before death?
Yes. These terms are used interchangeably. The formal clinical term is anticipatory grief, coined by psychiatrist Erich Lindemann in 1944 and significantly developed by Therese Rando from the 1980s onwards. It describes the grief response that occurs in anticipation of a significant loss, rather than after it.
Does grieving before a death mean you will grieve less afterwards?
Not necessarily. This is a common misconception. Research by Rando and others suggests that anticipatory grief does not "use up" grief or shorten post-death grieving. The two are related but distinct processes. You may find that post-death grief involves different feelings, or that some things have been processed — but anticipatory grief is not a shortcut.
Is it normal to feel relieved when someone is dying?
Yes. Particularly when the person has been ill for a long time, or when their suffering is severe, it is entirely normal to feel a degree of relief that the end is coming — for their sake and for yours. This does not mean you love them less. It is a sign that you have been carrying enormous weight.
Can children experience anticipatory grief?
Yes. Children whose parents or grandparents are terminally ill experience anticipatory grief, though they may express it differently — through behaviour changes, regression, or questions about death. Children benefit from honest, age-appropriate conversations and from seeing that adults around them are also allowed to have feelings about what is happening.
When does anticipatory grief become complicated grief?
When anticipatory grief significantly impairs functioning over an extended period — making it impossible to work, care for yourself, or maintain relationships — it may have moved into what clinicians call "complicated grief" or "prolonged grief disorder." A grief therapist or mental health professional is the right person to assess this.
Say it out loud. Someone is listening.
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