Pre-grieving a Terminally Ill Loved One

Pre-grieving a Terminally Ill Loved One

End-of-life care is a complex situation that heavily weighs upon the terminally ill patient and caregivers. On the medical side, teams are put in place to reduce pain and increase comfort for the dying patient. There’s also the non-medical caretaker side of end-of-life, which often has loved ones, such as children of a terminally ill patient, feeling overwhelmed with stress and often neglecting their well-being. A primary concern of end-of-life care revolves around “anticipatory grief,” which is the process of pre-loss grieving.

Anticipatory grief explained

Anticipatory grief is similar to the usual process of grieving except it happens before death occurs, so there are additional phases. And depending on the length of the death process, these stages can linger, restart and be revisited. The first pre-grief stage involves realizing the inevitability of death. This first phase occurs when a healthcare provider gives the sad news that a cure is not likely. Sadness and depression mark this initial phase.

The next stage involves a significant amount of concern for the terminally ill person. This concern could be over a dying person‘s feelings or fear of death, and can also involve regret about past interactions with the dying loved one.

A third phase arises when death appears imminent, so loved ones begin to make arrangements. Sometimes, this stage can be harrowing, especially when caregivers ready themselves for the worst but the end does not come.

The final phase occurs when caregivers and loved ones begin to think about what their lives are going to be like without the person in it anymore. Depending on the age of the terminally ill patient, the feelings can range from a certain amount of guilt over feelings of relief to utter devastation.

A professional care team can significantly assist in navigating these phases of the end of life. This team can include nurses and mental health professionals. A palliative care nurse may best be able to assure you that the patient’s pain is being reduced as much as possible. If the terminally ill person is spending their last days at home with hospice care, then the hospice care nurse may be able to assist you in preparing for the end.

It’s essential for caregivers and loved ones to be aware of their vulnerabilities and potential for burn out. The following are signs of caregiver stress:

  • Experiencing mood swings

  • Becoming physically ill

  • Gaining or losing weight

  • Avoiding socializing

  • Making caregiving not only your full-time job, but your 24-hour-a-day identity


It’s important to note that the younger a caregiver is, the higher the risk becomes that pre-loss grief will be complicated. Younger people still often possess strong feelings of invincibility that can be shattered by experiencing the death of a loved one from the close perspective of caregiving. Physicians are increasingly attuned to this problem, fortunately, and the team approach to end-of-life care almost always includes support for the caregiver.

There are no easy answers when dealing with a terminal illness, but the goal of dignity and dying can be reached if your available resources and support mechanisms are used. As HomeAdvisor notes, “After all, that’s what it’s all about: caring for your loved one and treating him or her as you would want to be treated. As long as we show kindness and compassion to our loved ones throughout the process, they will be able to say goodbye with the dignity they deserve.”


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