Anticipatory grief is a grief we experience when a loved one is going to die in the foreseeable future. It is what we feel before an impending loss. This may be because the person has a terminal condition, or if we are watching a loved one decline e.g. from dementia or addiction and there is a gradual sense of losing them without them having died.

There is a similar process we also go through ourselves, for example if we are given a terminal diagnosis. You may also find this article useful if there are feelings arising before other impending losses outside of a bereavement, such as being made redundant or an approaching move of career or home.

Symptoms of Anticipatory Grief

The limbo of delayed grief can have lots of impacts on our mental and physical health, as well as our routines and relationships.

Anxiety & Worry

Anticipatory grief features a huge fear of a known unknown. We might have ideas of what is going to happen, yet at the same time being completely unsure how we might cope or what the future looks like. Humans value certainty, and the unknown understandably provokes worry.

Being preoccupied with whether our loved one’s health is going to decline, or our head running scripts and preparing for the worst case. This agitation can be constant and rob us of presence, sleep, and routine. Thought loops don’t have an easy answer to them which can leave us stuck ruminating about their decline, with no outlet. You’d imagine that the worry would prepare us for the loss, but many people report feeling underprepared when the death happens. Like many anxieties or worries that escalate, it’s grounded in a partial truth – your brain is preparing for the threat of a death that is coming, but you’re in limbo until it arrives.

Numbness

The body can shut down into a dissociative state where you may not feel connected to your own experience, or depersonalisation can make things feel somehow distant. People report ‘going through the motions’ with a chore list of caring for the person who is dying or trying to sort events like a funeral or will, whilst experiencing cognitive dissonance as the person is still alive. Experiencing all of this at once would overwhelm the Self, so the body shuts down. You may notice an absence of feeling, energy, drive, and presence as you continue trying to exist in this transitory state of anticipatory grief.

Selflessness

Being a carer can be an incredibly taxing thing, looking after a loved one who is terminal. We can put their needs first and feel as though we should ignore our own as we’re not the one who is dying. Ignoring our needs to care for others is a short-term strategy that keeps us going as a species, but in the long term it isn’t sustainable and we may well experience a strong sense of guilt at having our own needs that aren’t being met.

Resentment and Relief

Introjecting that we should be selfless can ironically just hide the parts of us that need care and are also grieving so needing support. This can cause those parts we suppress to boil over and for us to feel resentment towards our care responsibilities to the person who is dying. This is a perfectly natural human response to losing our independence from the demands of anticipatory grief.

Because of the demands of care-responsibilities and the emotional upheaval of anticipatory grief, as well as the change in routine and freedom to look after our own needs, many people feel a sense of relief after the death – that the pain is finally over. This feeling of relief is natural, but can be met with strong feelings of guilt for those feelings, or even shame – believing we are a bad person for feeling relief. It is human to struggle as a carer and wish that it was over, whilst also savouring every moment.

Regret

It’s natural to grieve, not just a person’s impending death, but also the life that could have been. People often want a ‘bucket list’ to squeeze the most positive experiences out of life whilst they’re still there. There may be regret about ‘years lost’, or if we have had arguments with the person, falling-out over things that feel trivial. After the death, carers have worked to exhaustion but still often experience a perfectionism wishing they had done more. This is a natural process considering the uncontrollable reality of death and part of the process of acceptance that our loved one is dying.

Burnout

Carrying the emotional intensity of grief, the care responsibilities for the person who is dying, the anxiety of preparing but it not yet coming, perfectionism to make the most of the time, and putting yourself on hold can all be exhausting without the usual breaks to rest. Burnout is a very common symptom of anticipatory grief that you may not even recognise until late in the process, when you feel empty and your feelings drained.

Strong Feelings

Before the numbness of burnout, people often experience strong emotions. You may have heard of Kubler Ross’s Stages of Grief:

Denial -> Anger -> Bargaining -> Depression -> Acceptance

What you might not know, is that these stages weren’t originally intended to be linear. People can oscillate between stages and there is no correct way to grieve. However Kubler Ross is an emotional model of grief and identifies strong feelings many people recognise within anticipatory grief.

Numbness – in denial, we often feel dissociated and deny the reality that our loved one is going to die.

Anger – an intense foreign rage against the injustice of death and the boundary violation of our loved one dying. Anger is a motivating emotion that causes us to act and try all reasonable steps to prevent the loss and save our loved one.

Depression – sadness, despair, pangs of grief at knowing they will die and we can’t stop it.

Fear

Death is the ultimate lack of control, and loss of agency is a common cause of fear. There are a lot of big things that are going to happen, and we will be unsure of our ability to cope with them. It is natural to be afraid of decline, death, practicalities, and our ability to cope.

Death Anxiety

Death anxiety is a preoccupation with death to the point that it interferes with our life. Existentially, we manage the Angst of death by knowing it will happen with our logical Reasonable Mind, but not emotionally or psychologically engaging with it. Anticipatory grief unveils the existential reality of death though, and we are suddenly aware that our loved one is going to die, our other loved ones could die, and we could and will die.

Death anxiety can present with rumination over death, physiological symptoms such as panic, checking minor symptoms, and feeling over protective towards loved ones. Death anxiety can be debilitating and lonely, when others seem to only engage with death logically.

Difficulty Being in the Present

The existential reality of an impending death can become a focal point for us and take us away from the present moment. Alongside this, there can be a tension to try to make the most of the time you have left, and pressure to ‘do’ this can also rob from the present moment. Finally, dying is an unpleasant process and the present moment can be uncomfortable or frightening.

For some people the death itself can be peaceful after a long time of suffering, and family report a peace or serendipity – as though the person was ready to go.

Distressing Memories

After a bereavement, people can experience distressing memories alongside grief. In anticipatory grief, you are watching your loved ones decline which can expose us to upsetting imagery or difficult experiences, such as witnessing decline or medical emergencies.

Loneliness

Anticipatory grief can be lonely for several reasons.

You are losing someone who would have previously been there for you.

Being a carer or looking after our loved one’s needs can demand a lot of our time, sapping us of the relational energy to socialise or making it practically unfeasible.

Life is on hold waiting for your loved one’s death which can seem like limbo, and make prioritising other work or social engagements difficult.

You may feel as though no one else knows what you are going through, and responses feel like platitudes which can feel lonely, even when people try to console you.

Expectations

People often have expectations and assumptions of how we should be grieving which are usually done with the best of intentions, but no two people will grieve the same – nor is there a correct way to grieve. This is especially the case with anticipatory grief, which can feel as though it stunts or even elongates our grieving.

We might also have expectations of ourselves that we may even introject from others. Expectations to be infinitely caring or not to have our own needs, to be patient and understanding, that we should be strong for the family.

Support That Meets People Where They Are

At Hope Therapy & Counselling Services, support is designed to feel calm, human and accessible rather than clinical or transactional.

The service includes more than 90 therapists supporting clients across the UK, with online counselling available nationwide alongside selected in-person clinics.

Support is available for:

• anxiety
• stress and burnout
• addiction
• depression
• ADHD and autism
• grief and bereavement
• trauma
• relationship difficulties
• workplace wellbeing
• LGBTQIA+ support

The organisation was founded by Ian Stockbridge, whose background combines counselling practice, workplace wellbeing expertise and long-standing work supporting emotional wellbeing across both individuals and organisations.

For many people, reaching out for support is not about crisis. Often, it is about recognising they no longer want to spend all of their energy simply trying to keep going.

Frequently Asked Questions

When should somebody consider counselling?

People often seek counselling when emotional difficulties begin affecting stress levels, sleep, relationships, anxiety, motivation or overall wellbeing. Therapy does not require somebody to be in crisis before seeking support.

Is online counselling effective?

For many people, yes. Online counselling can offer flexibility, accessibility and consistency while still providing meaningful therapeutic support.

What happens during a consultation?

Hope Therapy offers a free 15-minute consultation designed to help individuals explore what support they may need and whether counselling feels right for them. There is no obligation to continue afterwards.

Taking the First Step

Anticipatory grief can feel isolating and emotionally exhausting, particularly when you are trying to hold uncertainty, fear, and responsibility all at once. Reaching out for support before a loss happens is valid, and many people find it helpful to have space to process what they are experiencing. Hope Therapy & Counselling Services offers a free 15-minute consultation if you would like to explore counselling support in a calm, non-pressured conversation. https://calendly.com/hopetherapy/15-minute-consultation