Anticipatory Grief - DementiaHub.SG

Anticipatory Grief

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Dementia may gradually change the personality of a person.

Anticipatory grief occurs when someone questions whether this “stranger” who is living with dementia is the same person he/she knows and loves. The changing personality of the person living with dementia could be difficult to accept, especially if the caregiver has had a special bond with them.

Though they may appear different, remember that the person living with dementia is still the same person despite all the challenges they now have in communicating and expressing themselves.

Here are some things to remember when supporting caregivers to deal with anticipatory grief:

Accept that anticipatory grief is normal

Caregivers are allowed to feel this type of grief when an eventual loss is approaching. This is a common phenomenon that has been documented for nearly a century.

Acknowledge the losses

It is okay to grieve even though the person living with dementia is still alive and there are other things going well for the caregiver. Caregivers can consider having a creative outlet to express emotions of resignation, fear and depression. Explore mindfulness as a way of being present and aware of the many emotions going through them. Encourage them to connect with others.

Anticipatory grief is common among caregivers. Unfortunately, they may feel alone and isolated if they had devoted all their time to caregiving. They can seek out caregiver support groups either in their areas or online so they can connect with others who understand the challenges they are facing.

Remember that anticipatory grief doesn’t mean they are giving up

As long as caregivers are there to support and care for their loved one, they are not giving up on them. It is important for caregivers to acknowledge that terminal illnesses are not within their control. Instead, they can focus on what they are doing and shift their energy towards creating peaceful and meaningful moments together.

Reflect on the remaining time

Spend the remaining time together in a way both parties would find meaningful and fulfilling. This is the time to really do something together that caregivers will never be able to do with them again. If the person living with dementia is open, encourage caregivers to consider discussing practical matters, like advanced directives and funeral arrangements to ensure that they are able to honour their loved one’s wishes.


Anticipatory grief is different for everyone. Expect that everyone in a family may be experiencing and coping with anticipatory grief in different ways, so keeping an open line of communication to support and understand one another. Encourage caregivers to consider involving close family and friends in their loved one’s remaining moments.

Take care of oneself

Taking care of oneself is easier said than done. However, it is important, and is achievable. Remember the old cliché: caregivers can’t take care of others if they don’t take care of themselves first.

Tap on a support network

Caregiving and anticipatory grief can be a long and difficult road. Work with them to assess and map out their support network so they will know who may be able to help them out.

Seek professional help if necessary

People need a place to process complicated emotions and have some time for themselves. If ever caregivers feel overwhelmed with feelings of anticipatory grief and other emotions, advise them to seek professional help (e.g., see a doctor or visit a counsellor).

Relief is normal

When someone dies, experiencing a sense of relief is a normal response. Although this sense of relief can also create feelings of guilt, remember that feelings of relief arising from an anticipated death does not mean caregivers love the person any less. It is a natural reaction after a stressful and overwhelming time in their life.

Do not assume one will not grieve

Just because losing someone was anticipated, do not assume this will either speed up or slow down caregivers’ grief after the death. Remember that everyone grieves differently.

Advise and refer caregivers to see a doctor or visit a counsellor if they continue to experience five or more of these symptoms 12 months after their loved one have passed on:

  • They feel that their grief is making them unhealthy or sick
  • They feel that they have been grieving for much longer than
    they want to
  • They keep thinking about harming themself or ending their life
  • They are worried that they might hurt others
  • They are hallucinating about things that aren’t really there
  • Their behaviour or routine suddenly changes
  • They have felt hopeless and unable to cope with life for more than two weeks at a stretch
  • They cannot function at home, work or school
  • They just cannot get over a feeling of guilt
  • Their speech functions and body movements have become
    slow and tired

If they need help, consider letting them know about services for caregivers.

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