Grieving Before Death

Odd thought, you might initially think. How can one grieve a loss before it has happened, before someone has died?

I’ve been experiencing this regarding my 82-years-of-age mother, and although suffering from ravages of old age (stroke, hip fracture, paralysis, congestive heart failure, hypertension, vascular dementia), she does not have any terminal disease. So what’s there to grieve? She’s stable. Don’t bury her before she’s dead, I keep saying to myself. So why do I feel so tearful at times, and have an undercurrent of sadness as my constant companion?

I began to wonder why I was feeling grief in anticipation of her eventual passing. “Anticipatory grief,” I thought, must be a new concept. I thought my coining of the term was new and unique. Maybe I’m the only one who feels like this at the prospect of losing my last parent.

Little did I know that ‘anticipatory grief,’ now known as ‘anticipatory mourning’ was a legitimate, already coined and researched concept. In fact, Therese A. Rando wrote an entire book on it: Clinical Dimensions of Anticipatory Mourning (Research Press: 2000; $29.95 paperback).

She first explained that ‘anticipatory mourning’ is more encompassing than ‘anticipatory grief.’ ‘Grief’ presupposes an emotional reaction to the death of a loved one. Rando points out that the caregiver experiences many, many losses before the loved one ever gets close to the passage of death. For instance, as primary caregiver to my mother for the past 14 years, I have experienced a loss of relationship due to her severe speech impairment, her decreased mobility, and gradual fogging of her short-term memory. Talking with her is incredibly tedious, energy-consuming work. Her answers come out in spelling, always starting with ‘a’ until she hits the right letter. The drain I feel during a conversation is another loss. Then there’s having to assume her bill-paying and medical claims tracking, making all her phone calls and arranging her appointments, being her companion due to her increased isolation as her get-up-and-go-ability is greatly impaired, listening to the thud in the middle of the night as she falls merely taking one step to get to her bedside commode, and on and on and on. How about all the work-flexing to get her to where she needs to go, lost wages, increased costs in subsidizing her life, and on and on. How about the emotional sadness I feel as I merely stand by and watch my mom struggle with the ‘easy’ things of life…grabbing something from more than shoulder height, walking from room to room in the house, opening something (she often can’t with only one functioning arm), hearing her cry “no, no, no!” when she gets frustrated.

Your story could include just as much as a sole caregiver, and maybe more. Our losses are emotionally hard to digest. We cry or do whatever we do to cope as we stand by our loved ones. Then they die, and our grief intensifies.

Now I can’t imagine life without “mom.” My dad died when I was 9. I clung to my mom for dear life. Life without mom, that just doesn’t begin to compute in my brain and gut. Revising my inner world as I watch her fade is hard work, and it is all a part of anticipatory mourning.

Rando is right on when she says we have two major competing demands, learning to let go of our loved one while at the same time wanting to be more involved in their lives because we know the clock is ticking. She describes the experience of anticipatory mourning as “if our love for them is suspended in midair with no place to land…[as we anticipate that] the central characters in our life dramas and comedies no longer [will] share the state with us.” Another person shared the experience exactly as I feel it (to paraphrase) ‘It is like standing under a huge, cresting tidal wave, waiting for it to descend upon and engulf me. I can see it looming and know there is no escape. [Rando, p.201].

After taking many weeks and months to digest a chunk of anticipatory mourning in reaction to my mother’s hip fracture and 7 months of nursing home care last year, and Rando’s material, I next wondered what I can do to help me walk with this changing season of my life. I don’t like this middle passage in many respects. I have to deal with my own changing body, and the prospect of watching my mother walk over earth’s horizon into the next life. I want to hold onto her! But I know I can’t, in truth, and I know I can’t put this emotionally on my mom, for both our sakes. So what do I do with all these feelings?!? That’s for next time.

Sue E. Fabian
Geriatric Care Manager
Elder Law Attorney
Licensed Professional Counselor

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