When Tomorrow Hurts Today: Grieving Someone Who Is Still Alive

Compared to our Victorian ancestors, we’ve become experts at keeping death at a distance. A hundred years ago, most people would have sat at the bedside of a number of relatives in their final hours. I often think about how fortunate I was to be with my mum when she died—a moment denied to both my dad and brother.

Thanks to medical advances, people now live longer, healthier lives. But this has also changed how we experience death and grief. Funerals, once one of the few public rituals for acknowledging loss, are less frequent and are less of a community event - attended almost 'by invitation'. More of us grieve in private. And that can come at a cost.

National Grief Awareness Week is an annual event that encourages open conversations about grief and highlights the support available.

Anticipatory Grief: what is it?

Most of us expect to feel grief after a bereavement—when someone we love dies. But what’s less talked about is the grief that begins before someone has actually gone.

Anticipatory grief—sometimes described as 'grief before death'—is the sadness, worry, and sense of overwhelm that can arise when you know a loss is coming. Its the emotional pain experienced before an expected loss, often due to a terminal illness or severe decline in health.

It often affects carers and families supporting someone with a terminal illness or a condition like dementia. It can also be triggered by any major life change that signals a loss—like divorce, job loss, or serious diagnoses.

Anticipatory grief is just as real, painful, and complicated as the grief that comes after death.

Why Carers Experience Anticipatory Grief

Carers witness the slow decline of someone they love. This can mean losing the person twice: once as illness or dementia changes who they are, and again when death finally comes.

The stress of caregiving, the physical demands, the emotional strain, and the isolation can intensify feelings of grief. Carers may find themselves constantly navigating uncertainty while trying to provide love, care, and support.

Common Symptoms of Anticipatory Grief

Grief is deeply personal—there’s no right or wrong way to experience it. But if you’re caring for someone whose health is declining, you might notice:

• Intense sadness: Watching someone you love fade away can feel heartbreaking. You may become aware of 'last times'—the last walk, the last conversation—and feel deep loss even before death occurs.
• Regret: You might wish for more time, revisit old arguments, or mourn the closeness you once had.
• Anxiety and worry: You may feel on edge, watching for signs of decline, or dreading what comes next.
• Fear: Fear of the future, of life without them, or of how you’ll cope is common.
• Anger: At the illness, at the situation, even at the person you care for or others you love—especially if you feel exhausted or unsupported.
• Guilt: You may feel guilty for not doing enough, for wanting life to return to normal, or even for hoping their suffering ends.
• Exhaustion: Caring is demanding. The emotional weight can leave you drained, both physically and mentally.
• Loneliness: Illness can change relationships with the person you care for as well as friends. If communication or connection fades, you might feel isolated.
• Moments of hope: Even when you know the prognosis, you may find yourself hoping for more time, or for a miracle.

Sometimes people feel numb or detached. Whatever you’re feeling—sadness, anger, hope, or relief—it’s all valid.

How to Cope with Anticipatory Grief

There’s no easy way through grief, but there are ways to support yourself:

1. Learn what to expect: Understanding your loved one’s condition can give you a sense of control and help you prepare.
2. Connection: If you can, share memories, express love, and have those difficult conversations with your loved one while there’s still time. Honest conversations can bring peace, closure, and connection.
3. Create moments together: Even small activities—listening to music, looking at old photos—can become treasured memories.
4. Plan ahead if you can: Discussing wishes or even funeral plans may feel daunting but can bring comfort and clarity later.
5. Acknowledge your feelings: Name what you’re feeling without judgment. Your emotions are valid, even when they contradict each other.
6. Look after yourself: Eat well, rest when you can, move your body, and spend time outdoors. Caring for yourself is not selfish—it makes you more able to care for others.
7. Find support: Talk to friends, join a local or online support group, You don’t have to carry this alone.
8. Ask for help: Explore respite care or practical support if caring responsibilities become overwhelming. Speak to your GP or a counsellor.

Finding Support as a Carer

Carers often carry heavy emotional and physical burdens.

Support can come in many forms:

• Carer support groups (both online and in-person)
• Hospice services offering emotional and practical help
• Counselling and therapy for grief and stress
• Respite care services to give you time to rest and recover

Many carers find comfort in connecting with others who truly understand their experiences.

Final Thoughts on Anticipatory Grief and Caring

Caring for someone as they near the end of life brings unique emotional pressures. Watching someone you love fade away—sometimes physically, sometimes mentally—can feel like losing them twice.

Anticipatory grief doesn’t mean you love them any less or that you won’t grieve when they’re gone. It may help you prepare emotionally, but it doesn’t erase the pain of loss. It simply means you’re human.

This grief can be painful, exhausting, and messy. It may last weeks, months, or even years—depending on your loved one’s illness and your personal circumstances. But it can also bring moments of closeness, healing, and even peace.

Be kind to yourself. There’s no 'right' way to grieve. Take what support you can, allow yourself to feel what you feel, and remember: caring for you matters too.