Sarah sits beside her father’s hospital bed, holding his hand as he sleeps. He was diagnosed with advanced heart failure three months ago, and she finds herself crying during her morning commute, feeling exhausted even after a full night’s sleep, and struggling to focus at work. She wonders if something is wrong with her—after all, her father is still alive. What Sarah doesn’t realize is that she’s experiencing something completely natural: anticipatory grief.
This article will help you understand what anticipatory grief is and why it’s a normal response to impending loss. You’ll learn about the emotional, physical, and behavioral signs of anticipatory grief, and discover the difference between grief coaches and licensed grief counselors. Most importantly, you’ll learn that these feelings don’t mean you’re weak—they show how deeply you love.
Understanding anticipatory grief matters because it affects millions of caregivers, family members, and even people facing their own mortality. When you can name what you’re experiencing, you can find the right support and give yourself permission to feel what you’re feeling.
What is Anticipatory Grief?
Anticipatory grief is the sadness, worry, and sense of loss you feel before someone dies. It happens when you know a loss is coming—when a loved one has been diagnosed with a terminal illness, when their health is declining, or when you’re facing your own death.
Unlike grief after death, anticipatory grief occurs while your loved one is still alive. You’re mourning many things at once: the person they used to be, the future you won’t have together, the relationship that’s changing, and the approaching goodbye. After someone dies, you grieve what was. With anticipatory grief, you’re grieving what is ending and what will never be.
Anticipatory grief is entirely normal and natural. It’s not a sign of weakness or a lack of faith. Your body and mind are doing exactly what they’re designed to do—responding to the knowledge that someone you love is leaving. Healthcare professionals and grief experts have recognized this response as a healthy part of the human experience.
The depth of your grief reflects the depth of your love. You wouldn’t feel this pain if you didn’t care so deeply. Every tear, every moment of sadness, every wave of anxiety shows how much this person means to you. Anticipatory grief is love with nowhere to go except inward, where it transforms into tears and heartache.
Signs and Symptoms of Anticipatory Grief
Anticipatory grief affects your emotions, your body, and your behavior. Understanding these signs can help you recognize what you’re experiencing and seek appropriate support.
Emotional Symptoms
You might feel profound sadness that comes in waves, sometimes without warning. Anger is common too—anger at the illness, at the unfairness, sometimes even at the person who is dying or at yourself. Guilt can surface, especially when you feel relief at the thought that suffering will end, or when you find yourself laughing or enjoying something. Anxiety about the future, about being alone, or about how your loved one will die can feel overwhelming.
Physical Symptoms
Your body carries grief, too. Profound fatigue that doesn’t improve with sleep is one of the most common physical signs. Sleep disturbances—either insomnia or sleeping too much—often accompany anticipatory grief. You might notice changes in appetite, eating much less or much more than usual. Headaches, muscle tension (especially in your neck and shoulders), stomach problems, and chest tightness are all physical expressions of emotional pain.
Behavioral Changes
Anticipatory grief can change how you act. Some people withdraw from friends and social activities, feeling like no one understands what they’re going through. Others become hyper-focused on caregiving, planning, or preparing for what’s ahead. Difficulty concentrating or making decisions is common—your mind is processing so much that everyday tasks feel overwhelming.
Why These Feelings Show Your Love
Every symptom you experience—the exhaustion, the tears, the worry—is evidence of a meaningful relationship. People don’t grieve for those they don’t love. The intensity of your anticipatory grief measures the significance of your connection. When you feel guilty about relief or worry you’re not doing enough, remember that these conflicted feelings prove you care deeply.
Why Anticipatory Grief Happens
Your brain is designed to prepare you for challenging experiences. When it recognizes that loss is approaching, it begins the grief process before the actual death occurs. This isn’t a malfunction—it’s your mind trying to help you cope with what’s coming.
Anticipatory grief can actually be protective in some ways. It gives you time to say important things, resolve conflicts, make memories, and prepare, both practically and emotionally. Some research suggests that people who experience anticipatory grief may adjust somewhat better after the death because they’ve already begun processing the loss.
Preparing emotionally for loss doesn’t mean you won’t grieve after death—you will. But it does mean you might have fewer regrets because you used the time you had. You might have difficult but meaningful conversations. You might create rituals or share stories. You might simply sit together in comfortable silence.
Grief doesn’t wait for permission or for the “right” time. It arrives when your heart realizes what’s happening, not when you feel ready to handle it. This is why anticipatory grief can feel so confusing—logically, you know your loved one is still alive, but emotionally, you’re already beginning to say goodbye.
How Anticipatory Grief Affects Different People
Family Members and Caregivers
Family caregivers often experience the most intense anticipatory grief because they witness every change, every decline, every loss of ability. They’re grieving while simultaneously providing care, making decisions, and trying to stay strong for everyone else. The physical exhaustion from caregiving combines with emotional exhaustion from grief, creating a unique kind of overwhelming tiredness.
The Person Facing Their Own Death
People who are dying experience their own form of anticipatory grief. They grieve the life they’re leaving, the experiences they won’t have, and the people they’ll be saying goodbye to. They might worry about their loved ones—how will they manage, will they be okay, will they remember them. This grief, sometimes called preparatory grief, deserves the same respect and support.
Children and Teenagers
Young people experience anticipatory grief differently depending on their age and development. Children might show their grief through behavior changes, regression to earlier stages, or questions that seem to come from nowhere. Teenagers might withdraw, become angry, or throw themselves into activities to avoid feeling the pain. They need age-appropriate explanations and permission to feel whatever they’re feeling.
Extended Family and Friends
Not everyone close to the dying person has the same level of involvement in their care. Extended family members and friends might experience anticipatory grief but feel they don’t have the “right” to express it because they’re not primary caregivers. Their grief is just as real and valid, even if they’re not providing hands-on care.
Working with Grief Support Professionals
Why Professional Support Matters
You don’t have to navigate anticipatory grief alone. Professional support can help you understand what you’re feeling, develop healthy coping strategies, and find meaning during an incredibly difficult time. Just as you’d see a doctor for a physical injury, seeking help for emotional pain is a sign of strength, not weakness.
Grief professionals provide a safe space where you can express feelings you might not feel comfortable sharing with family or friends. They help you process complex emotions without judgment and offer tools for managing the practical challenges of grief. They also understand that everyone’s grief journey is unique and can tailor support to your specific needs.
Feeling Comfortable Asking for Help
Many people hesitate to seek grief support because they worry they’re “not grieving correctly” or that their feelings aren’t “bad enough” to warrant professional help. The truth is, there’s no threshold you need to meet. If you’re struggling, that’s reason enough to reach out.
Some people worry about the stigma of seeking emotional support. Remember that talking about grief isn’t a sign of being broken—it’s a sign of being human. The most resilient people are often those who recognize when they need help and have the courage to ask for it.
Understanding Your Options: Grief Coaches vs. Licensed Grief Counselors
When seeking grief support, you have two main options: grief coaches and licensed grief counselors. Understanding the differences will help you choose the right fit for your needs.
What is a Grief Coach?
A grief coach focuses on helping you move forward from your current situation toward a meaningful future. Coaches are present and future-oriented, helping you identify goals, develop action plans, and build resilience. They take a holistic approach, addressing emotional, physical, social, and spiritual aspects of grief.
Grief coaches are not licensed mental health professionals. They typically complete certification programs through organizations like the Global Grief Institute or the Grief Recovery Method, but these certifications don’t require state licensing. This doesn’t mean they’re unqualified—many are highly trained and experienced—but it does mean their training and oversight differ from licensed counselors.
Grief coaching typically costs less than licensed therapy and is usually paid out of pocket. Because coaches aren’t diagnosing or treating mental health conditions, there’s no risk of receiving a medical or psychiatric diagnosis. This can be important for people concerned about how diagnoses might affect insurance, employment, or other aspects of life.
Grief coaching works best for people who are functioning reasonably well but want support navigating their grief journey. It’s ideal for those who prefer a collaborative, action-oriented approach and don’t need treatment for clinical depression, anxiety disorders, or complicated grief.
What is a Licensed Grief Counselor?
Licensed grief counselors are mental health professionals—licensed therapists, psychologists, clinical social workers, or professional counselors—who specialize in grief. They use therapeutic approaches grounded in clinical research and evidence-based practices. They can address complex mental health issues that sometimes accompany grief, such as major depression, anxiety disorders, or prolonged grief disorder.
These professionals hold advanced degrees (master’s or doctoral level) and maintain state licenses that require ongoing education and adherence to professional standards. They’re trained to recognize when grief has become complicated or when other mental health conditions are present.
Licensed grief counseling may be covered by health insurance, which can make it seem less expensive initially. However, using insurance typically requires a mental health diagnosis, which becomes part of your permanent medical record. Whether this is beneficial or problematic depends on your individual situation and future plans.
Licensed grief counselors are the better choice when grief is accompanied by clinical depression, suicidal thoughts, substance abuse, severe anxiety, or when grief persists in ways that significantly impair daily functioning. They’re also appropriate when you prefer a therapeutic relationship and clinical treatment approach.
Key Differences Between Grief Coaches and Counselors
Category
Grief Coach
Licensed Grief Counselor
Training
Certification programs; no degree requirement
Master’s or doctoral degree required
Licensing
Not licensed by state boards
State-licensed mental health professional
Approach
Action-oriented, goal-focused, holistic
Therapeutic, clinical, evidence-based treatment
Cost
Typically $25-$200 per session
Typically $100-$250+ per session
Insurance
Generally not covered; self-pay
Often covered by health insurance
Diagnosis
Cannot diagnose; no medical record
Can diagnose; creates medical documentation
Focus
Present and future; building resilience
Can address past, present, and complex pathology
How to Decide Which is Right for You
Consider a grief coach if you want someone to help you move forward, set goals, and find meaning after loss without a clinical diagnosis. Choose a licensed counselor if you’re experiencing symptoms of depression or anxiety that interfere with daily life, if you have a history of mental health conditions, or if you prefer the structure of clinical therapy.
Some people work with both—a coach for forward movement and practical strategies, and a counselor for deeper therapeutic work. There’s no “wrong” choice as long as the professional’s approach aligns with your needs and values.
The Importance of Values Alignment
Why Your Values Matter in Choosing Support
Not all grief professionals approach grief the same way. Some focus on “moving through” grief quickly, while others emphasize sitting with pain. Some incorporate spiritual or religious perspectives, while others take a secular approach. Finding someone whose values and philosophy match yours can mean the difference between feeling supported and feeling misunderstood.
Your beliefs about grief, death, spirituality, and healing should be respected and honored by any professional you work with. If you believe grief is something to integrate rather than overcome, find someone who shares that view. If your faith is central to how you make meaning of loss, find someone who understands and respects that.
Questions to Ask Potential Grief Coaches or Counselors
Before committing to work with someone, ask these important questions during an initial consultation:
What is your training and experience in grief support?
What is your philosophy about grief—do you see it as something to “get over” or something to integrate?
How do you approach spirituality or religious beliefs in your work?
What does a typical session look like?
How do you measure progress or success?
How long do people typically work with you?
What happens if I’m not feeling like we’re a good fit?
Can you share an example (without names) of how you’ve helped someone in a situation similar to mine?
Red Flags to Watch For
Be cautious of professionals who promise to “cure” your grief or guarantee specific timeframes for healing. Avoid those who judge your emotions, tell you you “should” feel differently, or push you to move faster than feels right. If someone makes you feel worse about yourself or dismisses your concerns, that’s a clear signal to find someone else.
Trust your instincts. If something feels off, even if you can’t articulate exactly what, it probably is. You should feel heard, respected, and safe with your grief professional.
The Importance of Feeling Heard and Respected
The therapeutic relationship matters as much as the professional’s credentials or approach. If you don’t feel heard, understood, and respected, even the most qualified professional won’t be able to help you effectively. Permit yourself to “shop around” until you find someone who feels like the right fit.
Life Transition Coaches and Grief Integration
What Life Transition Coaches Do
Life transition coaches help people navigate significant life changes, and many specialize in supporting people through illness, dying, death, and grief. They serve as coordinators who help you understand your situation, make informed decisions, and access appropriate resources. Think of them as project managers for your healthcare journey or grief experience.
How They Help with Grief Recovery
Life transition coaches often incorporate grief coaching into their practice. They help you integrate loss into your life story rather than trying to “get over it”. Integration means finding ways to carry your love and memories forward while also building a meaningful life.
These coaches recognize that grief doesn’t exist in isolation—it affects your physical health, relationships, work, and sense of identity. They take a holistic approach that addresses all these dimensions.
The Connection Between Life Transitions and Anticipatory Grief
Anticipatory grief is itself a significant life transition. You’re transitioning from life with your loved one to life without them, and that process begins before they die. Life transition coaches understand this unique challenge and can help you honor what’s ending while preparing for what’s ahead.
Finding a Life Transition Coach Who Understands Grief
Look for coaches who specifically mention grief, end-of-life, or bereavement in their areas of expertise. Ask about their training and personal experience with loss. The best coaches combine professional training with a personal understanding of what grief actually feels like.
Practical Ways to Navigate Anticipatory Grief
Acknowledging and Naming Your Feelings
The first step in managing anticipatory grief is recognizing it for what it is. When you can say, “This is anticipatory grief,” you move from confusion to clarity. You’re not falling apart—you’re responding normally to an abnormal situation.
Creating Space for Difficult Emotions
Grief needs room to exist. Set aside time to feel what you’re feeling without judging yourself. This might mean crying in the shower, journaling, or sitting quietly with your pain. Creating space doesn’t mean dwelling, but it does mean not running from difficult emotions.
Talking Openly About the Situation
Silence around dying and death often makes grief harder. When possible and appropriate, talk with your loved one about what’s happening. Share memories, express gratitude, ask questions, say what needs to be said. These conversations are gifts to both of you.
Self-Care During Anticipatory Grief
Your body and mind need extra care during this time. Prioritize sleep, even if you need to ask your doctor for help. Eat nutritious food regularly, even if your appetite is diminished. Move your body gently—walk, stretch, or do yoga—to release tension. These aren’t luxuries; they’re necessities for sustaining yourself through grief.
Building a Support Network
Identify people who can listen without trying to fix, who can sit with you in pain, and who respect your process. This might include friends, family members, support groups, or online communities. You need people who understand that anticipatory grief is real grief deserving of support.
Balancing Grief with Being Present
One of the paradoxes of anticipatory grief is that while you’re mourning future loss, your loved one is still here now. Practice being fully present during your time together, even when it’s painful. This balance—honoring your grief while cherishing the present—is one of the most significant challenges and greatest gifts of anticipatory grief.
When someone shares their anticipatory grief with you, resist the urge to make it better. You can’t fix this situation, and trying to will only make the grieving person feel more alone. Instead, offer your quiet presence and willingness to sit with complicated feelings.
Validating Emotions Without Judgment
Say things like “This is so hard” or “I’m here with you” rather than “At least…” or “Everything happens for a reason”. Validation means accepting their feelings as real and reasonable, rather than trying to talk them out of them. Every emotion—including anger, guilt, and relief—deserves acknowledgment.
Practical Ways to Help
Offer specific, concrete help rather than “Let me know if you need anything”. Say “I’m bringing dinner Tuesday—do you prefer chicken or pasta?” or “I’m coming over Saturday to do laundry—I’ll be there at 10”. Anticipatory grief makes decision-making harder, so eliminate decisions when you can.
What Not to Say
Avoid phrases like “They’re in a better place” (they’re not dead yet), “God never gives you more than you can handle” (feels dismissive), “I know exactly how you feel” (you don’t), or “Stay positive” (invalidates their pain). These statements, though often well-intentioned, can make grieving people feel misunderstood and alone.
Being Comfortable with Silence and Tears
Sometimes the most supportive thing you can do is simply sit quietly while someone cries. You don’t need to fill silence with words or stop tears with reassurance. Your steady presence is enough.
When to Seek Professional Help
Signs That Professional Support Would Be Beneficial
Consider seeking professional help if you’re experiencing thoughts of harming yourself, if you can’t perform basic self-care tasks, if you’re using alcohol or drugs to cope, or if your grief feels overwhelming most of the time. Also consider professional support if you feel entirely alone, if you’re having relationship problems because of your grief, or if you simply feel you need more support than family and friends can provide.
Understanding That Seeking Help is Strength
Asking for help requires courage and self-awareness. The strongest people are often those who recognize their limits and reach out before they’re in crisis. Professional support isn’t admitting defeat—it’s taking active steps toward healing.
How to Find Qualified Grief Coaches or Counselors
Start by asking your hospice team, primary care doctor, or hospital social worker for recommendations. Search online directories like Psychology Today, the National Alliance for Grieving Children, or professional coaching organizations. Ask friends who’ve worked with grief professionals for referrals. Many professionals offer free consultations to help you determine if you’re a good fit.
Questions to Ask During an Initial Consultation
In addition to the values-alignment questions mentioned earlier, ask practical questions: What are your fees? Do you accept insurance? How long are sessions? How often would we meet? What’s your cancellation policy? How do you handle emergencies between sessions? These practical details matter as much as philosophical alignment.
Call to Action: Taking the Next Step
For Individuals Experiencing Anticipatory Grief
If you’re experiencing anticipatory grief, know that what you’re feeling is normal and natural. Your grief shows your love. Give yourself permission to feel whatever you’re feeling without judgment. Consider reaching out to a grief coach or licensed grief counselor who can provide support tailored to your needs. You don’t have to navigate this alone.
For Caregivers Supporting Someone with Anticipatory Grief
If you’re caring for someone who’s dying, you’re likely experiencing anticipatory grief yourself. Remember that you can’t pour from an empty cup. Seek support for your own grief, even as you support your loved one. Consider working with a grief coach or counselor who understands the unique challenges of caregiving.
For Family Members Navigating This Together
Families often experience anticipatory grief differently, which can create tension and misunderstanding. Respect that each person grieves in their own way and on their own timeline. Consider family counseling or a family meeting facilitated by a grief professional to help everyone communicate openly.
Encouragement to Reach Out
Reaching out to a grief coach or licensed grief counselor is an act of self-compassion and courage. These professionals understand anticipatory grief and can offer strategies, support, and validation that you might not be able to find elsewhere. Most provide initial consultations to help you determine if you’re a good fit.
Permission to Grieve While Still Being Present
You can grieve the approaching loss and still be fully present with your loved one. You can cry about tomorrow and laugh today. You can feel sad about what’s ending and grateful for what remains. These aren’t contradictions—they’re the complex reality of anticipatory grief.
Resources for Finding Support
Ask your hospice team for grief support referrals
Contact your hospital’s social work department
Search online directories for grief coaches and counselors
Explore support groups through local hospices or online communities
Consider working with a life transition coach who specializes in end-of-life support
Conclusion
Anticipatory grief is a natural, normal response to impending loss that reflects the depth and breadth of your love. Every tear you cry, every moment of exhaustion, every wave of sadness shows how much you care. This grief isn’t something to be ashamed of or to hide—it’s proof of a meaningful relationship that matters deeply.
Help is available. Whether you choose to work with a grief coach, a licensed grief counselor, or a life transition coach, you don’t have to navigate anticipatory grief alone. These professionals understand what you’re experiencing and can provide support tailored to your unique needs.
Permit yourself to express your feelings freely, to ask for help, and to take care of yourself during this difficult time. Talk about what’s happening with people you trust. Seek professional support when you need it. Remember that grieving before loss doesn’t mean you love any less—it means you love so much that your heart is already preparing to say goodbye.
You are not alone in this journey. Reach out, speak up, and let yourself be supported. Your grief matters because your love matters.
All the Blues in the Sky by Renée Watson – About a 13-year-old whose best friend dies on her birthday, exploring grief through counseling group experiences.
The Truth as Told by Mason Buttle by Leslie Connor – Chronicles a boy dealing with a friend’s death, a learning disability, and community judgment.
The Year of the Rat by Clare Furniss – A 15-year-old coping with her mother’s death during childbirth and caring for her baby sister.
The Dougy Center offers extensive free resources, including activity sheets, tip sheets, and guidance for children and families. They provide age-appropriate materials and have partnered with Sesame Street on grief resources.
Winston’s Wish provides comprehensive bereavement support for children up to age 25, including online chat, phone support, and downloadable resources. It also offers specialized guidance for different types of loss.
Sesame Street Communities: Helping Kids Grieve features interactive videos with Elmo and other characters, activities for expressing feelings, and family guidance. All resources are free and available in multiple languages.
The National Alliance for Children’s Grief (NACG) provides educational toolkits, connects families to local support services, and offers professional development for those working with grieving children.
GriefShare helps locate local grief support groups for families and provides daily email encouragement for those processing loss.
Enhanced Online Resources for Teens
Specialized Teen Platforms
Talk Grief—Winston’s Wish operates this dedicated online space for teenagers and young adults aged 13-25. It features peer stories and professional support.
Teenage Grief Sucks – A teen-run website opening conversations about grief where teens can read candid stories and share their own experiences.
Actively Moving Forward – A national network specifically created for grieving young adults, addressing the unique challenges of this age group.
The Dinner Party – Young adults in nearly 100 cities worldwide meet for dinner, creating community for emerging adults who’ve experienced loss.
Comprehensive Teen Support Centers
The Dougy Center Teen Resources provides age-specific materials, including tip sheets, that acknowledge “grief usually does what it wants” and doesn’t follow rules or schedules. They emphasize that there’s no right or wrong way to grieve.
Hospice of the Valley Teen Resources offers specialized materials addressing how teens grieve differently than adults, sudden versus expected death, and losing siblings or friends.
Children’s Room Teen Program provides peer support groups and activities specifically for teens to connect around shared interests while processing grief.
Interactive Support Options
Winston’s Wish offers immediate support through live chat, helpline, and text services – no waiting lists required. They also provide one-to-one sessions with bereavement specialists for teens 13 and older.
HEART Play for Young Adults connects late high school and college-aged individuals, providing space to discuss challenges of graduation, leaving home after loss, and meeting new people.
Educational Resources for Teens and Families
The JED Foundation provides mental health resources showing teens how they can support one another and overcome challenges during the transition to adulthood.
Eluna Network offers grief resources organized by specific age ranges, including detailed developmental information and support strategies for both middle school and high school students.
National Alliance for Children’s Grief provides educational toolkits and connects families to local services, with materials specifically designed for adolescent grief.
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At present, no official organization oversees end-of-life doulas (EOLDs). Remember that some EOLDs listed in directories may no longer be practicing, so it’s important to verify their current status.
End-of-Life Doula Schools
The following are end-of-life (aka death doula) schools for those interested in becoming an end-of-life doula:
Remember that there is currently no official accrediting body for end-of-life doula programs. It’s advisable to conduct discovery sessions with any doula school you’re considering—whether or not it’s listed here—to verify that it meets your needs. Also, ask questions and contact references, such as former students, to assess whether the school offered a solid foundation for launching your own death doula practice.
