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Anticipatory Grief

In 1969, Dr. Elizabeth Kubler-Ross published On Death and Dying and later went on to launch the Hospice movement in America. Even though her studies focused more on those who were dying than the caregivers that were left behind, her work has had enormous influence on the understanding of various stages of death and grief.

She described five distinctive stages of the grief process: * Denial * Anger * Bargaining * Depression * Acceptance Although not everyone progresses through these stages in the same order and not everyone experiences each stage, the feelings and emotions identified seem to be universal.

At one time the diagnosis of cancer, AIDS or COPD was a death sentence. Advances in medicine and treatment now sometimes place patients with these diseases in a chronic rather than acute condition, leaving the caregiver with a sense of on-going sadness, or "anticipatory grief."

Anticipation in this context refers to the anticipation of an event in the future. Barring a miracle, the caregiver has a sure knowledge that death will occur in our loved one sooner rather than later. In anticipation of eventual death, the caregiver changes her focus from the hopes of a miracle cure to ensuring comfort and quality at life's end.

Many of the caregivers I have worked with not only mourn the anticipation of death of a loved one, but also the end of their role in life. They are afraid of who they will become when they no longer bear the title of "wife", daughter" or "caregiver."

The overwhelming burden of caring, worrying and dedication will end with the death of a loved one. What will fill the void? Have they been strong for so long that when death does occur, they will collapse?

Nature demonstrates that almost everything occurs in cycles. Each individual experiences an endless flow of beginnings and endings. Much of our fear and grief stems from our uncertainty about the new beginning and if we will be able to handle it.

The more we can trust that with every ending is a new beginning, the less likely we are to resist letting go of the old. We play a part in choosing what the new beginning will be. We do not need to rush into anything. We have worked hard and with love, and we deserve to rest and regroup.

Trust yourself and trust nature that you will be guided in your journey. Each one of us goes through the cycles of life in our own way. We can see each ending as a tragedy because we will no longer have daily exposure and experiences with our loved one, or we can see it as a new beginning for everyone concerned.

article re-published 4 August 2006