Anticipatory grief – A death doula’s perspective

News & Updates | November 24, 2023 | Dying With Dignity Canada

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A photo of Death Doula Sarah Kerr

Dr Sarah Kerr, PhD is a death doula and ritual healing practitioner. Sarah trains people in the ritual skills of both death and loss at The Centre for Sacred Deathcare. We spoke to Sarah about anticipatory grief and her experience supporting people through this stage. 


Anticipatory grief is the experience and feelings we have when we know a loss is coming and it hasn’t arrived yet. These are complex and difficult feelings because there are two things happening at the same time; we’re loving and we’re letting go. There is an oppositional flow of energy that we have to hold. As humans we like to land somewhere and know what is going on. When we land, something in our nervous system settles, but with anticipatory grief, we are not able to land because we are loving someone, but we also know they are dying. It is a stretch, energetically, that we are asked to hold.  

Grief is love – they are two sides of the same ribbon – we grieve because we love. As a family is getting ready for someone to die, we need to allow the energy to move, and the energy is love and grief.  

It’s important to prepare yourself for what’s coming. Thinking about a death and previewing it in your awareness has value and gives you resources when you get there so it’s not a complete shock. It is our mortality that makes love so precious, so being aware that our time together is limited can make that time much more meaningful. It can be a route to more beauty and connection.  

With a MAID death, there are a particular set of emotional and relational processes. For the person dying, there is relief and gratitude that they were able to make the choice they want, for some the choice is straightforward and for others it can be fraught. And then there is the experience of the friends and family; on one hand you are happy that the person will no longer suffer, and you are glad on their behalf, but at another, more primal level, a person might think, “they are choosing to leave me”, and for some, this is another level of grief.  

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A loved one might also feel guilt for grieving before the person has died, believing that somehow, by experiencing anticipatory grief, we are putting the person in their grave before their time. This guilt can confuse an already complicated grief process. Similarly, a person may think they don’t deserve to feel sad before a person has died.   

What can be most helpful when all these complicated feelings are happening is to be honest, share how you feel, because it’s all normal and there is no one way to grieve. Grief is not math, it never adds up to a tidy total, but we can open up about how we feel to help process those feelings.  

When someone is grieving, I help them understand what’s happening, understand these things they are feeling as part of a normal, healthy process of loss. I validate that it is a reasonable and expected experience, and then help them move through the grief. Grief is like water and we need to keep it moving, otherwise it gets dammed up and stagnant. Grieving is an action that you do with your body – writing, walking in nature, screaming into a pillow – it’s an energy that needs to be moved.  

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