Anticipatory grief – A social worker’s perspective

News & Updates | December 8, 2023 | Dying With Dignity Canada

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A photo of Susan Zwick outside

Susan Zwick is a retired social worker who worked with youth and young adults for most of her career. After losing two parents, she became interested in grief and end-of-life. One parent processed their death very openly, which supported her grief to some extent; the other experience was more contained, and Susan observed the difference in how speaking openly about death can be profoundly helpful. We spoke to Susan about her role as a peer support worker with MAID Family Support Society and the topic of anticipatory grief. 

After listening to an interview with David Atwood, the founder of Death Cafés, I was moved by the experience and began hosting them myself over the last six years. When medical assistance in dying (MAID) became legal in 2016, conversations about assisted dying became common in the Death Cafés. Not long after I supported my aunt through the MAID process in my garden; it was the most beautiful death I have ever witnessed. 

I became involved with MAID Family Support Society (MFSS) in the early days when it was identified that there was little to no support for people who had lost a loved one through a MAID death. Since 2021, MFSS has provided support to those helping a loved one who is considering or planning for medical assistance in dying or those who are grieving a loss due to MAID. 

All the calls are different, but for some it is about preparing for the fact that the MAID death has been set, how to properly say goodbye, and also how to be present for the loved one who has chosen MAID. What’s unique in Canada is that with MAID we can know exactly when a person will die. 

Another challenge, for some, can be when a person has been approved for MAID but has not set a date. Not knowing when the MAID provision will happen can hang over the loved ones to a certain extent. Often people don’t know how much they should talk about the potential assisted death, or they are concerned that their loved one will wait too long and miss the opportunity to have MAID because of a loss of capacity, this is less likely now with the waiver of final consent, but still possible. 

Anticipatory grief can appear in different ways, but when we can name it and explain that there can be grief before a death, it can provide real comfort and relief to people. I try to help folks identify the gifts presented in this challenging process. The time before a MAID provision allows for intimate conversations, or the opportunity to look at old picture albums and reminisce. Sometimes people don’t know what to do with the time, or feel guilty for not doing enough, but I remind them there is no one right way. 

Through my own experience, I know that anticipatory grief has no time limit. My mother died from Alzheimer’s; it was six years of grief watching her decline and die. As compared to my aunt whose MAID process was only weeks. Both circumstances come with their own set of feelings and grief – too fast, too slow?  

I think what’s most important for people to understand about grief is that it is a different experience for everyone, that it’s okay to talk about it, name it and find ways to move through it. 

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