Anticipatory Grief for Adults & Teens

• Feelings of anxiety/avoidance of spending time with a seriously ill friend or family member
• Depression – feeling heavy, lethargic and like nothing seems to matter
• Feelings of being alone and that nobody understands what you are experiencing
• Change in sleeping and eating patterns
• Loss of interest in school/work
• Lack of concentration
• Sadness and tears
• Disbelief that this is really happening
• Anxiety – like you can’t stop moving, thinking or worrying
• Anger
• Fear of other people becoming sick
• Thoughts about hopes and dreams that may not happen
• Guilt
• Worry about what life will be like without your friend or family member
• Frustration about disruptions in your daily life

For Teens:

• May need to help take care of the sick family member
• May need to help take care of younger siblings
• May need to have more responsibilities such as meal planning, laundry, or outdoor chores

For Adults:

• May need to balance work and caregiving responsibility
• May need to take on new household responsibilities such as grocery shopping, meal preparation, or car maintenance
• May need to take responsibility for financial desires and bill paying
• May need to assist aging parent/family member in decision making regarding safety concerns such as driving and living independently
• May need to advocate for seriously ill person at medical appointments
• May need to assist seriously ill person in end of life decision making/Hospice options
• May need to assist seriously ill person with medication management/setting up weekly pill box
• May need to be gatekeeper for encouraging or regulating visitors
• May need to update family/friends on patients condition via phone calls, email, Facebook, or Caringbridge.org website
• Changes in the family routine since your loved one has become ill
• Your daily schedule may change
• You may not be able to sit down to a meal together as often as a family.
• Other family members may be stressed, exhausted, worried and not readily available

• Request information about your loved one’s illness.
• Identify support systems, such as family, friends, church, or grief support counselor.
• Identify someone you can confide in who is outside your family.
• Decide how you want to communicate with your loved one in person, via e-mail, or by telephone.
• If hospice is involved, ask the hospice team members for support. They can
  • Find more help for the family
  • Lead a family meeting where everyone airs feelings
  • Listen to your concerns
  • Help you find information and answer your questions about your loved one’s illness

Express Your Thoughts & Feelings

• Express what you need to say through writing (journal, letter, poem, song), music or art
• Create a photo album or memory book together
• Create a special music CD by downloading music that you can enjoy together
• Create a family Web site like Caringbridge.org
• Put together a photo CD
• Tape record or video tape conversations or stories with your friend/family member

Manage the Stress of Caregiving

• Take breaks as needed without feeling guilty
• Ask for help when you need it
• Practice slow Belly Breathing – slowly in through your nose to the count of 5 and gently out through your mouth to the count of 5
• Tend to your physical needs: adequate water, nutrition, sleep, exercise (walking)
• Avoid excess caffeine which can contribute to anxiety
• Limit/avoid alcohol which can contribute to depressive symptoms and dehydration
• Avoid worrying about what is beyond your control. Focus on taking charge of what is within your control
• Take time for activities which help you feel more relaxed – time with a pet, reading, soothing music, warm bath, gardening
• Take time for your spiritual needs: prayer, meditation, coloring mandalas, refection in nature
• Visualize a safe/calm place with Belly Breathing – imagine laying on a beach, in a tree house, etc.

• Meet the person where there are at in that moment. Some days they may want to talk about their grief and other times may focus on the here and now
• It’s important to keep in mind that the person that is dying knows they are dying and it is something you don’t have to avoid or force.
• Don’t forget to say “I Love You”- the book The Four Things That Matter Most, by Dr. Ira Byock, writes that dying people typically want to hear (and to say) four things: “Please forgive me,” “I forgive you,” “Thank you,” and “I love you.”
• Talk about how they are feeling (and listen) - Listening to your loved one is the first step to understanding what they truly need most.
• Ask them what they’re thinking about, what they may need – and if they need help with something, do the best you can, whether they ask for help with household chores or simply your company.
• Encourage them to share memories and Goals
• Be truthful, but kind - You don’t have to avoid talking about the fact that your friend/family member is dying.
• Don’t be afraid of tears – yours or the dying individuals. Tears may help that person express their death in a healthy way with you. Be present to give warmth and love. You don’t have to fix or heal their pain. Just be there.