Ambiguous Loss and Anticipatory Grief

I wish I had known about ambiguous loss and anticipatory grief much earlier in my life.

In yesterday’s post, I alluded to my Dad’s transition into residential aged care. 

Today, I want to share some knowledge I have gained over the past few months, because I have found it enormously helpful and therapeutic in dealing with my own experiences and feelings.  I am sure I wasn’t the only person who didn’t know these things, and my hope is that others will benefit from these insights. 

My father has become increasingly frail, and even though I knew the time was coming, making the decision to move him into residential aged care was incredibly painful. For him, it was a loss of independence, his home, his cat and my dog. His sadness was profound, and completely understandable. Still, he was very thankful — as were my siblings and I — that he could move into an excellent place where the care is consistently empathetic and kind, where the food is good, and where he can have his own things around him. 

My emotions, too, were complex. I felt guilty, even though I knew it was the right time and the right thing to do. No loving child wants to see their dad leave behind the life he has known and the things he has accumulated, and no loving child wants to see their Dad so sad. 

I experienced a very real sense of grief and loss while packing up his things, setting up his room, and helping him transition to a new phase of life, There was more to it, though, and often I didn’t know how to express what I was feeling. 

Through my research and reading, and through wonderful constructive advice from friends who have been through similar situations, I have come to understand that many of the things I am experiencing are encompassed by two terms: ambiguous grief and anticipatory grief

I had never heard of either one until recently, and I think they should both be much more commonly known.

Ambiguous Loss is a kind of grief experienced where there is no distinct end or no closure. Generally speaking, it arises from an emotionally painful or turbulent situation that one is going through, and which doesn’t have an “end date”. The reasons for grief or a profound sense of loss might be indistict, or complex, or unidentifiable at the time. Sometimes the grief masquerades as anger, frustration or overwhelm. To experience ambiguous grief is vague, exhausting and indefinite in more ways than just the timeline. 

It’s that mixed feeling of sadness at having to make big decisions that we didn’t feel ready to make, and thankfulness that things worked out perfectly when we needed them to.

It’s the sadness we felt at making decisions about what to do with his things, and asking my best friend to adopt his cat, even though he is still with us.

It’s the sadness I feel at saying goodbye and leaving Dad behind every evening, knowing he is safe and well cared for in his new home, but also that he is no longer ‘at home’. He is exactly where he needs to be, and I love it and hate it at the same time. 

Anticipatory Grief occurs when one realises or acknowledges that death is approaching, or even just a likely outcome. 

This is what I have experienced on a number of occasions when Dad had a health crisis and ended up in hospital. Most vivid in my memories was March 1st this year when I had followed the ambulance to the ER in the wee hours of the morning. When I got there, instead of being taken through to see Dad right away as I had always been before, the doctor on duty actually took me into a little room and  had “the talk” with me to made sure I understood how precarious Dad’s condition was, and that he might not make it this time. To his relief, I was fully aware of that. I suppose many people are surprised by it, or in denial, and I totally get that, too. It’s the natural reaction but, having been there more than once, it is no longer my default. There was no dozing while I sat by my father’s bed that night: instead, I spent hours composing the message I would send to my siblings, and another that I would send to other family and friends, at a decent hour of the morning. 

This is what we felt when packing up Dad’s things for his room at the home, and when sorting and cleaning out the accumulation of papers, trinkets, and household items in his house. Those are the sorts of things usually done after someone dies, not before. Still, it had to be done. 

Similarly, putting his wallet and the jewellery box containing my grandfather’s wedding ring and Dad’s much-loved pocket watches in a special spot in my own house for safekeeping felt strangely poignant and painful and incredibly sad. 

This is what I go through every time Dad has a episode of poor health, or gets an infection, or can’t express why he doesn’t feel good. It happens when he has times of vagueness or confusion, and when he can’t find his words All of those things are happening more often than they used to, so the sense of grief increases as time goes on. 

What I have learned thus far is that ambiguous grief is a very real and important part of the emotional process, and that my feelings don’t always have to be understood to make sense and be accepted as valid

In hindsight, I wish I had understood both of these realities when my mother was diagnosed with dementia, when she went into care, and when she didn’t know who I was anymore. My father, siblings and I were grieving the loss of the person she had been long before she actually passed away. When she died, it felt like it was my mother and someone entirely different at the same time. I felt so guilty about feeling that her passing was a liberation for her and a relief for us, even though my grief was as desperate and profound as ever. I was angry at myself for not knowing how to feel. 

At least this time, with experience and some knew understandings, I can accept the vagueness and complexity of my feelings, which can change from one moment or one day to the next, and just let it be whatever it is. I can cherish every moment with Dad and grieve at the same Time. I am free to laugh and cry, to tell my siblings the stories that are simultaneously sad and funny, and to live each day as it comes without having to explain to myself or anyone else why I’m a mess. 

As awkward and painful and weird as that may be, but I think it’s a healthy way to be. Still, I know I need to manage all those pesky feelings so I stay healthy, too. 

So, I try to make sure I talk honestly with my husband, siblings and closest friends about my thoughts and feelings. My sisters and brother are feeling the same things, and they all live interstate, so keeping them in the loop and encouraging them to express their feelings are hugely important, too. 
I allow myself to cry. ‘Being strong’ is rubbish. 
I refuse to beat up on myself when things are tough, or if I don’t achieve everything on my ‘to-do’  list. 
I remind myself to take each day as it comes.
I remind myself that we are doing the best thing for our dad, and that he is being expertly and compassionately cared for.

And every single day, I hold Dad’s hand and I tell him I love him. Because, throughout this whole process, Dad being sure of that is the most important thing of all.  

Different Kinds of Grief‪
#EmotionalIntelligence #emotions #grief #feelings #MentalHealthMatters  #MentalHealthAwareness‬ #personal #blogpost 

Helpful Reading: 

What Is Ambiguous Loss? 

Ambiguous Grief: Grieving Simone Who Is Still Alive 

How To Deal With Ambiguous Loss

Grief Before Death: Understanding Anticipatory Grief

Grieving Before A Death: Understanding Anticipatory Grief

5 thoughts on “Ambiguous Loss and Anticipatory Grief

  1. Wow…that is such a good read…for me…right now. We are not as far into the process as you, just at the point of trying to get my parents to understand their living situation needs to change. They both have different types of dementia/Alzheimer’s and the path is not the one we expected when dad was first diagnosed. We talked about putting things into place for mum for when/if he needed to go into care or passed. Now , a couple of years down the track, dad is stable and mum is progressing much quicker and may need help before he does!
    I understand the “grief” that you feel and how conflicted it can make you feel. But as you say, you just have to make sure he knows that he is loved.
    Such a hard time.
    Hugs.

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