Impact of Caring on Families and Carers
Mary E. Braine, Julie Wray in Supporting Families & Carers, 2018
There has been much debate and controversy over the concept and definitions of anticipatory grief. Erich Lindemann (1944) introduced the term ‘anticipatory grief’ in the 1940s when he focused on grief that a person might experience when the loss of a close loved one was anticipated but had not yet occurred. Some 40 years later, Theresa Rando (1986) expanded the definition of anticipatory grief and asserted that it is a response to a known terminal illness and that the full breadth of grief cannot be appreciated until the dying person is dead. Anticipatory grief refers to a grief reaction that occurs in anticipation of an impending loss, i.e. before the death of a loved one. For family caregivers, anticipatory grief is related to the actual and anticipated loss of the loved one’s personhood and of their relationship with their loved one (Rando 1986). The definition of anticipatory grief offered by Rando (2000, p. 29) is widely accepted: The mourning, coping, interaction, planning, and psychological reorganisation that are stimulated and begun in part in response to the impending loss of a loved one and the recognition of associated losses in the past, present, and future.
Psychiatric Emergencies in Grief
R. Thara, Lakshmi Vijayakumar in Emergencies in Psychiatry in Low- and Middle-Income Countries, 2017
Anticipatory grief is a term that describes the grief process a person undergoes before a loss actually occurs. Clayton et al. (1973) attempted to define anticipatory grief in the context of subjects whose spouses had short terminal illnesses (six months or less), those whose spouses had longer terminal illnesses (more than six months), and those whose spouses died suddenly (in less than five days). Gilliland and Fleming (1998) conceptualized anticipatory grief as a multidimensional phenomenon similar to grief. They empirically compared and contrasted the features of anticipatory grief and conventional grief, and addressed the effects of anticipatory grief on post-death bereavement. It was found that the anticipatory grief experienced by the spouses of terminally ill persons was marked by more intense levels of acute symptomatology than was conventional grief. Furthermore, it was found that anticipatory grieving played a role in helping the individual to adapt. Those experiencing anticipatory grief tended to have less intense and acute levels of symptoms during post-death bereavement.
Child-Centered Play Therapy With Children Who Are Dying
Lawrence C. Rubin in Handbook of Medical Play Therapy and Child Life, 2017
Terminally ill children experience a multitude of losses in relation to their illness (Aldridge & Sourkes, 2012), particularly that of normalcy. Illness is unpredictable and the child’s predictable and safe world changes as his or her disease progresses. The child also experiences a loss of one’s ability as the disease progresses. For instance, a school-aged child may lose the ability to control his or her bowels and along with it, the trust and confidence in his or her body to function normally. As the child physically deteriorates, the child’s autonomy is also lost. The child becomes more dependent on others for daily care. Strong emotions often accompany loss. Children may feel sadness, frustration, resignation, or anger toward the changes. Anticipatory grief is a common reaction to loss and entails the process of grieving in advance when a person knows loss is inevitable (Wolfelt, 1996). According to Wolfelt, grief is a natural and necessary process of coping. Grief and loss are two sides of the same coin and often accompany one another. Children express their grief and reaction to loss in multiple ways, with young children typically processing through their grief through the use of play (Pearson, 2009).
Pediatric Palliative Care
Published in Hospital Practice, 2021
Benjamin Moresco, Dominic Moore
Grief and bereavement may include multidimensional reactions by children and their families [94]. Cognitive, psychosocial, and emotional reactions vary widely even in families who have been unified in their approach to the care of a child with serious illness. Individuals may see more value or sincerity in their own expressions of grief, resulting in conflict within families. Often the grief that some expect at the time of death begins much earlier. Anticipatory grief is a term referring to the loss and grief that families may feel even before a loss. While all grief is complicated, the clinical term ‘complicated grief’ refers to painful emotions connected to loss lasting longer than expected without improvement in the severity and impacting other aspects of one’s life. Among the risk factors for complicated grief, a death of a child or a sudden death are noted risk factors. As PPC teams work with families they are often able to address the grief that the child and family are experiencing as well as the impact it may have on interpersonal relationships [95,96].
Caregiving for Parents Who Harmed You: A Conceptual Review
Published in Clinical Gerontologist, 2021
Jooyoung Kong, Anne Kunze, Jaime Goldberg, Tracy Schroepfer
Relatedly, adults who experienced childhood maltreatment by a parent are at particularly high risk for experiencing anticipatory and complicated grief throughout the perpetrator’s illness and after their death (Brown, 2012; Coombs, 2010; Crunk & Burke, 2020; Doka, 1999). During times of stress, such as a parent’s worsening illness, a history of maltreatment may lead to exacerbated anticipatory grief responses (Coombs, 2010) and further challenges with coping and interpersonal reactions. These expressions of grief (e.g., anger, sadness) can influence the relationship between the adult child and parent who is dying, thus changing roles and interactions. Understanding that emotional expressions may be coming from a place of grief can be particularly helpful for other family members as they relate to one another, and for healthcare and other helping professionals who may be charged with providing support to family members experiencing anticipatory grief.
Trajectories and predictors of stress and depressive symptoms in spousal and intimate partner cancer caregivers
Published in Journal of Psychosocial Oncology, 2020
Qi Chen, Lauren Terhorst, David A. Geller, Wallis Marsh, Michael Antoni, Mary Amanda Dew, Michelle Biala, Josh Weinstein, Allan Tsung, Jennifer Steel
A higher proportion of caregivers reported clinical levels of depression when compared to the study by Chen and colleagues which included breast cancer patients’ caregivers.22 We also found a decrease of depressive symptoms with a larger effect size. This finding may be secondary to the longer follow up period that we included in the present study. The trajectories of caregivers’ depressive symptoms in our study showed a similar pattern with the “resilience trajectory” described in the study by Tang and colleagues.21 This resilience trajectory is reflected by the sharp decrease in depressive symptoms followed by stable levels of depressive symptoms. Differed from this trajectory, our findings reveal that caregivers who have high levels of depressive symptoms at baseline continue to have symptoms above clinical threshold over the course of 18 months. One explanation for the difference was the nature of our study participants. The cohort of caregivers in the present study included carers of advanced cancer patients. Thus, they are more likely to show increasing depressive symptoms that may reflect anticipatory grief. This suggests that closely monitoring depressive symptoms among spousal caregivers of cancer patients and constantly providing emotional supports are critical along the way of their caregiving journey. Anticipatory grief shares some symptomatology with depression but may be treated differently.41 Interventions to assist the coping with anticipatory grief have been developed and tested with caregivers of dementia patients, but little has been done with cancer caregivers.42
Related Knowledge Centers
- Death
- Denial
- Mastectomy
- Grief
- Five Stages of Grief
- Anger
- Depression
- Acceptance
- Delayed Grief
- Disenfranchised Grief