How to Cope With the Impending Death of a Loved One

While the sudden, unexpected death of a loved one can unleash a torrent of anguish and grief, a family member or friend over days, weeks, months or even longer can prove just as traumatic for survivors because of anticipatory grief — the sadness felt in advance of the death.

Tips for Coping With Anticipatory Grief

Here are a few of the emotional challenges you might encounter as you attempt to cope with the impending death of your loved one, and suggestions to help you deal with them.

Feeling Exhausted

Regardless of whether you are serving as a caregiver or not, knowing that your loved one's time is limited will take a toll on your physical and emotional strength.

This can manifest itself in many ways, including:

• An overwhelming need to sleep
• Insomnia
• Lack of concentration
• An emotional "numbness" or detachment
• Feeling disconnected from others or not feeling close to anyone

It is important to understand that these feelings are perfectly normal and do not mean you are cold or unfeeling. Eventually, your body and mind will recover, and you will feel normal again — until something else triggers a state of heightened emotional response. You should expect to experience such waves of feeling and to view the times when you shut down as necessary and healthy.

That said, make sure you are engaging in your own self-care routines, including getting adequate and restful sleep, eating well, spending time with your support network, and are recognizing the signs of caregiver burnout.

Feeling Tongue-Tied

Death is a difficult subject for most people to talk about, and particularly so when we must bear witness to the protracted death of a loved one. That said, comfort levels with talking about death vary significantly based on one's culture and religion.

If the topic is uncomfortable, we often begin making assumptions in our head about what our loved one does or doesn't wish to talk about concerning their impending death, such as, "If I express how much I will miss him, it will make him feel worse," or "I won't say goodbye until the very end so she and I can find some happiness in the time remaining."

The net effect of such internal conversations is often that nothing is said, which can actually make a dying person feel isolated, ignored or alone.

As difficult as it might feel right now, open and direct communication might be an ideal way to interact with a dying loved one in most cultures and families. You can consider letting them know that you would like to talk about how you are feeling, as well as what you can provide during the time remaining in terms of support and comfort.

Once the honest conversation takes place, you might discover that your fear of having this conversation may have actually been a result of wanting to avoid the negative emotions.

Feeling Guilty

When someone we love is diagnosed with a terminal illness, it is very easy to focus all of our attention and energy on the patient almost to the exclusion of our own needs. The strain caused by caring for a dying loved one — particularly for those providing a significant amount of the care — can often lead to caregiver stress as the physical, emotional and even financial impacts take their toll.

Caregiver stress can lead to feelings of resentment, anger, or frustration toward the dying patient — and those feelings often trigger a profound sense of guilt. If left untreated, such emotions can seriously complicate the grief one feels after the patient dies, increasing the survivor's risk of depression, thoughts of suicide or post-traumatic stress disorder.

If you are exhibiting signs of caregiver stress, you can consider speaking with your family or friends, or even the patient's doctors and saying, "I need help." There may be legal or financial resources available to you, and a support network may be helpful for providing emotional stabilization. Others may be able to assume some of the responsibility that you have shouldered, even temporarily, in order to give you a break and alleviate some of your stress.

If that is not an option, then consider a more formal type of respite care, such as an adult day-care facility or hiring an in-home caregiver, in order to give yourself the break you need and in order to provide the patient with specialized and trained care.

While it might seem difficult to force yourself to let go temporarily, you may be able to return more refreshed and energetic and provide much better care to your dying loved one.