Helping a Child with Anticipatory Grief

When children have just lost a loved one—whether parent, sibling, or dear friend—we usually expect a wave of grief, a time when a community can and should step up to help in any way possible.

But, say experts, beware: if the death was expected, feelings of mourning may have set in long ago. Especially if the loved one suffered a long illness, “anticipatory grief” can leave whole families feeling at once baffled and ravaged. If you, or someone you know, is facing such a loss, read on. Your help can make a huge difference.

So what, exactly, is this “anticipatory” grief? Therese Rando, PhD., renowned clinical psychologist and author of How to Go on Living when Someone you Love Dies, points out that when a death is expected—as, for example, with a terminal cancer diagnosis—families have an invaluable opportunity to “place the death in the context of events that (are) predictable and make sense.” Kids can join in saying “I love you,” in finishing “unfinished business” emotionally, and in saying a loving farewell.

Still, however, explains author and professor Kenneth J. Doka, PhD., the word “anticipatory,” which implies “looking forward,” is something of a misnomer. While adults are consumed with daily caretaking tasks, kids “are left dealing with all the changes they’re experiencing right now.”

Suddenly, for example, parents may have become more distracted, or anxious; otherwise healthy kids may be living in “houses of chronic sorrow.” Loss, for them, is already here, and it’s only getting worse. Such kids may retreat into silence, or may act out in anger; others may suddenly seem to soar in competence, taking on heavy family responsibilities. Don’t be fooled: they may all still be feeling deep grief.

So what can family, friends, schools and community members do to help? A lot! Here are suggestions from Doka and from Jennifer Allen, a practicing psychotherapist and author of Bone Knowing, a memoir about her husband’s death from cancer:

Share the load. Caretaking can be relentless, and no one person or family can handle it alone. In particular, counsels Doka, “Parents should make schools aware.” In addition to offering warmth and understanding, teachers, parents, and other community leaders can be invaluable help to healthy kids who yearn for “normalcy” and who worry profoundly, “who will take care of me now?” Warm meals, rides to soccer practice or school, playdates, and even laundry can all provide great comfort, especially when neighbors and friends offer these services and don’t even wait to be asked.

With questions, let kids take the lead. Long before an actual death, says Doka, kids can be flooded with worry and fear. After all, he says, “it is loss that is happening,” and it’s huge. In our efforts to help, however, it’s crucial not to promise falsely. When a kid asks, for example, “Can she die”? Doka says, we must not pretend that it can’t happen. Instead, we might say, “We’re doing everything we can and we hope not. But she could.” Allen adds, “Always end conversations with reassurance that their needs will be met. When applicable be specific,” such as “Aunt Sheryl will be taking you to practice on days I am at the hospital with Dad.”