Making Peace with Grief in the Last Chapter of Life

When a loved one receives a serious diagnosis or begins to show signs of mental or physical decline, life changes for everyone around them. There are new routines, difficult conversations and decisions about care. There’s often something else as well: grief that begins before a life ends.

Many caregivers are surprised to realize that they’re already grieving even while their loved one is still with them. It’s an emotional process called anticipatory grief, and it happens when someone you love starts changing, whether it’s forgetting names, losing mobility or needing help with simple tasks. Studies have shown that the ache of watching someone fade slowly affects our brain chemistry in a way that mirrors traditional grief. For example, caregivers of people with dementia often show increased stress hormones and symptoms of depression even before the end of their loved one’s life (National Library of Medicine). 

Stages of grief

For both the caregiver and the person facing decline, there’s a mix of disbelief, frustration, sadness and even anger that is part of the acceptance process. The Kübler-Ross model, also known as the “five stages of grief,” shows how people move through denial, anger, bargaining, depression and acceptance. Not everyone follows these steps in order — they can be unpredictable and some days you may experience them all. 

Protect today

According to a recent survey, 40% of U.S. caregivers say that their caregiving responsibilities negatively impact their stress levels (Guardian Life). This is especially true when caring for someone at the end of life, when the emotional weight can feel especially heavy. To deal with these feelings, try to shift your focus on appreciating the good that’s happening in the present rather than on the “what-ifs” to come. Is your loved one smiling at their favorite music? Were they able to sit outside and feel the sun on their face? Spend some time making new memories with them.

Grief doesn’t have to steal the joy of today. Encourage your loved one still do things they enjoy if they can — bake, listen to music, take walks, tell family stories. Seeing your loved one live as fully as they can, in whatever way is still possible, can help both of you feel more connected and less afraid.

Reach out for help

The key is to not try to carry all of this alone. Talk to someone: a counselor, a support group, a trusted friend. Hospice services often offer grief support throughout the caregiving journey. Your Employee Assistance Program (EAP) may also be a source of support. Many EAPs include compassionate specialists who help caregivers find trusted eldercare, hospice and emotional support services. They can offer one-on-one phone consultations and conduct personalized searches for in-home care, grief counseling, respite care and other local resources.