Breathe in, breathe out

anticipatory grief death Nov 09, 2022

What is anticipatory grief? Sometimes it’s like holding your breath.


 Sharing a laugh and my dogs with Nana


She exhales.

She stirs in bed.

A sleepy mumble, a weary cough.

Then: eerie quiet.

I hold my breath, waiting…

Then finally,

she inhales.

I exhale.

This spring, I sat next to Nana's bed and jotted down thoughts in my notebook as she slept, because I didn't know what else to do with myself. I just wanted to be next to her. After 98 years, my grandmother's body was giving out, even though her mind never really did. She'd lived a very long, full life, and was in relatively stable health up until these last two years. But she was dying, and she knew it. I knew it. We all knew it.

Anticipatory grief is the emotional weight ahead of a loss you know is inevitable. When it came to my nana, it felt like I was holding my breath for months. Every day, I was playing out and bracing myself for what was coming, the grief tapering in over time. Nana outlived everyone in her immediate family: both of her children, her son-in-law, her sister, and my grandfather all passed away before she did. And so, my brother and I—her only grandchildren— were it. All that heavy anticipatory grief rested on our shoulders.

That feeling was something I'd never really experienced before. While I'd certainly seen way too much death in my 33 years, I hadn’t ever grieved ahead of time. My father died suddenly, so there was no anticipation at all. That grief hit like a ton of bricks. As for my other three grandparents, they were elderly, so their deaths weren't unexpected. But I was still too young to have really been anticipating them. 

And my experience with my mother's death from brain cancer falls into some other category that's still not quite anticipatory grief. Although my mom was sick for eight long years, as a young child, I didn't see her death coming. I'd only ever really known her as my mom who was sick, and so I thought she'd just stay sick— forever. This was my normal. And by the last month of her life when my dad warned my brother and me that this was likely the end, I remember not fully understanding what was going on…but I also remember not wanting to burden my dad with any questions. He seemed stressed enough, which now I recognize as his own anticipatory grief in high gear.

Even though I know I shouldn’t compare grieving experiences, I've played the perverse mental game a few times of choosing which grief is worse: the slow march toward death, or the sudden pang after an unexpected loss. I've decided that they can each be awful in their own way, but I do have an opinion as to which is worse— I think it’s the anticipatory grief. It can be torturous.

When it was clear earlier this year that Nana’s health was deteriorating beyond recovery, every time my brother called me, the anticipatory grief made my stomach drop. My brother was her primary caretaker in Montreal, so I assumed every phone call was him delivering the worst news. No matter where I was when he called me, I’d get up and whisper “Hi” solemnly, and brace for whatever came next. My brother and I, ever the logical and direct people, came to a seemingly peculiar agreement that somehow worked for us: I asked that he start every phone call with the words "Nana's not dead," immediately after I answered. I wanted to know so I could quickly pick my stomach back up and breathe again. Some days we’d talk on the phone multiple times, depending on what was happening with her care, and that refrain was how we started every single call.

Even in the final couple days when she stopped eating and my brother told me I should probably start my drive to Canada, he began each update call with: “Nana’s not dead, but…”

Until the final phone call.

I was still two hours away. It was pitch black out and rainy, and I was somewhere in upstate New York when I answered from my car’s speaker phone.


"It happened," is what I think he said. But my reception was terrible.

I’d missed her last exhale.

All that time holding my breath, knowing this moment was coming…and I wasn’t with her. Why didn’t I start driving earlier? My phone signal was now completely gone, there were no exits nearby, and I was a wreck. I couldn't do anything except keep going through the rain and my tears. I was really beating myself up when, at last, I got to hug my brother at 2AM. I was so upset with myself for not being there for Nana in that final moment.

But, ever thoughtful and patient even in his own grief, my brother calmly reminded me that I had been there for Nana so much this year. We’d even spoken on the phone just a few days before her death, when she was still up for it, and we got to tell each other “I love you.”

And that, it turns out, is the really beautiful part of anticipatory grief that maybe we don’t think about enough: because you know what’s coming, you have the privilege of showing up for the person you love over and over and over again. You can choose to be brave. You can look your loved one in the eye, bear witness to their pain, hug them, kiss them, and tell them that you care. You can crack a joke to raise their spirits. You can help them feel safe when they’re scared.

So yes, anticipatory grief can feel like torture as you hold your breath waiting for The Phone Call. But it can also feel joyful, like when Nana decided in her final months that she wanted to try foods she’d never eaten before, because why the hell not, and I taught her about DoorDash. (For the record, she did not care for the spicy seafood pho I brought her one night.) It can feel peaceful, like giving Nana’s hand a squeeze when she’s falling asleep so she remembers you’re there as she slowly breathes in and out.

Anticipatory grief isn’t all bad.

My nana died this year. It was both painful and a privilege to know that it was coming.


Grieve on. 

---If you like learning about grieving alongside me, scroll down to the bottom of this page and sign up for my mailing list---

Join the Grieve Leave movement

Share your info to join our Grieve Leave community. You don’t want to miss anything!