When grief actually begins: can we pre-grieve a coming loss?

Pamela Jane Bell just wanted to join a grief support group. With her husband in hospice care, she was losing more of him day by day. She needed people who would understand and show her the way forward. But she was denied entry to the group. The problem: He wasn’t dead yet.

She tells her story in “Good Grief, but Not Good Enough” in The Wall Street Journal and reveals a common myth about grieving – that it begins when someone dies. In fact, grief begins far earlier than that.

I have noted that losses start well before anyone thinks to use the word grief, when a loved one starts to seem ill or not himself, with the loss of the comfortable assumption that life will continue as is. If a serious diagnosis follows, the future is transformed from what looked like a smooth road to a treacherous one. The future becomes less certain as lost capabilities mount, and each medical visit threatens to add more. With each step away from health, the need grows to face reality and find the ways to soldier on anyway. If that’s not grief, I don’t know what is.

People ask me if they can pre-grieve a coming loss, and I say that the answer is both yes and no. As losses pile up, grief appears and accompanies us through the whole rest of the journey. So, yes, Pamela was legitimately grieving her husband’s decline. And yes, she knew what she needed.

Once a loved one dies, the emphasis of the grief changes as caregiving is over and self-care begins. Even people who have long expected the death of a loved one describe the death when it comes as a shock. While we prepare, nothing can ready us for the sudden absence from earth of the person we care for. I am also aware that if there has been a great deal of suffering, the relief at seeing that end can help to lighten the burden a bit.

I encourage people to do what Pamela was attempting – to seek help and support at every turn, though as she learned, every support group may not be able to accommodate.