{"id":172376,"date":"2026-02-06T19:07:11","date_gmt":"2026-02-07T01:07:11","guid":{"rendered":"https:\/\/tecscience.tec.mx\/en\/?post_type=sciencecommunication&#038;p=172376"},"modified":"2026-02-06T19:09:02","modified_gmt":"2026-02-07T01:09:02","slug":"anticipatory-grief","status":"publish","type":"sciencecommunication","link":"https:\/\/tecscience.tec.mx\/en\/science-communication\/anticipatory-grief\/","title":{"rendered":"Anticipatory Grief: Mourning Before Goodbye"},"content":{"rendered":"\n<p>By\u00a0<strong>Marcela Guadalupe Cerecedo Mart\u00ednez<\/strong>\u00a0|<strong>\u00a0Ciencia Amateur<\/strong><\/p>\n\n\n\n<p><em>Reviewing author\u00a0<strong>Sof\u00eda S\u00e1nchez Rom\u00e1n<\/strong><\/em><\/p>\n\n\n\n<p>In many families, the process starts when illness advances and reshapes daily life.<\/p>\n\n\n\n<p>A study by Tecnol\u00f3gico de Monterrey, in collaboration with the National Institute of Medical Sciences and Nutrition Salvador Zubir\u00e1n (INCMNSZ), examines how caregivers experience grief before loss and how it relates to anxiety, depression, and physical and emotional burden. Recognizing this process early can improve psychological care in clinical settings.<\/p>\n\n\n\n<p>\u201cHe\u2019s still here, but I feel like I\u2019m already losing him,\u201d a woman said as she accompanied her husband\u2014who is living with advanced cancer\u2014during his treatment at INCMNSZ.<\/p>\n\n\n\n<p>Her words capture a phenomenon more common than it seems: anticipatory grief, a form of farewell that unfolds while life and caregiving continue. To better understand this process, researchers conducted a descriptive study with family members of patients with advanced chronic illness treated at the institute.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Is Anticipatory Grief?<\/h2>\n\n\n\n<p>Anticipatory grief emerges when family members begin to feel loss as illness progresses. It may manifest as deep sadness, fear of the future, repetitive thoughts, emotional exhaustion, and a constant sense of uncertainty.<\/p>\n\n\n\n<p>Although it is a natural response\u2014and in many cases a necessary one for adaptation\u2014it can become harmful when combined with high emotional stress, limited support networks, or physical overload.<\/p>\n\n\n\n<p>Unlike grief after death, this type occurs while caregivers remain active: accompanying their loved one, making decisions, overseeing treatments, and providing both physical and emotional support.<\/p>\n\n\n\n<p>It is like carrying a backpack that grows a little heavier each day: it is never set down, rest is incomplete, and it is almost always borne in silence.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Does the Study Examine?<\/h2>\n\n\n\n<p>The research seeks to understand how families experience pre-loss grief\u2014the farewell that begins as they accompany a loved one with advanced chronic illness\u2014using a psychological research questionnaire designed for this purpose, known as the PG-12-R.<\/p>\n\n\n\n<p>It also analyzes how pre-loss grief relates to three core factors:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Anxiety<\/strong>, measured using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire.<\/li>\n\n\n\n<li><strong>Depression<\/strong>, assessed with the Patient Health Questionnaire-9 (PHQ-9).<\/li>\n\n\n\n<li><strong>Caregiver burden<\/strong>, measured through the Zarit interview.<\/li>\n<\/ul>\n\n\n\n<p>The ultimate goal is to understand how these emotional experiences interact for those accompanying a prolonged illness and to make visible their impact on daily life.<\/p>\n\n\n\n<p>The study shows that anticipatory grief is a real, deep, and highly prevalent process. It is not simply sadness before loss, but a complex emotional state where anxiety, depression, caregiver burden, and\u2014above all\u2014profound uncertainty converge.<\/p>\n\n\n\n<p>Recognizing these patterns allows for better support of caregivers, offering tools and intervening before exhaustion turns into prolonged or unhealthy grief. Caring for the caregiver\u2014seeing them, listening to them, and offering support\u2014is also an essential way of caring for the patient.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Living in a State of Alert<\/h2>\n\n\n\n<p>So far, 76 family members of people living with advanced, chronic, degenerative, and incurable illnesses (including advanced cancer and neurological, respiratory, and cardiovascular diseases) have been evaluated. Six in ten caregivers showed some level of anxiety, and one in four experienced moderate to severe anxiety.<\/p>\n\n\n\n<p>Most participants were women caring for a relative with an oncological diagnosis, the most common condition in the sample.<\/p>\n\n\n\n<p>Anxiety often stems from uncertainty. About 71.1 percent of caregivers do not know their loved one\u2019s life expectancy\u2014a fact that alone creates a constant state of alert.<\/p>\n\n\n\n<p>It is a way of living in continuous emotional vigilance, as if the mind can never lower its guard. This anxiety affects sleep, decision-making, and sometimes the ability to continue providing care.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Silent Sadness<\/h2>\n\n\n\n<p>The study also found that 71 percent of caregivers experience some level of depression, mainly mild to moderate.<\/p>\n\n\n\n<p>The numbers become clearer when looking at daily experiences. More than 70 percent report intense longing for the patient\u2019s previous state; half describe deep emotional pain. About 36.8 percent report constant worry, and 35.5 percent have difficulty accepting the illness.<\/p>\n\n\n\n<p>For healthcare professionals, this sadness may be mistaken for \u201cfatigue,\u201d but it is in fact a sign of profound emotional wear.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Caregiver Burden<\/h2>\n\n\n\n<p>Caregiver burden involves excessive responsibilities, physically demanding tasks, financial strain, lack of support, and social isolation. While most caregivers do not experience severe burden, 18.4 percent do.<\/p>\n\n\n\n<p>Analyses showed a clear relationship: those with higher caregiver burden also reported higher levels of anticipatory grief.<\/p>\n\n\n\n<p>Imagine someone holding a rope that grows tighter day after day. Anticipatory grief is the emotional tension; caregiver burden is the physical effort of holding that rope with one\u2019s entire body.<\/p>\n\n\n\n<p>When both forces accumulate, the strain can be significant. Recognizing it early allows for intervention before the rope finally breaks.<\/p>\n\n\n\n<p>Maladaptive anticipatory grief often goes hand in hand with depression and is also linked to anxiety. Depression and anxiety tend to intensify one another.<\/p>\n\n\n\n<p>This means the caregiver\u2019s experience is holistic, not fragmented: worry feeds sadness, sadness increases exhaustion, and over time everything becomes harder to sustain.<\/p>\n\n\n\n<p>A notable finding is that younger caregivers reported higher levels of anticipatory grief, anxiety, and depression. Facing the possibility of losing a loved one at an early age can be especially emotionally disruptive.<\/p>\n\n\n\n<p>Understanding these relationships allows physicians, psychologists, and healthcare professionals to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Identify caregivers at risk of <strong>developing pathological grief<\/strong>.<\/li>\n\n\n\n<li>Offer emotional support before crises emerge.<\/li>\n\n\n\n<li>Prevent complications such as severe depression or burnout.<\/li>\n\n\n\n<li>Develop targeted interventions for those accompanying prolonged illness.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-white-color has-text-color has-link-color wp-elements-c645e628e62f8fbab9d9726851472d16\"><\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>References<\/strong><\/h5>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Coelho, A., de Brito, M., &amp; Barbosa, A.<\/strong> (2018). <a href=\"https:\/\/journals.lww.com\/co-supportiveandpalliativecare\/abstract\/2018\/03000\/caregiver_anticipatory_grief__phenomenology,.11.aspx\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Caregiver anticipatory grief: phenomenology, assessment and clinical interventions<\/em><\/a><em>.<\/em> Current Opinion in Supportive and Palliative Care, 12(1), 52\u201357.&nbsp;<\/li>\n\n\n\n<li><strong>Li, C., Tang, N., Yang, L., Zeng, Q., Yu, T., Pu, X., Wang, J., &amp; Zhang, H.<\/strong> (2023). <a href=\"https:\/\/www.frontiersin.org\/journals\/psychology\/articles\/10.3389\/fpsyg.2022.1020517\/full\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Effect of caregiver burden on anticipatory grief among caregivers of elderly cancer patients: Chain mediation role of family functioning and resilience.<\/em> <\/a>Frontiers in Psychology, 13.&nbsp;<\/li>\n\n\n\n<li><strong>G\u00f3mez, I. B., Gallego-Alberto, L., Baltar, A. L., Herrera, L. M., Batalloso, I. G., &amp; M\u00e1rquez-Gonz\u00e1lez, M.<\/strong> (2023). <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0211139X23000732?via%3Dihub\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Duelo anticipado en familiares de personas con demencia. Variables psicosociales asociadas y su impacto sobre la salud del cuidador. Una revisi\u00f3n de literatura<\/em><\/a><em>.<\/em> Revista Espa\u00f1ola de Geriatr\u00eda y Gerontolog\u00eda, 58(4), 101374.&nbsp;<\/li>\n\n\n\n<li><strong>Treml, J., Schmidt, V., Nagl, M., &amp; Kersting, A.<\/strong> (2021). <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0277953621005724?via%3Dihub\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Pre-loss grief and preparedness for death among caregivers of terminally ill cancer patients: A systematic review<\/em><\/a><em>.<\/em> Social Science &amp; Medicine, 284, 114240.&nbsp;<\/li>\n\n\n\n<li><strong>Sun, D., Mao, Z., Zhang, X., Li, J., &amp; Zhang, L.<\/strong> (2022). <a href=\"https:\/\/www.frontiersin.org\/journals\/psychiatry\/articles\/10.3389\/fpsyt.2022.914862\/full\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Relationship Between Post-traumatic Stress Symptoms and Anticipatory Grief in Family Caregivers of Patients With Advanced Lung Cancer: The Mediation Role of Illness Uncertainty<\/em><\/a><em>.<\/em> Frontiers in Psychiatry, 13.<\/li>\n<\/ol>\n\n\n\n<p class=\"has-white-color has-text-color has-link-color wp-elements-7e4ac651328708ea719ac0894fa30934\">.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Author<\/strong><\/h5>\n\n\n\n<p><strong>Marcela Guadalupe Cerecedo Mart\u00ednez. <\/strong>An eighth-semester student in the Bachelor\u2019s degree in <a href=\"https:\/\/tec.mx\/es\/salud\/licenciatura-en-psicologia-clinica-y-salud?utm_campaign=PSIC&amp;utm_source=google&amp;utm_medium=search&amp;utm_content=Profe_26_PSIC_Texto_NA_GENERAL&amp;gclsrc=aw.ds&amp;gad_source=1&amp;_gl=1*aocz49*_gcl_au*NTU0MTgzMzg3LjE3NzA0MTU3MDY.*_ga*MTU0NDQ3ODYzLjE3NzA0MTU3MDY.*_ga_D9LSDN87GD*czE3NzA0MjQyNTQkbzIkZzEkdDE3NzA0MjYzNTIkajYwJGwwJGg2Mjc2NjI0MzQ.\" target=\"_blank\" rel=\"noreferrer noopener\">Clinical and Health Psychology at Tecnol\u00f3gico de Monterrey<\/a>. She is currently completing clinical rotations at the National Institute of Medical Sciences and Nutrition Salvador Zubir\u00e1n (INCMNSZ), where she collaborates on research projects focused on pre-loss grief and caregivers\u2019 emotional health.<\/p>\n\n\n\n<p>This article was reviewed and advised by <em>Sof\u00eda S\u00e1nchez Rom\u00e1n<\/em>, a research professor of Clinical Psychology at Tecnol\u00f3gico de Monterrey and head of the Psychology Department at the <a href=\"https:\/\/www.incmnsz.mx\/opencms\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Institute of Medical Sciences and Nutrition Salvador Zubir\u00e1n (INCMNSZ)<\/a>. She is a member of the National System of Researchers and conducts research in clinical and health psychology, while developing a new line of research on grief at the Mexico City campus.<\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A study documents the profound emotional burden borne by caregivers of people with advanced chronic illnesses.<\/p>\n","protected":false},"author":18,"featured_media":172377,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"_acf_changed":false,"_eb_attr":"","footnotes":""},"categories":[86],"tags":[195,138],"class_list":["post-172376","sciencecommunication","type-sciencecommunication","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-amateur-science","tag-school-of-medicine-and-health-sciences"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.0 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Grief Before the Loss | TecScience<\/title>\n<meta name=\"description\" content=\"A study documents the profound emotional burden borne by caregivers of people with advanced chronic illnesses.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/tecscience.tec.mx\/en\/science-communication\/anticipatory-grief\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Anticipatory Grief: Mourning Before Goodbye\" \/>\n<meta property=\"og:description\" content=\"A study documents the profound emotional burden borne by caregivers of people with advanced chronic illnesses.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/tecscience.tec.mx\/en\/science-communication\/anticipatory-grief\/\" \/>\n<meta property=\"og:site_name\" content=\"TecScience\" \/>\n<meta property=\"article:modified_time\" content=\"2026-02-07T01:09:02+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/tecscience.tec.mx\/en\/wp-content\/uploads\/sites\/9\/2026\/02\/anticipatory-grief.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"750\" \/>\n\t<meta property=\"og:image:height\" content=\"500\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/science-communication\\\/anticipatory-grief\\\/\",\"url\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/science-communication\\\/anticipatory-grief\\\/\",\"name\":\"Grief Before the Loss | TecScience\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/science-communication\\\/anticipatory-grief\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/science-communication\\\/anticipatory-grief\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/wp-content\\\/uploads\\\/sites\\\/9\\\/2026\\\/02\\\/anticipatory-grief.jpg\",\"datePublished\":\"2026-02-07T01:07:11+00:00\",\"dateModified\":\"2026-02-07T01:09:02+00:00\",\"description\":\"A study documents the profound emotional burden borne by caregivers of people with advanced chronic illnesses.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/science-communication\\\/anticipatory-grief\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/science-communication\\\/anticipatory-grief\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/science-communication\\\/anticipatory-grief\\\/#primaryimage\",\"url\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/wp-content\\\/uploads\\\/sites\\\/9\\\/2026\\\/02\\\/anticipatory-grief.jpg\",\"contentUrl\":\"https:\\\/\\\/tecscience.tec.mx\\\/en\\\/wp-content\\\/uploads\\\/sites\\\/9\\\/2026\\\/02\\\/anticipatory-grief.jpg\",\"width\":750,\"height\":500,\"caption\":\"Caring for a patient with advanced chronic illness takes an emotional toll: the study shows that six in 10 caregivers experience anxiety, and 71 percent report some level of depression. 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