Is it healthy to grieve before a loss?
By Jancee Dunn
NY Times, October 16, 2025
When Alan Wolfelt’s mother, Virgene, died from Alzheimer’s disease, he wasn’t surprised by what he felt. As the director of the Center for Loss and Life Transition in Fort Collins, Colo., he knew the symptoms of grief all too well.
But he realized that he was mourning her for a second time. He had begun to grieve several years earlier, he said, “when she entered the transition into dementia.”
Typically, we experience grief as a reaction to loss. But sometimes it crops up before a life transition or a death that we’re expecting. We can feel grief while a parent is sick, when we’re contemplating divorce, or before moving, retirement or an empty nest.
What we feel in this “in-between time,” as Dr. Wolfelt calls it, is known as “anticipatory grief.” Because we’re not primed to expect it, he said, our reactions can be unsettling, confusing and painful.
During this time, people will try to mentally “rehearse” for a major loss, Dr. Wolfelt explained. And because many big life changes and losses aren’t instantaneous, he added, this period can be long.
While immersing yourself in anticipatory grief doesn’t mean that a loss will be less painful, experts say it can help you prepare. Here’s how to navigate these feelings.
Recognize that this is grief.
Like conventional grief, anticipatory grief looks different for everyone, Dr. Wolfelt said. If you find you are experiencing heightened emotions such as sorrow or fear, acknowledge that you’re grieving, and that a loss is coming and you can’t control it, he said.
Naming what you’re experiencing helps you better understand your current circumstances and be more compassionate toward yourself, he added.
That honesty may help your overall healing process, added Mary-Frances O’Connor, a professor of psychology at the University of Arizona who studies grief and is the author of “The Grieving Body.” Research on late-stage cancer patients found that when the people around these patients worked to accept the loss of their loved one, they adjusted better to bereavement after the death.
So, it’s wise to be open about your feelings and ask other people for support, said Peggy Morton, a clinical associate professor at the Silver School of Social Work at New York University. Talk to friends who have been through similar situations and seek their advice, she said.
Deal with unfinished business.
You can use a period of anticipatory grief as an opportunity to figure out if there are any issues you need to work through, such as things that have gone unsaid, Dr. O’Connor said.
When someone is in hospice care, Dr. O’Connor said, “they are encouraged to have closure conversations, getting a chance to say: ‘I love you, thank you, I’m sorry, please forgive me, I forgive you, goodbye.’” Research suggests that survivors experience less depression after a death when they have these types of meaningful communication.
If you’re expecting a death, Dr. Wolfelt said, you might use this time to gather mementos and archive memories. Follow the person’s lead, he said, but if they are up for reminiscing, ask them questions and give them prompts such as photographs.
Stay in the present.
Constantly worrying about the future can be demoralizing, Dr. Wolfelt said. “Don’t spend more time and energy in your imagination than in the present.”
Dr. O’Connor agreed, adding: “It’s in the present moment that we get to have connection and compassion and joy and love.”
While you’re in the midst of anticipatory grief, try to cultivate hope by looking for interests, activities and people that make you feel optimistic, Dr. Wolfelt said. Then put an activity on your schedule every day — whether it’s phoning a friend, sharing a home-cooked meal with a loved one, or praying. Hope keeps you going, and it balances the darkness and confusion.
Know that the loss will still be hard.
Some anticipatory grievers imagine that by the time their loss takes place, “they will have ‘used up’ all their grief, or that it will be easier when the loss happens,” Dr. Wolfelt said.
“That’s a misconception,” he added. “It’s still hard. You’re not all done.”
All the experts warned that you can never fully predict what a loss will be like. “My mother was quite ill for a protracted period of time,” Dr. Morton said. “And every time there was a close call, my sister and I rehearsed and thought about what we would do and what would life be like without her.”
But when her mother died “rather suddenly,” Dr. Morton said, “I was very overwhelmed and upset. And I would never have anticipated that, because we had rehearsed it so many times.”
If you’re ruminating about your upcoming loss or change, or if your worrying affects your daily functioning, consider seeking help, whether it’s peer support or a therapist, Dr. Morton said.
And yes, it’s OK to join a support group before your loss has happened, she said.
“Find people to talk to,” Dr. Morton said. “Don’t keep it all inside.”
Marc D Malamud
Transitioning Doula
{UNSUB}
Finding Meaning at the End of Life
(Gary Wederspahn, co-editor of the Good Death Society Blog, recently interviewed Robert A. Neimeyer, PhD. Dr. Neimeyer is Professor Emeritus of the Department of Psychology, University of Memphis. He also directs the Portland Institute for Loss and Transition and has published 35 books, including New Techniques of Grief Therapy: Bereavement and Beyond and The Handbook of Grief Therapies, and is editor of the journal Death Studies. The author of over 600 articles and book chapters, his focus is on grieving as a meaning-making process. Neimeyer served as president of the Association for Death Education and Counseling (ADEC) and chair of the International Work Group for Death, Dying, & Bereavement.)
=====================================
Your work on meaning at the end of life reminds me of Viktor Frankl’s quote: “Challenging the meaning of life is the truest expression of the state of being human.” Is your seminar on “A Quest for Meaning in Terminal Illness” informed by his school of psychotherapy?
Yes, certainly. Frankl’s own experience in Nazi concentration camps powerfully confronted him with countless violations of the assumptive world he had previously known, with its relative predictability, security, control, and at least some sense of justice and a hoped-for future. His life as a physician in a pre-war context just “made sense” implicitly, in the day-to-day way that most of our lives do, most of the time. But there are times – like the rise of Nazi authoritarianism and ethnic hatred, the outbreak of WWII, or the diagnosis of life-threatening illness in ourselves or in someone we love – that shatter the mundane stories of our lives, challenging our personal, social, and sometimes existential realities. It is at those times that we struggle to reaffirm or reconstruct a world of meaning as we are flooded by the anxiety, despair, or grief that such events bring to our families and ourselves. Our work as professionals accompanying people at the end of life is to help them navigate these unwelcome challenges in a way that conserves and restores their humanity.
I see the parallels. But what are the issues and challenges of making sense of the end of life specifically?
Well, in a sense, the wording of your question suggests its own answer: It’s the challenge of making sense of a life that is ending. For practical existentialists like Frankl and myself, the task is really a multifaceted one. How do we come to terms with the significance of the life we have lived, in all of its possible imperfection and incompleteness? How do we understand the role of suffering in human life, including our own? What lessons of enduring value did our life carry, for ourselves or relevant others? What could we do now to affirm sources of meaning in our being and doing, as life grows short? How might we reaffirm continuing bonds between the dying and the living, bonds that endure beyond the life of the patient? And what implications do these questions have for our identities as individuals and families as we seek resilience in this quest? These are big questions that are lived rather than asked, and they are the sorts of fundamental concerns that we try to help people address in the context of meaning-focused support at the end of life and in grief therapy.
These are heavy issues for a dying person to confront. What tips and recommendations can you offer in how best to accompany them?
Good question, and one whose answers will vary depending on the questions and concerns arising in each specific case. But in general, it is important to recognize that accompanying a patient and family begins with who we are and then extends to what we do. That is, it is primarily about how we show up, ideally in non-anxious presence, bringing a respectful, compassionate stance to their circumstance that is uncluttered with treatment plans or specific objectives. From this centered, mindful, emotionally regulated and responsive stance, we are able to read the patient or family member’s signals – verbal, nonverbal and co-verbal – about what they need in a given moment. Perhaps it is simply to be heard and symbolically “held” in a troubling time. Perhaps it is to acknowledge a feared reality, to express a concern about another family member, to take in the implications of a recent diagnosis or prognosis, or to wrestle with a looming decision about treatment. Joining the client in finding words in the emotional press of such moments in a way that validates their concerns, honestly seeks a way forward and grants them a measure of dignity and humanity that is fundamental, whatever specific interventions or strategies we might then offer.
Just one more question: After all your research and work on this topic, how do you make sense of your own mortality?
I see you’ve saved the biggest question for last! I suppose that the truest answer is: One day at a time, leaning hopefully into an uncertain future. Mostly I do that in practical terms, asking myself: What is important to do today? What do those who matter most to me require of me at this time? What current relationships deserve nurturance? What shared or personal plans of significance have action steps that can be taken now? If I can pause and let the pool of my consciousness grow still and clear rather than agitated and turbid, what becomes clearer at depth? Acting with creative engagement and appreciative reflection on what emerges embraces meaning in the moment, and the sum of such moments, for me, constitutes my meaning in life. As with most fraught and limited human beings, living this stance in the midst of life losses and challenges is something I do inconsistently, and, in this sense. is always a work in progress.
Marc D Malamud
Transitioning Doula
{UNSUB}
It Takes a Village
Rethinking Death Care as Community Care
Reprint from Substack
Oct 16, 2025
We say it takes a village to raise a child.
But it also takes a village to help someone die well.
And another to carry the living after loss.
Yet somewhere along the way, we stopped seeing death as a community responsibility.
We outsourced it.
We built systems and professionals to handle it for us.
We took something once shared and sacred and turned it into a service you call when something goes wrong.
It’s time to take it back.
Because death was never meant to belong to one profession.
It was meant to belong to all of us.
Photo by Tim Marshall on Unsplash
Death Education: Where the Village Begins
Most people were never taught what happens when someone dies.
Not what the body does.
Not what paperwork is needed.
Not who to call.
Instead, we learned to look away. To change the subject. To protect others from sadness. But avoidance doesn’t protect us; it isolates us. It leaves us unprepared when loss comes. And it will come.
Death education isn’t about morbidity. It’s about literacy.
When we talk about death early and often, we normalize it. We empower people to plan. We replace fear with understanding.
I’ve seen the difference.
In classrooms where students ask questions with curiosity, not horror.
In bars where “Death Over Drafts” events turn into honest, healing conversations.
In families who, after learning the basics, approach death as something they can meet with grace, not confusion.
Education is where community care starts.
Because when people understand death, they don’t run from it; they show up for each other.
When the Village Shows Up
When someone is dying, the best care happens when everyone works together.
Hospice nurses ease pain and offer comfort.
Funeral directors help plan the goodbye.
End-of-life doulas hold space for the emotional work of dying.
Clergy, therapists, neighbors, friends, all have a role to play.
Each brings a different kind of medicine.
But right now, these worlds are often separate.
Hospice ends where the funeral begins.
The funeral ends where grief support should start.
And families fall through the cracks between systems that were never meant to be separate.
We can do better.
We can build bridges instead of silos.
We can treat deathcare as a continuum, not a collection of disconnected services.
Imagine this instead:
A hospice nurse calls a trusted funeral partner before death occurs to prepare the family for what comes next.
A funeral director connects that family with a grief counselor in their own community.
An end-of-life doula collaborates with both, ensuring continuity of care.
Each one hands the family forward gently, never dropping them in the space between.
That’s holistic deathcare.
That’s what it means to have a village that shows up, not only for the dying, but for the living who remain.
After Loss: Carrying Each Other Forward
The funeral is not the end. It’s the beginning of a new kind of living.
After the service ends and the flowers fade, people are left with a quiet no one prepares them for.
The silence of a house that holds too many memories.
The pile of mail that keeps coming.
The tasks no one wants to do: sorting clothes, returning medical equipment, changing account names.
Grief lives in those ordinary moments.
Professionals can support those who grieve, but it’s the community that carries them through it.
A check-in text two weeks later matters.
A meal left on a porch matters.
An invitation to coffee months after everyone else has moved on matters.
We need more of that.
Grief companions and support groups are essential, yes, but so are coworkers who understand, neighbors who remember, and friends who don’t say “let me know if you need anything,” but instead say, “I’m coming by.”
Community care after loss doesn’t require training. It requires willingness.
To sit in discomfort. To show up imperfectly. To remember that grief isn’t a problem to solve, it’s a process to witness.
The Missing Piece: Connection
The future of deathcare isn’t about more technology or efficiency. It’s about connection.
Connection between professionals.
Connection between the living and the dying.
Connection between people and the land they’ll return to.
We need spaces where hospice, funeral, and grief professionals talk to each other. Where doulas, cemeterians, celebrants, and therapists share resources instead of competing. Where families know where to turn because every door leads to someone ready to help.
This is already happening, in small ways, in small towns, in community-led projects, in forests, in living rooms.
Every time someone chooses to learn about death before they need to, every time professionals collaborate, every time a community rallies around someone grieving, another piece of the village returns.
Building the Village Again
So how do we rebuild it?
We start by talking.
By educating.
By remembering that this work belongs to everyone.
We host community events where death isn’t taboo.
We teach the language of dying and grief to kids, so they grow up unafraid.
We create partnerships between hospice and funeral homes, doulas and cemeteries, grief groups and local businesses.
We make space in our neighborhoods for conversations about how we want to live, and how we want to die.
We make death a part of life again.
Because Here’s the Truth
No one should die alone.
No one should grieve alone.
And no one should carry the sacred work of care alone, either.
It takes a village to live well.
It takes a village to die well.
It takes a village to remember well.
And if we can remember that, maybe we’ll start to see death not as something to avoid, but as something we walk through, together.
Marc D Malamud
Transitioning Doula
{UNSUB}
Help Us Keep the Light On at TransitioningDoula.com 💜
Hi friends,
I’m reaching out with a full heart and a humble ask.
Transitioning Doula, LLC started as a quiet dream—a space where people could find comfort, guidance, and gentle support during one of life’s most tender transitions. Today, it’s grown into a community of care, and I’m so grateful you’re here.
As a 501(c)(3) nonprofit, we rely on the kindness of donors to keep our services accessible to everyone who needs them. Whether it’s helping someone navigate grief, offering comfort to those nearing the end of life, or simply being a steady presence when things feel uncertain—we’re here, and we want to keep showing up.
What Your Support Makes Possible:
- Free grief counseling courses for families
- End-of-life comfort care for those without close loved ones
- Resources and education for caregivers and communities
- A growing online hub of compassion and connection
How You Can Help:
- Donate (even a few dollars makes a big difference!)
- Share our story with your circle
- Sponsor a care session in honor of someone you love
We’re Officially Registered!
Transitioning Doula, LLC is proud to be a 501(c)(3) nonprofit organization, which means your donations are tax-deductible as allowed by law.
You can view our IRS determination letter https://apps.irs.gov/pub/epostcard/dl/FinalLetter_93-4613115_TRANSITIONINGDOULAANJNONPROFITCORPORATION_03072024_00.pdf for full transparency.
Thank you for believing in this mission. Thank you for being part of it.
With warmth and gratitude,
💜 
Marc D Malamud
Founder, TransitioningDoula.com
What this course IS
This class is a small, online, interactive gathering of adults working through a past or anticipated grief.
We will guide you through exercises to see your circumstances in a new light, honoring you and your experiences.
Register for day one and additional days are included.
Event Information
Event Date 10-08-2025 8:00 pm
Event End Date 10-08-2025 9:30 pm
Cut Off Date 10-08-2025 5:00 pm
Capacity 22
Registered 0
Available Place 22
Individual Price $500.00
Location https://zoom.us/meeting/register/9wI3wGoJS1uEnH2DQww-vw
https://www.transitioningdoula.com/index.php/death-cafe/event-list/grief/navigating-grief?tmpl=component&print=1
Warmly,
Marc D Malamud
Transitioning Doula
{UNSUB}