Jonathan Singer explains the phenomenon of grieving loved ones who haven’t yet passed.
Jonathan Singer, a visiting assistant professor of clinical psychology in Texas Tech University's Department of Psychological Sciences, recently authored a paper on pre-death grief, or grieving that occurs before the death of a person with a life-limiting illness.
The paper, “An examination and proposed definitions of family members' grief prior to the death of individuals with a life-limiting illness: A systematic review,” synthesizes existing literature on pre-death grief and proposes new clarifying terminology in order to advance the field.
According to the study, pre-death grief is composed of two distinct constructs: anticipatory grief and illness-related grief. Anticipatory grief is future-oriented and characterized by separation distress and worry about a future without the person with the life-limiting illness being physically present. Illness-related grief is present-oriented and is characterized by grief over current and ongoing losses experienced during the illness trajectory. These definitions provide the field with uniform constructs to advance the study of grief before the death of an individual with a life-limiting illness.
Current evidence suggests that family members' grief before the death of an individual
with a life-limiting illness is a robust predictor of prolonged grief disorder.
Significant conceptualization issues exist when defining and measuring grief before death.
This systematic review of the literature on grief experienced by family members prior to an individual's death due to life-limiting illness revealed wide variation in the terminology used and characterization of such grief across studies (e.g., more than 18 terms and more than 30 definitions have been used to describe this form of grief).
In many cases, even when certain terms were frequently used (e.g., anticipatory grief, pre-death grief), the same term was often defined differently across studies.
Pre-death grief is comprised of two separate constructs: anticipatory grief and illness-related grief.
- “With prolonged grief disorder being added to the DSM-5-TR, this study provides the field with clear and well-defined constructs that will guide future research aimed at identifying intervention targets for pre-death grief and preventing its eventual transition to prolonged grief disorder,” Singer said.
- “This study provided uniform constructs to advance the study of grief before the death
of an individual with a life-limiting illness,” Singer said. “The constructs should
be applied in future research to allow for comparison of results across studies.”
- inSYNC Healthcare Solutions (September 2021) No Relief From Pre-loss Grief: Maintaining Mental Health for Caretakers
- US News and World Report (May 2021) Grief Can Strike Even Before a Loved One is Gone
- WebMD (May 2021) Grief Can Strike Even Before a Loved One is Gone
- The Ohio State News (May 2021) Understanding family members' grief for a living loved one
- The Ohio State University Wexner Medical Center (May 2021) Study looks at factors that influence pre-loss grief
- Business Insider (March 2021) How to cope with sadness on the anniversary of the COVID-19 pandemic, according to a grief therapist