Often touted as the most wonderful time of the year, the holidays can bring on a host of mixed emotions for caregivers and their families. Happiness and sadness co-mingle during family gatherings and, for some, the rosy glow of Christmas tree lights or Hanukkah candles serves only to highlight the pain of spending one last holiday with a loved one.

The myriad emotions that arise when a family member is dying are difficult enough under normal circumstances, but the holidays tend to complicate things even further. Adopting a realistic approach to this situation and allowing yourself to both celebrate and grieve will help you cope with these difficult feelings and make the most of this time with the people you love.

What Is Anticipatory Grief?

“Anticipatory grief” is the term used to describe the grim limbo that occurs in the time between when an elderly loved one is diagnosed with a serious or fatal disease and when they actually pass away. According to the Family Caregiver Alliance, “anticipatory grief is a way of allowing us to prepare emotionally for the inevitable.”

The duration of this type of early grief depends on the nature of a senior’s illness and the quality of a caregiver’s relationship with them. For example, Alzheimer’s caregivers may grieve for many years as this chronic progressive condition slowly runs its course, whereas a caregiver for a loved one who was just diagnosed with very advanced cancer may only grieve the impending loss for a few weeks or months.

Read: Grieving Before Death: Alzheimer's or Terminal Illness Grief


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Reconciling Grief and Holiday Cheer

Grieving is a difficult process at any time, but the holidays can be a particularly trying time for people who are dealing with the impending death of a loved one. There is a lot of pressure during this time of year to be upbeat, generous, social and gracious. Caregivers can feel torn between wanting to enjoy a final holiday with their loved ones and dreading the death they know is coming.

Steven Barlam, MSW, LCSW, CMC, chief executive officer at JFS Care in Los Angeles, says that, despite the stereotypical cheer that is supposed to accompany this time of year, the holidays can be fraught. “This is a season that heightens one’s sense of loss,” he explains.

For the elderly, the holidays often bring forth memories of loved ones who have already passed away. For caregivers and younger family members, spending the holidays in the presence of an ailing senior can intensify their sense of impending loss. They know that future celebrations will never be the same. However, being a part of a senior’s final holiday celebration, while at times painful, can turn out to be a gift in disguise for family members—if they’re willing to accept some unpleasant realities.

Managing Grief During the Holidays

Unlike the grief that strikes after the sudden death of a loved one, anticipatory grief gives the whole family the opportunity to prepare for the loss. To fully appreciate this remaining time with a terminally ill senior, Barlam urges family members to face the fact that they will soon have to carry on without this person. “While everyone’s grieving process is unique, shying away from the reality of the situation will only serve to make it worse,” he advises.

Recognizing that an elderly loved one only has a certain amount of time left to live can open the door for important discussions regarding end-of-life care and preferred funeral arrangements. While these are not very merry topics, knowing that certain plans are in place can help put both the senior and their caregiver at ease.

Accepting this reality can also encourage family members to communicate more freely with one another. Although it is bittersweet, sharing stories, family history, and emotions, asking important questions of one another, and growing closer is an excellent way to spend the holidays together.

Barlam suggests making the senior the focus of the holiday celebrations. Make sure that they are as involved in the festivities—decorating, cooking, etc.—as they want and are able to be. Let them tell stories, share recipes and engage with the family as much as possible. Adapt traditions and celebrations to ensure they can participate.

The holidays can also be a time for forgiveness and repairing relationships. Death has a way of putting things into perspective. Disagreements and transgressions may suddenly seem less important than they did before. During this time, family members should try to loosen their grip on whatever anger or negative feelings they may have towards their dying loved one and each other.

Read: Forgiveness Helps Us Live and Die with Serenity and Peace

Barlam also notes that caregivers should not be afraid to discuss loved ones who have already passed away. Reminiscing about family members and friends who are no longer present shows the senior who is dying that they will not be forgotten once they are gone and that they will be remembered fondly.

Keep in mind that the person dying is also going through their own difficult emotional processes as well. They may be fearful, sad, shocked, helpless, contemplative, angry, in denial, hopeful, or cycling through any combination of these feelings. Just as surviving family members often go through a wide range of thoughts and emotions, so, too, do seriously ill individuals who are facing the end of life.

Everyone Mourns Differently

No one should feel guilty or self-conscious about their personal grieving process. Some people may grieve for longer periods of time than others. Some may experience sadness in unexpected waves. Ultimately, there is no one “right” way to mourn the loss of a loved one.

Barlam notes that each person in the family will likely be feeling different emotions at different times, including fear, pain, anger, regret, sadness and loss. Make a point of being gentle and understanding towards one another during this difficult time. If these feelings become too much to handle, seek the help of a counselor, religious leader or hospice worker. Hospice providers offer support to both the ill person and their family throughout the dying process and after death.

Sources: Anticipatory Grief (https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P03043); Grief and Loss (https://www.caregiver.org/grief-and-loss)