Support for family before a death
What is anticipatory grief, and how does hospice help?
Anticipatory grief is grief that starts before a death. You may grieve each loss along the way: the person's strength, their memory, the conversations you used to have, the future you expected. It is common with dementia and other long illnesses, and it is not a sign that you have given up. At Beta Hospice in San Bernardino, support for the family is part of hospice from the first day, not only after the death.
Reviewed by Jack Demirchyan, Chief Operating Officer, October 26, 2026
On this page (5 sections)
What does anticipatory grief feel like?
It can show up as sadness, anger, guilt, trouble sleeping, or a wish for it to be over followed by shame for thinking so. These feelings are normal. Family caregivers often feel exhaustion and relief mixed with sadness. Family who live far away grieve too, sometimes with guilt for not being present.
The National Institute on Aging describes how family and friends sometimes stop visiting or withdraw because they are already grieving, which can add to the dying person's sense of isolation. Knowing that this pull-away is grief, not indifference, helps families stay in the room.
What losses do families grieve before a death?
Each of these is a real loss, and grieving it is not giving up.
- The person's strength and independence, as they need more help each week
- Their memory and recognition, in dementia
- The conversations you used to have, as the person sleeps more and talks less
- Roles in the family, when the person who handled the bills or the cooking no longer can
- The future you expected together
How does hospice help before the death?
Support for the family is part of hospice care under Medicare's rules, and it starts at admission.
- Step 1
The team asks early
The social worker or chaplain asks how family members are coping and who may need extra support. This is written into the plan of care. Medicare requires a bereavement plan of care that notes the kind of services to be offered and how often (42 CFR 418.64).
- Step 2
Someone to tell
Tell the hospice social worker or chaplain what you are feeling. The chaplain offers spiritual support for any faith or none, only if you want it. The social worker helps with emotional strain, family communication and practical planning.
- Step 3
Honest information
Knowing what is ahead eases some of the fear. Read signs that death is near for the changes families usually see, and ask the nurse directly what she sees.
- Step 4
Support continues after the death
Beta Hospice Care, Inc. offers grief support to the family for 13 months after a death. You choose how much contact you want, and you can say no and change your mind later.
Common questions
Is it normal to grieve before the person has died?
Yes. It is called anticipatory grief, and it is very common during a long illness. You may feel sadness, anger, guilt or relief. It does not mean you love the person less or that you have given up.
Does grieving early make the grief after the death shorter?
There is no set length for grief, before or after a death, and no one can promise that one shortens the other. Many people find the hardest feelings soften over the first year, with waves around holidays and anniversaries.
Who do I talk to on the hospice team?
The social worker or the chaplain, at any visit, or call the office. Our contact for bereavement questions is Jackie Melkonyan, at (877) 258-7129.
Read more
Bereavement and grief support, how to help a child grieve, grief support groups in the Inland Empire and what hospice provides.
About this page
- Written by
- Beta Hospice care team
- Reviewed by
- Jack Demirchyan, Chief Operating Officer
- Last reviewed
- October 26, 2026
- Next review
- April 26, 2027
How we write and review this site
Sources
- 42 CFR 418.64: Core services, including bereavement counseling (opens in a new tab)
- National Institute on Aging: Coping with grief and loss (opens in a new tab)
- National Institute on Aging: Providing care and comfort at the end of life (opens in a new tab)
- SAMHSA: 988 Suicide and Crisis Lifeline (opens in a new tab)
These sources support the general information on this page. For one person鈥檚 care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (877) 258-7129 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the person鈥檚 own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice