Grief & Bereavement
You Are Allowed to Grieve Someone Who Is Still in the Next Room.
Anticipatory grief while caring for an ageing or seriously ill parent — the guilt that comes with it, and why naming it helps more than resisting it.
Anticipatory grief is mourning a loss that has not happened yet, or one already underway while the person is alive. It is common in families caring for a parent with dementia or a long illness, and it usually arrives with guilt. It is a genuine form of grief, not a failure of hope.
"A daughter told me she had been mourning her mother for four years, and that her mother was in the next room asking for tea. Both of those were true at the same time, and nobody had ever told her that was allowed."
It usually starts with something small. Your father asks the same question twice in ten minutes. Your mother, who ran a household of eleven people, cannot follow a phone conversation.
You put it down to age. Then it happens again, and at some point you stop being able to.
What follows is a long stretch, sometimes years, in which you are caring for someone and grieving them simultaneously. Both are exhausting. Doing both at once, while telling everyone you are managing, is what brings people to my room.
What anticipatory grief looks like
Rarely like ordinary sadness, which is why people fail to recognise it in themselves.
- Grieving the person they were. The parent who advised you is gone, and the person in the chair needs your help with a spoon. That is a real loss, occurring now.
- Rehearsing the death. Imagining the call, the arrangements, who to tell. This is normal and people find it monstrous in themselves.
- Emotional distance. Pulling back from someone still alive, which feels like abandonment and is often self-protection.
- Irritability that surprises you. Snapping at the person you are caring for, then hating yourself for it.
- Wanting it to be over. The thought almost nobody says aloud, and one of the most common in this room.
- Numbness at the actual death. A great deal of the grieving already happened, and then people wonder why they feel so little.
The scale of it
Sources: India Ageing Report, UNFPA and Ministry of Statistics and Programme Implementation; Longitudinal Ageing Study in India (LASI) dementia prevalence estimates; National Mental Health Survey of India, NIMHANS.
The guilt, which is the hardest part
Nearly everyone who brings me this brings the guilt first, usually before they will name the grief at all.
"I'm grieving someone who isn't dead"
It feels like giving up on them, or wishing it. It is neither. Your mind has registered a loss that is genuinely occurring, and it has begun doing what minds do with loss. That is not disloyalty.
"Sometimes I want it to be over"
Almost universal in long illness, and almost never about wanting them dead. It is wanting the suffering to stop, theirs and yours. Two entirely different things that feel identical at three in the morning.
"I get angry with them"
At the repeated question, the refused medication, the accusation that you have stolen something. Anger at a person who cannot help it produces a particular kind of shame, and it is nearly inevitable when care runs for years.
"I'm not doing enough"
Especially sharp for those managing this from another country, where every arrangement is made by phone and someone else does the daily work. The guilt is rarely proportionate to the facts.
Why it lands so hard on Indian families
Because the care almost always happens at home, and usually falls to one person.
Institutional care carries stigma here, and the expectation is that a child, most often a daughter or daughter-in-law, absorbs it into an existing life. She keeps her job, raises her children, runs the household, and adds nursing to it. Nobody names this as a role, so nobody offers her any relief from it.
She is also expected to do it without complaint, because complaining about caring for a parent is close to unspeakable. So the exhaustion goes unmentioned, the grief goes unrecognised, and the resentment builds somewhere it cannot be seen. Where a marriage is already under strain, this is frequently what tips it.
Siblings make it sharper still. One person does the work and the others visit at festivals with opinions. The anger that generates outlasts the parent by years, and it is one of the more common reasons adult siblings stop speaking.
The daughter who apologised for being tired
A woman in her late forties came about her sleep. Her mother had advancing dementia and had been living with her for three years. She worked full time. She had two teenagers.
She did not describe herself as grieving. She described herself as coping badly, which she was not.
What she eventually said, having apologised twice before saying it, was that she missed her mother. Not the woman upstairs. Her mother, who used to ring her every morning and had opinions about everything. That person had gone some years earlier and nobody had marked it.
Naming the loss did not lighten the caring. It stopped her treating her own exhaustion as evidence that she was a bad daughter.
A composite drawn from several presentations, not a real client. No identifying details belong to any individual.
What actually helps
- Name it as grief. Not stress, not coping badly. Something is being lost while you watch, and calling it what it is changes how you treat yourself.
- Say the forbidden things somewhere. That you are angry, that you sometimes want it to end, that you resent your brother. Said aloud once, these lose most of their power.
- Separate the person from the illness. The accusation, the refusal, the repeated question are the condition speaking. Knowing this does not stop the hurt, but it stops you carrying it as rejection.
- Take relief without negotiating for it. Rest is not a reward for having earned it. A carer who collapses helps nobody.
- Have the sibling conversation early. Before resentment sets. It is far easier to divide work than to redistribute it after four years of imbalance.
- Expect the death to feel strange. Numbness, or relief, or a second wave of grief months later. All ordinary after a long illness.
Long-term caring carries a real risk of exhaustion tipping into something more serious. If you have stopped being able to see a point to any of it, or have had thoughts of not wanting to be here, please tell someone today. If you cannot keep yourself safe, contact your local emergency services or attend your nearest hospital now.
Caring for them, and losing them, at the same time
Sessions with Dr. Kohli directly, in Gurugram or online worldwide, in English or Hindi. Including for those managing a parent's care from abroad.
Book a session WhatsApp +91 9811862338Grief and loss
Start with the hub, or read across the set.
- Grief counselling. The overview.
- What happens in grief counselling
- Prolonged grief disorder
- Anticipatory grief (you're here)
- Grieving far from home
- Guilt about ageing parents from abroad
- Coping with grief
- Stress and burnout. The wider hub.
Common questions
What is anticipatory grief?
Mourning a loss that has not happened yet, or one already underway while the person is alive. It is common in families caring for someone with dementia, a terminal diagnosis or a long decline. It is a recognised form of grief rather than premature mourning or a failure of hope.
Is it normal to grieve someone who is still alive?
Yes, and it is far more common than people realise. With dementia especially, the person you knew can be substantially gone while their body is still present. Your mind registers that as a loss because it is one. Grieving it is not disloyalty and it is not giving up.
Why do I feel so guilty about it?
Because it feels like mourning someone who has not given you permission. There is also no social recognition for it: no funeral, no condolences, no fortnight of visitors. Grief without acknowledgement tends to convert into guilt, which is why naming it plainly helps so much.
I sometimes want it to be over. Does that make me terrible?
No. It is one of the most common things said in this room, and it almost never means wanting the person dead. It means wanting the suffering to stop, theirs and yours. Those feel identical at three in the morning and they are completely different things.
Why do I get angry with my parent?
Because caring for years is depleting, and because the repeated question, the refused medication and the accusation land as personal even when you know they are the illness. Anger at someone who cannot help it produces a particular shame. It is nearly universal in long-term care.
Will I still grieve when they actually die?
Usually, though often differently than expected. Some people feel numb, having done much of the grieving already. Others are surprised by a fresh wave. Some feel relief and are frightened by it. All of these are ordinary after a long illness, and none of them measures how much you loved them.
How do I handle siblings who don't help?
Address it early, before resentment sets. Ask for something specific and time-bound rather than more help in general, since vague requests are easy to absorb and forget. Where the imbalance has already run for years, family sessions can be more effective than another conversation that goes the same way.
I'm abroad and my parent is ill in India. What can I do?
A great deal, and the guilt will still be disproportionate. Distance changes what care looks like rather than whether you are giving it: arranging support, managing medical decisions, being the one who calls. It is also worth naming that you are grieving at a distance, which is its own difficulty rather than a lesser version.
How do I look after myself while caring for someone?
Take relief without negotiating for it first. Rest is not something you earn by having suffered enough, and a carer who collapses helps nobody. Practical relief matters more than advice here: one afternoon a week that is genuinely yours does more than any amount of self-care language.
Should I tell my parent what I'm feeling?
It depends entirely on their condition and your relationship. Where someone is lucid and able, honest conversation late in life is often extraordinarily valuable for both people. Where dementia is advanced, the conversation you need is probably with someone else, and that is what this work is for.
Is this different from carer burnout?
They overlap and are not the same. Burnout is depletion from sustained demand. Anticipatory grief is mourning a person while caring for them. Most long-term carers have both, and treating only the exhaustion tends to leave the grief unaddressed and unnamed.
Can counselling help while the person is still alive?
Yes, and this is often the better time for it. Working through the guilt, the anger and the loss while it is happening tends to make the caring more bearable and the eventual bereavement less complicated. Waiting until after the death is common and it is not necessary.
Related reading: stress and burnout, depression, menopause and midlife, and NRI mental health.
This page is general psychoeducation and not a substitute for individual assessment or treatment. If you are in immediate danger or unable to keep yourself safe, contact your local emergency services or attend your nearest hospital without delay.