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Emotional Journey & Grief

The Loss Before the Loss

Anticipatory grief and ambiguous loss are the two parallel forms of grief that overlap in dementia care. Understanding the difference can bring clarity and compassion to what you're carrying.

Caring for someone with dementia or Alzheimer’s often means living inside two parallel forms of grief: anticipatory grief and ambiguous loss. They overlap, but they are not the same—and understanding the difference can bring clarity and compassion to what you’re carrying.

Anticipatory grief is the grief that begins before the final goodbye—the gradual, painful awareness that the person you love is changing, that the relationship is shifting, and that the future will hold loss. You begin grieving pieces of them as they fade, even as you continue to show up for them every day.

Ambiguous loss, however, is the grief of “both/and.” Your person is here, yet not fully here. Present, but changed. Physically alive, but psychologically or emotionally altered in ways that make the relationship feel unfamiliar or fragmented. There is no clear endpoint, no defined moment when the loss “starts” or “ends,” making closure impossible.

These forms of grief are heavy—sometimes heavier than grief after death—because they lack rituals, acknowledgment, and social understanding. They are quiet, chronic, and deeply personal.

Naming these experiences doesn’t fix them, but it does soften the edges. It gives you permission to feel what you feel without apology. And it honors the extraordinary complexity of grieving while still giving.

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