Grief and Bereavement Articles and Grief Research 

A good friend of mine lost her dad some years back. I found her sitting alone on a bench outside our workplace, not moving, just staring at the horizon. She was absolutely distraught and I didn’t know what to say to her. It’s so easy to say the wrong thing to someone who is grieving and vulnerable. So, I started talking about how I grew up without a father. I told her that my dad had drowned in a submarine when I was only 9 months old and I’d always mourned his loss, even though I’d never known him. I just wanted her to realize that she wasn’t alone, that I’d been through something similar and could understand how she felt.

My question is about anticipatory grief, the distress that family members can feel when a loved one is receiving end-of-life care. I work in a palliative care unit of a large hospital, and we often have families who are overwhelmed with the reality of the patient’s impending death, to a point that they can’t take in the message that further treatment is medically futile–no amount of heroic interventions can restore the person to health, but only prolong the patient’s suffering. Almost always we can control the patient’s pain,

Depression impacts quality of life at all life stages, but little is known about the factors related to depression in the last year of life. A recent study published in the Journal of the American Geriatrics Society found that 59.3% of individuals had depression in the last month before death. In the interview-based study that included 3,274 individuals who died by the end of the study, depression symptoms increased gradually from 12 to 4 months before death and then escalated from 4 to 1 months before death.