Anticipatory mourning: processes of expected loss in palliative care.

This qualitative study explored the retrospective perceptions of the anticipatory mourning experience of caregivers who had not received hospice services. Data revealed five major processes that were consistently described by informants: realization; caretaking; presence; finding meaning; and transitioning. Characteristics of each of these processes are described. Study informants provided information about what was helpful to them. The implications for health care providers include: an awareness of changed family roles and relationship attachments that can cause strain on family systems; familiarity with the complex demands on caregivers and their need for accurate information, anticipatory guidance and support resources; professional expertise especially in regard to education about what to expect; a caring presence; and pain and symptom management.