Dementia Support Group for Caregivers with Bill Cohen
Cohen Caregiving Support Consultants, LLC

A Session about Grief with Kara Kazemba 

As you know, I was my mom’s caregiver on a 10 year Alzheimer’s journey. I told you recently about my grief during her final weeks.

This month brings you a different perspective on grief, especially the anticipatory type, from a counselor and social worker, Kara Kazemba, with Ancora Therapy. 


Am I Feeling Grief?

Grief is complicated, to describe it nicely. What used to be defined as a linear set of stages is now described more as a coil: You may feel something, but then loop back around to it at a later point. I personally describe it to my clients as being on an ocean during a storm. Rather than denial, anger, bargaining, depression, etc., coming after each other in a nice, sequential, predictable manner—it comes in waves. Whether that is pictures of a spiral that keeps coming back around or as water hitting you and leaving you spluttering—the sentiment is the same. There’s nothing predictable about grief. There’s no order. Sometimes there’s no rhyme or reason (hello, crying in the produce section). The intensity varies at first. It leaves you surprised. Occasionally, you see it coming—far too much in advance.

My Loved One is Still Alive. Why am I Grieving Now?

Lesser talked about is anticipatory grief—the type you do see from a mile away, but because the person is still with us. This happens with long term illnesses such as cancer. We feel this also with terrible illnesses of the mind, such as dementia, including Alzheimer’s. In these cases, their bodies may be more or less fine—but the person we know and love starts slipping away from us.

In the early days, shock and denial are big—for loved ones as well as the person facing the illness. This is reasonable. We form attachments—to people, to outcomes, to futures. It’s human nature to want to hold on to those things:

“Why me, why them, why us?”

Then often, “It’s not fair.”

And, “No. I won’t let it.”

Or, “What if…?”

Anticipatory grief often brings about increased concern for the person dying. When you see the writing on the wall, you start doing things like trying to get your loved one to eat tofu smoothies and sneaking spinach into their lasagnas.

(Hello, bargaining. Leafy greens can stave off death, right?)

So Then What Should I Expect?

Some use their anticipatory grief as preparation for what’s to come. Preparation may present as imagining the death. In severe cases, this becomes anxiety. But preparation can also be beautiful, in the form of acceptance. A bittersweet type of beautiful.

It is a small blessing to make preparations, discuss final wishes, and make amends. There are some heart-wrenching conversations that take place at this time, as well as hard realizations. So much room for catharsis and healing. These processes can be huge for closure, both for the departing and those they are saying goodbye to.

That “in-between” is hard, though. Hope can be a tricky thing. You can hold on too hard and for too long. I’ve seen this in particular happen with dementia. Those lucid days in particular make you think: “Hey, maybe they are back. Maybe they can hold on for a little longer”.

Saying this loudly for the people in the back:

Letting go does not mean you stop loving them. 

This is challenging for people to realize. Even siblings get heatedly divided over this issue in Dad’s final moments. (See the hope thing mentioned above.) Not everyone will get it. Try to remember that anger is part of their grief processes. This can help to depersonalize the sting of the disagreement.

Loss of a loved one is so unique in that it can be very isolating. Someone may have also lost a parent but they didn’t lose YOUR parent.  They didn’t have YOUR memories or YOUR recollections of them. Grief is so personal, however, that sometimes we mistake personal for private.

What if I Dread Grieving Alone?

Find a support group as close to your situation as possible. Particularly if you are deep in the anticipatory grief. Find someone who can not just empathize with your situation, but SYMPATHIZE with it. You don’t have to go through this alone.

Let others take care of you. The mental fog that often comes with grief can make simple tasks challenging. If you can relinquish a bit of control, hand off some things to a friend or partner.

Why does Everyone Remind Me about Self-care?

There’s likely people rolling their eyes at hearing this for the 7,357th time. But, (in my experience) when hospice gets involved, when the time is close, staff will bring a small tray or cart. Snacks and coffee and underwhelming tea appear. The sentiment is this: Even when you’re close to goodbye, you still need to take care of yourself. With longer term grief, the idea is the same. Sometimes we are so busy in our anger, bargaining, and pain that we neglect ourselves.

Our loved ones wouldn’t want that.

When Should I Seek Help?

There comes a point where support isn’t enough and professional help is warranted. There’s a lot of understanding for feeling low during all of this, but if the world is losing you in this process as well, then we should have a conversation. At some point, it should be okay to move on. There’s likely a lot to unpack, if you’re feeling down, unmotivated, and broken. We’re here for you.

Thanks, Kara! Kara Kazemba is the owner of Ancora Therapy. She is certified in Alcohol and Drug Counseling (CADC) and licensed to practice clinical social work (LCSW). Kara lives in Hillsboro with her two children and a menagerie of animals. A therapist for almost ten years, she thrives on coffee, a healthy level of swearing, and watching her clients discover and renew their power.

How to reach her:

Kara Kazemba, LCSW, CADC

(971) 238-4408 

You don’t have to go it alone. Contact me or Kara. With our experience, network of resources, and compassionate support, you will feel less overwhelmed and stressed out.

I can advise and support you by phone, email, text, or videoconferencing:
☎️ 503-522-8320 or
🖊 or
Caring Regards,
Bill Cohen
Certified Senior Advisor (CSA)®
Cohen Caregiving Support Consultants 💜

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Dementia Support Group for Caregivers with Bill Cohen
Cohen Caregiving Support Consultants, LLC