Grief & Loss
Grief Before Goodbye: Support Through Hospice and Palliative Care
When someone you love is seriously ill or dying, the grieving often starts long before the loss. You don’t have to carry it alone.
When a loved one is facing a serious illness or entering hospice, families often experience anticipatory grief — mourning while the person is still here — along with caregiver exhaustion, guilt, and complicated emotions. Palliative care focuses on comfort and quality of life at any stage of serious illness; hospice focuses on comfort when curative treatment ends. Therapy supports caregivers and families through the grief, the caregiving, and the goodbye. Haley Childers, LSW helps families across Pittsburgh’s South Hills and by telehealth across Pennsylvania.
There is a particular kind of grief that most people aren’t prepared for: the grief that begins while your person is still alive. When someone you love is seriously ill, entering palliative care, or beginning hospice, you can find yourself mourning them in the present tense — and feeling guilty for it, as though grieving now is giving up. I want to say clearly: it isn’t. In fifteen years of walking with families through this, I’ve learned that this long, aching in-between is one of the hardest things a person carries. And you don’t have to carry it by yourself.
What Palliative Care and Hospice Actually Are
These two often get confused, and understanding them can ease some fear. Palliative care is comfort-focused care that can begin at any stage of a serious illness — often alongside treatment aimed at curing or controlling the disease. Its goal is quality of life: easing pain, symptoms, and stress for the patient and the family. Hospice is a form of palliative care for when curative treatment is no longer the goal, usually in the final months, focused entirely on comfort, dignity, and support. Both typically include a whole team — often social workers and chaplains alongside nurses and doctors — because they recognize that serious illness is never only medical. It’s emotional, relational, and spiritual too.
Anticipatory Grief Is Real Grief
The word for what you may be feeling is anticipatory grief — the mourning that happens before a death. It’s real grief, with all the same weight: sadness, anger, numbness, fear, moments of unexpected laughter, and the strange exhaustion of holding it all. You might grieve the person they used to be, the future you expected, the conversations you’re no longer able to have. You might feel relief at times, and then shame for feeling it. All of this is normal, and none of it means you love them any less. It means you’re human, and you’re losing someone.
The Weight on Caregivers
If you’re also the one providing care, you’re carrying two enormous things at once: the grief and the labor. Caregiver burnout is extraordinarily common in this season — the exhaustion, the resentment you don’t want to admit to, the way your own life narrows to appointments and medications and worry. Old family dynamics often resurface, too, right when everyone is least equipped for them. Please hear this: tending to your own well-being isn’t a betrayal of the person you’re caring for. You cannot pour from an empty cup, and you deserve support of your own.
How Therapy Helps
Therapy during this time offers something the situation rarely does: a space that’s just for you. A place to grieve out loud while your person is still here, without having to protect anyone from your feelings. A place to name the hard, complicated emotions — the guilt, the anger, the relief — and discover they’re normal. We can work on managing caregiver stress, navigating family conflict, and finding ways to make meaning and say what matters while there’s still time. And when the goodbye comes, you won’t be starting that relationship from scratch — you’ll already have support in place.
You Have More Strength Than You Know
The way I work is strengths-based, and I mean that genuinely here: a person carrying what you’re carrying is already demonstrating more resilience than they can usually see. You are showing up for someone in the hardest chapter of their life. My job isn’t to fix you — there’s nothing broken about grieving — but to help you find and lean on the strength that’s already in you, and to make sure you’re not doing it alone.
Let’s Talk
If someone you love is seriously ill or in hospice, and you’re quietly grieving, exhausted, or just need a place to put all of this down for an hour — that’s exactly what I’m here for. I support families through grief, caregiving, and loss at CPA Counseling’s South Hills office and by telehealth across Pennsylvania. This is a hard topic; if you’re struggling and need support right away, you’re not alone — reach out, and we’ll help you find it.
About Haley Childers
Haley Childers, MSW, LSW is a therapist at CPA Counseling’s South Hills office with 15 years of experience. She helps couples, families, children, teens, and adults navigate grief and loss, caregiver stress, life transitions, trauma, and relationships — with a warm, strengths-based approach.