Dear Laird: Your January column, recounting a woman’s grief about her mother forgetting how to crochet, really struck a chord with me. I’ve always associated grief mostly with death. Could you shed some light on experiencing grief before a loved one’s passing? Signed, Curious About Grief 

Dear Curious: When I was young, my best friend was Sam, a black cocker spaniel with white boots and a white chest. 

When Sam had to be put down, I was devastated. My parents were kind and tried to comfort me, but they didn’t use the word “grief.” Years later, I wondered why—wouldn’t Sam’s death have been an opportunity for me to learn about ambiguous loss and grief?

Pauline Boss, Ph.D, describes two types of ambiguous loss in her research. The first type is the ambiguity of an important person who is missing, leaving others unsure of their whereabouts or even if they are alive. 

An example she provides is the families of MIA service members during the Vietnam War. Is the soldier alive or dead? Should loved ones grieve or hope for his return?

The second type of ambiguous loss applies to situations involving terminal neurological diseases, where a person is alive and physically present, but not fully present mentally or emotionally. 

For example, a mother with brain failure has forgotten important life events, shared memories and even family names. She is alive, but her loved ones grieve because she is not the same. The loss is truly ambiguous, and we grieve it.

The two types of ambiguous loss have been described as “Leaving without Goodbye” and “Goodbye without Leaving.” 

Friends and family, especially those who live far away, often don’t understand it. They might observe, “Mom seems fine to me,” because they see her physically present and outwardly similar. However, they fail to recognize the significant internal changes and loss of self that aren’t immediately visible.

Our grief may manifest as anger without us realizing it. We know we’re losing our loved one, but we can’t do anything about it. We fool ourselves into thinking that if we do everything just right, their decline can be prevented. When reality confronts us with their deterioration, it feels like failure. 

But you are not failing; you are simply doing the best that you can. 

Caregivers often mourn more than just the decline of the person they’re caring for. When my wife was diagnosed, it coincided with our retirement. We had moved to Colorado to be closer to our son, built a new home and were looking forward to enjoying our golden years with our grandchildren. 

Instead, her illness reshaped our future. I found myself grieving not only for the life we had planned together but also for the prospect of facing the future alone.

Understanding our grief helps us adjust to loss and process it. Despite the pain, acknowledging and confronting our grief helps us make sense of what we’re going through and can lead to healing.