A terminally ill patient and family have been tearful since the diagnosis. What should be the nurse's focus when planning care?

• A. Hopelessness
• B. Caregiver role strain
• C. Anticipatory grieving
• D. Complicated grieving

Answer: (C)

Anticipatory grieving is the process of mourning that starts before the actual loss, as patients and families begin to adjust emotionally, practically, and spiritually to an impending death. When a terminally ill patient and family have been tearful since diagnosis, the nurse’s care plan should center on supporting that anticipatory grieving. This means validating feelings, facilitating honest conversations about prognosis and goals of care, helping with decisions about treatments and comfort measures, and guiding practical preparations (such as advance directives, plans for care at home, and rituals or spiritual support). Addressing grief early helps the family cope more effectively, maintain a sense of control, and may reduce the intensity or complications of grief after death. While issues like hopelessness, caregiver strain, or the risk of complicated grieving may also be present, the immediate focus in planning care is to support anticipatory grieving and its accompanying needs.