A few months ago, I organized a ten-day trip to Crete for my parents. My mother is 80, my father is 90. Ten of us in total, the whole family together. It sounded lovely on paper: all of us in one place, beautiful views, good food, time together as long as they’re still able to travel. And it was lovely, but at times challenging.
It was one of the more depleting things I’ve done in a long time.
My father has walking issues. Some of it is a real limitation, and if I’m honest, some of it I suspect is him not quite pushing himself the way he could. I never know which one I’m dealing with in each given moment, so I’m constantly calculating. How is he getting from the hotel to the taverna? Is this cobblestone street going to be a problem? Should we take the car for something that’s a five-minute walk? Multiply that by ten days, add my mother’s own needs on top, and by the end I was not just tired. I was emotionally and physically depleted.
On the first day of the trip, I sat my sister down and set a boundary right away. I told her: we’re both responsible here. I’m the one who prepared this trip and did most of the planning, and given the logistics they’re going to spend more time with me day to day, so you need to step in from the start, before we end up with issues and resentment later. It felt uncomfortable to say out loud, but it was one of the better decisions I made all trip. And I’m lucky here. I have a good sister. She understood, and she knew we both had responsibilities regarding our aging parents. That honest talk probably prevented any future resentment or disagreement.
Even with that, by the end of the ten days I came home and realized I hadn’t really been present for my husband the entire trip. He understood. He was patient with me. But I felt it: that particular guilt of having nothing left to give the person I share my life with, after I’d given it all to my parents. My kids noticed it too. They saw me somewhere else even when I was sitting right next to them, so focused on my parents’ care that I wasn’t fully with anyone.
I want to name something here, since I think it matters. I’m lucky. I don’t carry resentment toward my parents, and our relationship has never been complicated. So even on the most exhausting days in Crete, underneath the fatigue was something that felt like a genuine pleasure. I wanted to be there, doing this, giving back to two people who gave to me. That’s not everyone’s experience, and it changes so much about how this stage of life feels.
I tell you this not for the drama of the story, but for how ordinary it is. This is what caring for aging parents actually looks like most of the time: not one crisis, but a thousand small logistics carried alongside a thousand feelings, day after day. And one of the feelings that comes up most, and that almost no one names clearly, is anticipatory grief.
What is anticipatory grief?
Anticipatory grief is what happens when the mourning begins before the loss itself, often surfacing alongside terminal illness, cognitive decline, or the slow fragile shift of aging. Psychiatrist Erich Lindemann first named the concept in 1944, and our view of it has shifted from simple pre-loss sadness to something far more layered. The experience reaches beyond a future event; it can bring losses from the past, present, and future together at once. It lives in the relentless mental load of caregiving, the ache of witnessing someone you love suffer, the heavy uncertainty of when the end will arrive, and the quiet mourning for the life you’ll be left with once they are gone.
Anticipatory grief can begin when you start grieving your parent before they’re gone. It shows up as who they are slowly changes in front of you: the parent who used to be fully independent, the relationship you wish you’d had, the version of them that still felt permanent. Some people describe it as losing their parent twice, once slowly during the decline, and again when they actually die.
It’s distinct from the grief that follows a loss. It lives in the present tense. You are mourning something that is still happening, with no clear endpoint and no defined ritual, and often no one around you who names it for what it is.
If you’re in this stage of life, you already know the feelings don’t come one at a time. Love and resentment can be in the same breath. You can feel honored that your parent trusts you with their care and simultaneously think: I cannot do this anymore. Both are true, and both can exist at once.
Underneath all of that, there’s a role reversal happening that nobody quite prepares you for. The people who used to protect you, who made the decisions, who kept you safe, are now the people whose medications, doctors, finances, and sometimes safety you are managing. That reversal alone can stir up sadness, guilt, fear, resentment, and real confusion about where your limits even are anymore.
Why caregiver guilt shows up no matter what you do
The mental load is relentless, and the hardest part isn’t any single task. It’s the vigilance underneath. “Did Mom take her medication?” “Should Dad still be driving?” “What if I go away and something happens?” That kind of hypervigilance doesn’t have an off switch, because caregiving doesn’t have a predictable endpoint. And then there’s what runs beneath even that: watching a parent become fragile is a reminder that you’re next in line. People don’t say that out loud much, but it sits there.
Caregiver guilt shows up regardless of what you do. When you feel you’re doing too little, and when you’re doing so much you’ve lost yourself. When you feel angry. When you take a break. When you think about bringing in outside help. Caregivers often believe they’re supposed to feel only love and compassion, and then judge themselves harshly for feeling exhausted, resentful, even furious. None of that makes you a bad person. It makes you a person under sustained pressure with no real recovery time.
When the relationship was already complicated
Caregiving can be an opening, a chance to repair an old wound, to finally understand your parent as a full, flawed human being instead of just “mom” or “dad.” Some of my clients describe genuinely closer relationships forming during this stage.
But for others, caregiving reactivates old family roles in ways that are painful. The “responsible one” becomes the one doing everything. Old sibling rivalries resurface. And sometimes, people take on the caregiving role still hoping their parent will finally see them, finally say: you did so much, thank you.
I had a client — I’ll call her Eleanor — in her early 70s, whose mother was in her 90s. Eleanor had been the one showing up for years: doctor’s appointments, groceries, hard conversations. Her brother was barely present. And still, at 70 years old, Eleanor sat in my office wanting the same thing she’d wanted her whole life: to feel loved and special to her mother. Her mother never gave it to her. Not even near the end. It was her brother, the one who did almost nothing, who got the warmth. That’s one of the harder things I sit with in this work: watching someone do everything right and still not get what they’re aching for.
When there are unresolved issues, a lack of boundaries growing up, childhood trauma, or a parent who simply wasn’t emotionally available, caregiving now stirs up something much older than exhaustion. It brings up the core unfairness: “I’m caring for you now, when you were not there caring for me. We didn’t have a relationship, and now, suddenly, you need me.” That’s an incredibly hard place to sit in. You can want to do the right thing and still feel the old wound underneath it. Neither cancels the other out.
How family dynamics get louder when a parent needs care
Caring for a parent tends to pull you back into whatever role you played growing up. The peacekeeper starts managing everyone’s emotions. The one who always pulled away withdraws again. And unequal caregiving among siblings (one doing the driving and the doctor visits, another showing up occasionally with opinions) is one of the most common sources of resentment I hear about in the therapy room. “Why am I doing everything? Why do they get to criticize when they’re not even here?”
This is exactly why naming things early matters, the way I did with my sister on the first day in Crete. It doesn’t fix an unequal history overnight, but it puts words to something that usually just festers silently until someone explodes.
What the financial weight actually looks like
A lot depends on whether your parents actually planned for this. Do they have Medicare, savings, insurance? Or are you, often as an only child, suddenly absorbing costs nobody prepared for? I’ve worked with clients who inherited a parent’s total lack of planning and felt they had no real choice but to step in. Others watch a parent make decisions they think are unwise, financially or otherwise, and feel stuck between respecting their autonomy and fearing what comes next.
Beyond the obvious costs (aides, facilities, medications, equipment) there are the quieter ones: reduced work hours or lost income, drained retirement savings, travel costs if you live far away, and your own health slipping down the priority list because there’s no time or money left for it.
What is the sandwich generation?
The sandwich generation refers to adults who are simultaneously caring for aging parents and raising their own children, often while holding a career and a marriage together at the same time. The term captures the compression of it: needs coming from multiple directions, with little room in between.
It’s more common than most people realize. New research from Pew Research Center found that nearly one in four Americans with a parent age 65 or older considers themselves a caregiver. When that parent is 75 or older, the number rises to nearly one in three. And the weight of caregiving reaches far beyond the practical responsibilities. Among those regularly helping an aging parent, 39% say it has negatively affected their emotional well-being.
But statistics only tell part of the story. Caring for an aging parent can mean living in two worlds at once—helping with appointments, medications, finances and everyday needs, while quietly watching someone you love change. You are caring for the person who is still here while, sometimes, already grieving what is being lost.
If you’re in this, you already know what the data describes: everyone needs something from you, there’s no time left that’s actually yours, and somewhere in the middle of all of it you start losing track of who you are outside of it.
Left unaddressed long enough, this kind of chronic stress doesn’t plateau. It’s linked to higher rates of depression, anxiety, sleep problems, and burnout, with measurable effects on caregivers’ long-term cognitive health, especially for those putting in 50 or more hours a week.
And yet, there’s meaning here too
I don’t want to leave the hard side as the only picture, because it isn’t the whole one.
Many of the people I work with describe this stage as the first time they’ve truly understood their parent as a person, not just as “mom” or “dad.” Some say caregiving brought them closer than they’d ever been. Others describe it as a chance to give back in a way that felt genuinely honoring, even when it was exhausting.
That doesn’t cancel out what it costs. It exists right alongside it. And holding both at once (the weight and the meaning) is, I think, one of the more honest things caregiving asks of us.
How therapy can help when you’re caring for aging parents?
Anticipatory grief, caregiver guilt, the anger that comes from doing everything and still feeling unseen — none of it resolves on willpower alone. These are feelings that benefit from a space built specifically to process them, not just manage them from week to week.
In my work with parents and caregivers, what I see most often isn’t a single breaking point. It’s the accumulation: months or years of absorbing the weight without ever setting it down, not because you don’t want to, but because it’s hard to know where to start. Therapy creates room to name what’s actually happening (the grief, the role confusion, the old family patterns reactivating) rather than pushing through it.
If you’re already stretched thin, the idea of adding one more appointment to your week can feel like too much. That’s worth acknowledging. But what I’ve found, again and again, is that caregivers who get real support (from someone who understands this terrain specifically) are the ones who can actually sustain the long haul. What you’re carrying is particular. It helps to work with someone who knows it.
What I tell clients who are in this right now
You are allowed to feel all of it: the love, the grief, the resentment, the tenderness, the relief when a hard day ends, and the guilt about the relief. None of that means you’re failing. It’s hard because the work itself is hard.
You cannot keep spending energy you don’t have. Caregivers so often run on empty because taking care of themselves feels indulgent, or like one more thing on the list. But self-care in this context isn’t optional. It’s what determines whether you can sustain this for the long haul at all.
And if you’re heading into something like my trip to Crete (a big, logistically loaded stretch of caregiving) plan for your own depletion in advance. Build in recovery. Set limits with siblings early, before resentment has a chance to take root. Tell the people close to you that you might not be fully present for a while, and that it isn’t about them. Most of the time, they’ll understand. Mine did.
If any of this has been sitting with you while you read, that feeling is worth paying attention to. Anticipatory grief, caregiver guilt, and the particular exhaustion of caring for aging parents rarely announce themselves clearly. They tend to arrive as a sense that you’re carrying something too heavy, for too long, with no one around you who quite understands it. In my practice at Clarity Therapy NYC, I work with people who are ready to put some of that down. If you’d like to talk, you can reach out here.
Frequently Asked Questions About Anticipatory Grief and Caring for Aging Parents
What is anticipatory grief?
Anticipatory grief is the grief that begins before an actual loss. When caring for aging parents, it often shows up as mourning the parent they used to be (their independence, their presence, the relationship you had or wished you’d had) while they are still alive. It can feel disorienting because there is no clear moment that makes the grief feel justified, and often no ritual or language around it.
Is it normal to feel resentment when caring for aging parents?
Yes. Resentment is one of the most common feelings caregivers carry, and one of the least talked about. It often coexists with love, obligation, and genuine tenderness. Feeling resentful does not mean you love your parent less. It usually means you are doing a great deal, with little recovery time, and the weight has built up without anywhere to go.
Why do siblings often conflict during a parent’s decline?
Caring for an aging parent tends to reactivate old family roles. The sibling who always took responsibility takes on more; the one who stepped back continues to step back. What looked manageable when everyone was younger becomes a source of real resentment when the stakes are higher and the effort is unequal. Those patterns rarely resolve on their own without someone naming them directly.
What is the sandwich generation?
The sandwich generation refers to adults who are simultaneously caring for aging parents and raising their own children, while often managing careers and partnerships at the same time. The term captures the compression of it: needs coming from multiple directions, with little room in between. Research consistently links this sustained dual caregiving to higher rates of burnout, depression, and physical health decline, including measurable cognitive effects in those putting in 50 or more hours a week.
When should someone in a caregiver role consider therapy?
When the feelings stop being occasional and start being constant. When you notice that you’ve been running on empty for months. When guilt, anger, or grief are present so reliably that they’ve started to feel like your baseline. You don’t need to be in crisis to benefit from support. In my experience, the people who get the most out of this work are often the ones who come in before things fall apart — not after.
How do you cope with caregiver guilt?
The starting point is recognizing that guilt in caregiving rarely signals that you’ve done something wrong. More often it signals that you care deeply and are holding impossible standards. Naming the guilt directly (in therapy, in honest conversation with someone you trust) tends to reduce its grip. So does building in recovery time and allowing other people to share the load, even when that feels uncomfortable.
About Clarity Therapy NYC
Clarity Therapy NYC is a boutique therapy practice in Midtown Manhattan offering in-person and virtual psychotherapy, psychological testing, and psychiatric services for adults, couples, families, and young professionals across New York City.
Founded by Logan Jones, the practice is known for its highly personalized, specialist-led approach to mental health care. The practice brings together a carefully selected team of licensed psychologists, psychotherapists, psychiatrists, and testing specialists with expertise across anxiety, trauma, relationship concerns, depression, ADHD, burnout, personality dynamics, life transitions, and more. Therapeutic approaches include CBT, psychodynamic therapy, EMDR, somatic therapy, IFS-informed work, and other evidence-based and insight-oriented modalities tailored to each client’s needs. In addition to therapy, Clarity Therapy NYC offers psychological and neuropsychological evaluations for ADHD, learning differences, diagnostic clarification, cognitive concerns, and executive functioning challenges.
Clients seeking therapy in New York City often turn to Clarity Therapy NYC for its thoughtful therapist matching process, elevated clinical experience, and focus on long-term, meaningful change rather than one-size-fits-all care.
