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Sudden Death vs Anticipated Death: Is One Worse?

As a hospital chaplain, I have held the sacred privilege of discussing end-of-life wishes with the dying.  A common response of the dying is that they would like to die quickly, peacefully, at home and in bed. While providing support to the bereaved, in sharing their experiences of death, they regularly discuss which is worse, sudden death or anticipated death?  In both experiences, sudden death and anticipated death, pain is experienced and the pain is significant. How we cope, is what makes the difference.

In her book, How to Go On Living When Someone You Love Dies, Therese A. Rando, Ph.D., provides this image to help us better understand the difference in coping with a sudden death versus an anticipated death.

Suppose you are standing on a street corner and you see someone approach you as if he were going to hit you.  If you decide you can’t run, the usual response is for you to ready yourself for the assault. You steel yourself  against the oncoming blow.  You assume a fighting stance … When your assailant knocks you down you are ready for it and, despite the pain of the blow, get up to defend yourself.  This is like the situation of anticipated death.

In contrast, imagine that you are standing on a street corner minding your own business and all of a sudden someone comes from behind you and hits you.  The Blow comes from out of the blue and you are knocked to the ground.  Before you can respond to this, you have to figure out:  What happened?  What am I doing on the ground?  Where is this pain coming from?  What do I have to do now?  This is what happens in sudden death.

In sudden death, the grief is not greater, but the ability to cope is reduced.   Grief reactions include shock, disbelief, anger, guilt, despair. The world as you once knew it, is shattered, the death doesn’t make sense, life seems unfair, and you had no time to prepare for this life altering change.  Those preparing for an anticipated death share similar feelings, however, they had the precious gift of time, being able to prepare, and though also deeply painful, the death was fairly predictable and made sense.

In sudden death, the loss doesn’t make sense.  Traumatic events can be more difficult to recover from and are sometimes extended in duration, as investigations occur and potential legal action looms ahead.  The search for meaning challenges our belief system and values.  We may find ourselves looking backward, searching for anything that might help to understand the death.  And we seek an answer to the question, Why? acknowledging that sometimes there is no answer.   Because of the nature of this type of loss, grievers are at greater risk in their grieving, yet they can resolve their grief which will take longer and ask more from those who support them.  Gentleness, patience, love, and speaking with a mental health professional can make a significant difference.

What You Can Do To Cope

  • Consider sharing your thoughts and feelings with others who have experienced a similar loss.
  • Pay close attention to, and get help for, any changes in physical and emotional health as they
    may be related to the loss.
  • Talk to mental health professionals, family and friends to help gain perspective about the
    death and decrease feelings of guilt.
  • Become educated about the cause of death.
  • Accept rather than deny your feelings, even unpleasant ones such as anger.
  • Be active in making choices about engaging in activities and rituals.

For the Supporters

  • Offer specific help, i.e. preparing meals, running errands, helping with phone calls.
  • Remember the family even more after a few months. Ask what they need.
  • Listen.  Allow the bereaved to talk about their loss – if they want.
  • Offer to take them to a support group, or go with them.
  • Remember their loved one on birthdays, anniversaries, holidays.  People like to know that others still remember.
  • Allow the person to grieve in their own way.

What are other things have you found are helpful as a griever or a supporter? Add your comments below to share with others who may benefit from your insight!

Dyer, Kristi A., MD, MS,  Dealing with Sudden, Accidental or Traumatic Death, retrieved from

Rando, Therese A, Ph.D., How To Go On Living When Someone You Love Dies, New York,
New York, Bantam Books, Bantam Doubleday Dell Publishing Group, Inc, 1991.

Adapted from Robin F. Goodman, Ph.D., ATR-BC © 2000 Lifescape (352) 392 -1575 |,  Response to terror and mass trauma: American Psychological
Association CDC.


  • Anonymous Posted March 20, 2023 8:08 pm

    I can’t agree. There is no better way to cope with anticipated deaths. Watching someone suffer is far worse than sudden death. The trauma is much
    More severe . People think it’s easy and think it gives the person time to prepare but preparation doesn’t even matter in the grand scheme of things when watching someone waste away

    • Dani Posted April 10, 2023 7:44 am

      I watched my dad waste away it hurt like hell but I knew it was coming I didn’t have shock only shock I had was when I was told he was dying 1 year prior. That whole year I was expecting it although I struggled by the time it came although deeply deeply hurt I expected it and was relieved. 18 days ago I lost my mother and step dad to a sudden unexpected death I am crushed, shattered, lost, confused and the shock landed me in the hospital. I feel so dazed everytime I wake when I do finally fall asleep after being up 24 hrs or more straight. I feel like I’m in a dream state and I even call my step dads phone. I even feel compelled to ask ppl to check to see if it’s true that’s how dazed and out of it I feel. I have had a major physical reaction that I did not have with my dad who I also loved very much. I was just with them the night before and then boom next night they were both gone.

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