Grief and Regret: What Bereaved Families Wish They Had Done Differently

There is a particular kind of pain that only arrives after someone dies. It's not the grief itself — though that is heavy enough. It's the specific, pointed ache of the thing you didn't say, the visit you didn't make, the conversation you kept postponing because you assumed there would be time.

Researchers call it bereavement-related regret. A 2022 study published in BMC Palliative Care found that 70% of bereaved families report regrets about end-of-life care decisions. A separate analysis by Holland et al. (2018) found that among bereaved individuals, 42.4% experienced "unfinished business" — unresolved relational issues with the deceased — while 37.6% reported specific regret. These two constructs overlap but are distinct: unfinished business is about what was never addressed; regret is about what could have been done differently.

This article examines what the research tells us about bereavement regret — what people regret most, how it affects their grief, and what evidence exists for the one thing that consistently reduces its impact: meaningful communication before death.

What do people actually regret after losing someone?

When researchers ask bereaved people about their regrets, the answers cluster into surprisingly consistent categories. They are not primarily about medical decisions, financial arrangements, or funeral planning — though those matter. The regrets that cause the most lasting pain are almost always relational.

A 2020 Royal London survey found that 74% of people have regrets about what they did or didn't say to a loved one before that person died. A 2022 YouGov survey of over 6,000 U.S. adults found that 47% specifically regret not recording or documenting conversations with someone they were close to who has died. Among those who did record conversations, 77% wished they had started earlier.

The Conversation Project — a public health initiative by the Institute for Healthcare Improvement — found that 90% of Americans say talking about end-of-life wishes with loved ones is important, but only 27% have actually done it. And a 2021 national survey by StoryWorth found that 74% of Americans regret not learning more about relatives who have already died.

These numbers paint a consistent picture: the vast majority of people know that certain conversations matter, and the vast majority never have them. The regret that follows is not a surprise — it's a statistical inevitability.

What do the dying themselves regret?

Bereavement regret has a mirror image — the regrets of the dying themselves. Bronnie Ware, an Australian palliative care nurse, documented the most common regrets of her patients in their final weeks. Her account, later published as The Top Five Regrets of the Dying, has been cited in academic literature and resonated with millions of readers worldwide.

The five most common regrets she identified were: wishing they had lived a life true to themselves rather than the life others expected; wishing they hadn't worked so hard; wishing they had had the courage to express their feelings; wishing they had stayed in touch with friends; and wishing they had let themselves be happier.

The third regret — the courage to express feelings — is directly relevant to bereavement regret, because it describes the same silence from the opposite direction. The dying person wishes they had spoken; the bereaved person wishes they had listened, or asked, or said the thing that was on the tip of their tongue.

Dr. Ira Byock, a palliative medicine physician, distilled this understanding into five essential statements: "I forgive you," "Forgive me," "Thank you," "I love you," and "Goodbye." His clinical observation was that these five expressions — when spoken between patient and family — consistently produced a sense of completion and peace. When they went unspoken, they became the raw material for decades of regret.

How does regret complicate the grieving process?

Grief is already one of the most psychologically demanding human experiences. When regret is layered on top of it, the result can be clinically significant. The American Psychiatric Association estimates that 4% to 15% of bereaved adults develop Prolonged Grief Disorder (PGD), a condition formally added to the DSM-5-TR in 2022. PGD is characterized by intense yearning for the deceased, difficulty accepting the death, emotional numbness, and a pervasive sense that life is meaningless — persisting for at least 12 months after the loss.

Research consistently identifies unfinished business and regret as risk factors for PGD. A 2020 study published in Palliative Medicine by Holland Plant et al. found that bereaved parents with unfinished business were significantly more likely to experience prolonged grief symptoms. Regrets primarily centered on treatment decisions and a perceived lack of communication — not having said enough, not having asked the right questions, not having expressed what was felt.

A 2025 study published in Death Studies by Yang, Klaassen, and Wada explored the lived experience of bereavement-related regret through in-depth interviews with bereaved adults. Their findings revealed five features of how regret is experienced: it is physically felt in the body (tightness, nausea, a dark heaviness); it behaves like an active entity — unpredictable, relentless, demanding engagement; it is permanent yet dynamic, shifting in form and intensity over time; it is relationally embedded, intertwined with other emotions and memories; and it involves an ongoing internal dialogue between the past self (who didn't know) and the present self (who can no longer act).

One participant in that study captured the temporal tension of regret in a poem:

i should have said how much that meant to me
if this was now, i would have told her
i wish i had told her
i never got to tell her

The researchers note that while levels of grief and depression may decrease over time, self-blame and regret often do not. This finding has significant implications: regret is not a phase of grief that passes. Without deliberate action — either before the death or through therapeutic processing after — it can persist indefinitely.

What actually reduces bereavement regret?

If regret is so persistent and damaging, is there anything that prevents it? The research points to one consistent answer: meaningful communication before death.

A landmark 2017 study by Otani et al., published in the Journal of Pain and Symptom Management, examined 967 bereaved family members of cancer patients in Japan. The researchers measured two variables: whether the family had meaningful communication with the patient before death (defined as saying goodbye, expressing gratitude, resolving conflicts), and whether the family was physically present at the moment of death.

The results were striking. Meaningful communication before death was significantly associated with lower depression and lower complicated grief in surviving family members. Physical presence at the moment of death — which many families prioritize and feel guilty about missing — showed no significant association with grief outcomes. The conversation mattered more than the timing.

The implication is clear and actionable: the single most effective way to reduce future bereavement regret is to have the conversation now. Not a perfect conversation — just an honest one.

Why do most people never have this conversation?

If 90% of people agree that end-of-life conversations are important, and if research consistently shows they reduce suffering, why do fewer than 30% actually have them?

The first barrier is superstitious thinking — the irrational but deeply felt belief that talking about death somehow invites it. This is more common than most people would admit.

The second barrier is emotional overwhelm. The prospect of sitting down with a parent, spouse, or child and saying "I need to talk to you about what happens when you die" is, for many people, more emotionally terrifying than any other conversation in their lives. The discomfort is real, and it is powerful enough to override intellectual understanding of why the conversation matters.

The third barrier is the assumption of time. When everyone is healthy, death feels abstract and distant. There is no urgency, no deadline, no forcing function. Tomorrow will work. Next month will work. And then, for roughly 30% of people, death arrives suddenly — a heart attack, a stroke, an accident — and tomorrow never comes.

The fourth barrier is lack of a framework. Most people genuinely don't know what to say. "Have you thought about your funeral?" feels clinical. "I love you and I want you to know that" feels out of context on a random Tuesday. Without a structure or a starting point, the conversation never begins.

This is where tools and services can bridge the gap. A letter that you write at 2 AM when the words finally come doesn't require the other person to be in the room. A video message recorded on your phone can convey tone, emotion, and presence in a way that text never can. The conversation doesn't have to be synchronous to be meaningful.

What can you do — starting today?

The research points to specific actions that reduce bereavement regret. None of them require professional help, special equipment, or a terminal diagnosis.

What if the person is still alive and healthy?

Start with the easiest of Byock's five statements: "Thank you." Pick one specific thing the person has done for you — not a generic expression of gratitude, but a named moment, a concrete memory. "Thank you for driving three hours to help me move into my first apartment. I never told you how much that meant to me." Specificity makes it real. Specificity makes it memorable. And specificity opens the door to the rest of the conversation.

If a face-to-face conversation feels impossible, write it down. A handwritten letter, an email, a text — the medium is far less important than the content. The YouGov data shows that the regret isn't about the format; it's about the silence.

What if the person is ill or elderly?

Don't wait for the "right" moment. The Otani (2017) study demonstrated that meaningful communication at any point before death reduces grief outcomes — not just communication in the final hours. If your parent has been diagnosed with a chronic condition, you don't need to wait until they're in hospice. If your grandparent is 85 and slowing down, you don't need a medical crisis to justify the conversation.

Ask questions. The StoryWorth finding — that 74% of Americans regret not learning more about deceased relatives — suggests that asking is as important as telling. "What's a story from your life that I've never heard?" is a gift to both of you.

What if the person has already died?

The Yang, Klaassen, and Wada (2025) study found that bereavement-related regret involves an ongoing dialogue between the past self and the present self. This dialogue doesn't require the other person to be alive. Grief therapists from organizations like Cruse Bereavement Care and the Grief Recovery Method consistently recommend writing unsent letters as a therapeutic practice. The act of articulating what you wish you had said — putting it into words, giving it form — can reduce the intensity of regret even when delivery is impossible.

You can also redirect the impulse forward. If you regret not telling your mother how you felt, you can make sure your own children don't carry that same regret. Record a message for them — something they can hear in your voice, see in your face — that says what you wish your mother had heard from you. The regret doesn't disappear, but it transforms into action.

What if you want to prepare for both possibilities?

Record a message now, while you're healthy, for the people who matter most. Not because you're dying — because you're alive, and you want to make sure the words exist somewhere permanent and deliverable, regardless of what happens.

LastWithYou allows you to record video or text messages that are stored securely and delivered after your death. The free plan includes one video message for up to three recipients. You can record when you're ready, revise as often as you want, and know that even if the unexpected happens, the people you love will hear what you needed to say.

What if you're already carrying regret?

If you've already lost someone — and the regret is already there — it's important to hear this: regret is not a failure. It is evidence that the relationship mattered. The Yang et al. (2025) study makes this point explicitly — the researchers argue against treating regret as a disorder to be cured, and instead describe it as a natural, relational, and even meaningful part of the grieving process.

Regret hurts because the love was real. The silence happened not because you didn't care, but because the conversation was hard, and you were human, and you didn't know how little time was left. No one does.

If the regret feels overwhelming — if it's interfering with your ability to function, or if you recognize in yourself the symptoms of prolonged grief (persistent yearning, emotional numbness, a feeling that life is meaningless lasting more than 12 months after the loss) — consider reaching out to a grief counselor or therapist. Prolonged Grief Disorder is treatable, and evidence-based therapies exist that specifically target bereavement-related regret and unfinished business. Organizations like Cruse Bereavement Care (UK), the Grief Recovery Institute (US/International), and the American Psychiatric Association's PGD resources can help you find appropriate support.

Frequently Asked Questions

Conclusion

The research on bereavement regret tells a consistent story: the thing people regret most is not what they did, but what they didn't say. Seventy-four percent of bereaved people carry regrets about unspoken words. Forty-seven percent wish they had recorded conversations. Ninety percent know these conversations matter, yet fewer than thirty percent have them.

But the research also offers a clear solution. The Otani (2017) study demonstrated that meaningful communication before death — not physical presence at the moment of death — is what reduces depression and complicated grief. The conversation doesn't have to be perfect. It doesn't have to be long. It just has to happen.

If someone you love is still alive, you still have the chance to say what matters. If they're already gone, you can still process what was left unsaid — and you can make sure the people who come after you don't carry the same weight. Either way, the next step is the same: say something honest, to someone who matters, before the window closes.