SSM - Mental Health (Dec 2022)
How funerals mediate the psycho-social impact of grief: Qualitative analysis of open-ended responses to a national survey in Japan
Abstract
Background: As populations age and pandemics continue, grief disrupts the health and productivity of increasingly bereaved populations. While funerals can reconnect old friends and relations to provide psycho-social support, and satisfying funeral participation reportedly reduces such psychiatric complications of grief, the psychological effects of recent restrictions on funerals remains unclear. This first English report of open-ended responses to a Japan-wide survey sheds some light on this by looking at Japanese psychological reflections on their funerals. Objectives: To determine what aspects of funerals the Japanese bereaved feel psycho-socially valuable or conversely problematic, and for what reasons. Setting: Data were collected using anonymized all-Japan postal surveys from 2019 to 2020. Participants: 288 recently-bereaved chief mourners submitted 353 open-ended responses discussing their experiences and feelings about the funerals they conducted. Method: Anonymized data were divided into positive, regrets, vacillations, and negative comments about the subjects most frequently cited. Results: Most commonly cited were funeral directors (64), attendees (56), ritual/ceremony (49), and the need for (pre-)planning (40). Respondents profoundly appreciated funeral directors' support, and regretted not having planned better or invited more people to the funeral. Dissatisfaction tended to focus on unexplained expenses and mistakes or offenses in rituals. Many also criticized their doctors for not realistically forecasting their loved ones' demise. Conclusions: Responses validated that responsive funeral directors can significantly support their clients through early acute grief, and that inviting more celebrants to a full funeral facilitates psycho-social support and may obviate future regrets. Rituals too provide memorable means to help survivors deal with grief. Medical professionals should psychologically encourage terminal patients' families to communicate while patients are still coherent; families are strongly advised to discuss funeral plans with their elders before the end of life.
