Mourners’ Dissatisfaction with Funerals May Influence Their Subsequent Medical/Welfare Expenses—A Nationwide Survey in Japan

Japan’s super-aged mortality rate bereaves millions of people annually, threatening the mental health of the bereaved population. Previous research suggests that participation in satisfying funeral rituals can protect or improve the health of a bereaved population—but pandemic restrictions threaten traditional funeral assemblies. To determine how bereaved mourners’ mental health—and consequent dependence upon medical, pharmaceutical, or social services—are affected by funerals and the aspects of funerals most likely to cause satisfaction or dissatisfaction, we conducted an anonymous nationwide survey across Japan. In total, 1078 bereaved Japanese responded; we analyzed their responses by comparing the 106 citing funeral dissatisfaction with the 972 citing no dissatisfaction. The cohort showing greatest satisfaction with funerals tended to be older widows or parents who lost children; they showed greater grief but spent less on medical, pharmaceutical, or social services thereafter than the dissatisfied. Conversely, mourners with the greatest dissatisfaction toward their interactions with funeral directors and Buddhist priests tended to spend more on medical, pharmaceutical, or social services after bereavement. We conclude that training or education to improve priests’ and funeral directors’ interactions may reduce dissatisfaction with funerals, potentially reducing subsequent costs of medical, pharmaceutical, or social services for the rapidly growing population of bereaved Japanese.

Re-Feminizing Death: Gender, Spirituality and Death Care in the Anthropocene

Critiques of ecologically harmful human activity in the Anthropocene extend beyond life and livelihoods to practices of dying, death, and the disposal of bodies. For members of the diffuse ‘New Death Movement’ operating in the post-secular West today, such environmental externalities are symptomatic of a broader failure of modern death care, what we refer to here as the ‘Death Industrial Complex’. According to New Death advocates, in its profit-driven, medicalised, de-ritualized and patriarchal form, modern death care fundamentally distorts humans’ relationship to mortality, and through it, nature. In response, the Movement promotes a (re)new(ed) way of ‘doing death’, one coded as spiritual and feminine, and based on the acceptance of natural cycles of decay and rebirth. In this article, we examine two examples from this Movement that demonstrate how the relationship between death, religion, and gender is re-configured in the Anthropocene: the rise of death doulas as alternates to funeral directors and the invention of new necro-technologies designed to transform the dead into trees. We ask how gender is positioned within the attempt to remake death care, and show how, for adherents of the New Death Movement, gender is fundamental both to a critique of the Death Industrial Complex and to mending our distorted relationship to death. By weaving together women, nature, and spirituality, the caring labours of death doulas and the fertility symbolism of new arboreal necro-technologies build an alternative model of a good death in the Anthropocene, one premised on its (re)feminization.

‘Don’t forget the children’: a qualitative study when a parent is at end of life from cancer

Purpose Preparation for end of life is one of the greatest challenges faced by parents with cancer who have dependent children (< 18 years old), with requirement for support from professionals. The aim of this study is to explore how parents can be best supported in relation to their children, when a parent is at end of life from cancer. Methods This is an interpretive qualitative study, using 79 semi-structured interviews with parents at end of life (n3), bereaved parents (n21), health and social care professionals (HSCPs) (n32) and funeral directors (n23). Data were analysed thematically and triangulated. Results Parents are central to preparing their children for the death of a parent. Striving for everyday ordinariness, maximising social networks, maintaining hope and making preparations for the future are helpful for families when a parent is at end of life. Most HSCPs were unaware of the challenges faced by parents at end of life, and psychosocial support was often left outside the caring realm. As a result, funeral directors noted complexities faced by the families after the death. Results are discussed under four themes: (1) communication with the children as a process, (2) coping throughout the unfolding end of life experience, (3) tension and complexities at end of life and (4) preparing for the future. Conclusions Parents should be reassured that by involving the children early in the end of life experience when the ill-parent is ‘well enough’ to parent enables them to be actively involved in supporting their child through one of the greatest life changing event. A number of recommendations are discussed for professionals.

Challenges and Opportunities of Providing Pediatric Funeral Services: A National Survey of Funeral Professionals

Background: Funeral professionals offer a unique opportunity to support, educate, and advocate for grieving families after the death of a child. From the initial point of contact to the burial, funeral professionals shape the final moments and memories of a family and a community. And yet, little is known about the needs of funeral professionals to provide high quality services when a child dies. Objectives: To conduct a needs assessment among funeral professionals in conducting funeral services for children. Methods: Active National Funeral Directors Association members were surveyed on their experience and needs in providing pediatric funeral services. The survey contained 41 questions about experience, skills, and knowledge in providing pediatric funerals. The survey included multiple choice, yes/no, and open-ended questions. Descriptive statistics were generated from the survey items and comments/open-ended questions were coded and assessed for themes. Results: More than 200 responses were received. The respondents conducted 43 pediatric funeral services in a 5-year period (approx. 8 services/year). The top 5 self-identified training needs included grieving parents, grieving siblings, memorials, comforting the community, and outreach. Themes from the open-ended questions were (a) maintaining professionalism, (b) managing emotions and experiences, (c) assessing family dynamics, (d) managing professional skills, and (e) building collaborative networks. Conclusions: Specific training needs were identified that will inform the development of targeted training for funeral professionals to improve their skills and knowledge of pediatric funeral services.

‘Don’t Forget the Children’: A Qualitative Study When a Parent Is at End of Life From Cancer

Purpose: Preparation for end of life is one of the greatest challenges faced by parents with cancer who have dependent children (<18 years old); with requirement for support from professionals. This aim of this study is to explore how parents can be best supported in relation to their children, when a parent is at end of life from cancer. Methods: An interpretive qualitative study, using 79 semi-structured interviews with parents at end of life (n3), bereaved parents (n21), health and social care professionals (HSCPs), (n32) and funeral directors (n23) Data were analysed thematically and triangulated.Results: Parents are central to preparing their children for the death of a parent. Striving for everyday ordinariness, maximising social networks, maintaining hope, and making preparations for the future are helpful for families when a parent is at end of life. Most HSCPs were unaware of the challenges faced by parents at end of life, and psychosocial support was often left outside the caring realm. As a result, funeral directors noted complexities faced by the families after the death. Results are discussed under four themes: (1) communication with the children as a process, (2) coping throughout the unfolding end of life experience, (3) tension and complexities at end of life, and (4) preparing for the future.Conclusions: Parents should be reassured that by involving the children early in the end of life experience when the ill-parent is ‘well enough’ to parent, enables them to be actively involved in supporting their child through one of the greatest life changing event. A number of recommendations are discussed for professionals.

Compassion fatigue of funeral directors during and after the first wave of COVID-19

Background Compassion fatigue has not been studied among funeral directors. Yet, funeral directors have been exposed to the same risks for compassion fatigue as other caregivers during the coronavirus disease 2019 (COVID-19) pandemic. Methods An online survey was spread two times to 287 employees of funeral home DELA, in Belgium. Once during the height of the first wave of COVID-19 in Belgium, and a second time at the end of the first wave. The professional quality of life-scale 5 (PROQOL-5) was used to measure compassion fatigue, which includes burnout, compassion satisfaction and secondary trauma. Non-parametric tests were performed. Results In total, 104 participants answered the first survey, and 107 the second. Burnout increases from survey 1 to survey 2 (P &lt; 0.001), while compassion satisfaction (P = 0.011) and secondary trauma decrease (P &lt; 0.001). In survey 1, only age (P = 0.007) and gender (P = 0.040) were found to be significantly associated with secondary trauma. In survey 2, having more work experience is associated with having a higher burnout (P = 0.008) and secondary trauma (P = 0.001) score. Neither for burnout (P &lt; 0.001), nor for secondary trauma (P &lt; 0.001) are there any respondents in the highest category. Conclusions Although overall funeral directors do not have acute problems with compassion fatigue, burnout scores increase significantly after the first wave.