The good funeral: toward an understanding of funeral participation and satisfaction

Together, alone: Personal experiences of virtual funeral attendance during the COVID-19 global pandemic

The COVID-19 pandemic caused profound distortions in how deaths were marked by those left to mourn their passing. Public health restrictions prohibited gatherings of friends and families for traditional funerals, causing an upsurge in reliance on virtual alternatives. The aim of this study was to explore the experiences of individuals attending virtual funerals following a death of any cause, including reasons for choosing virtual attendance, perceived differences relative to in person attendance, and the extent to which mourning practices were accommodated. Between May 2021 and June 2022, we identified 57 participants with virtual funeral attendance experience. They identified many shortcomings of virtual funerals, captured under themes including, socialization, community support, sharing food, physical contact, consoling the bereaved, sharing memories, and connection. There were features of virtual funerals that participants appreciated, summarized by themes including, accessibility, taking part or marking the event, closure, technological advantages and privacy. Despite a sense that virtual funerals provided an opportunity to grieve "together, alone," most conceded it was better than not being able to take part at all. This study provides detailed information about participating in virtual funerals, identifying features of this experience that should be examined to determine how those may influence grieving processes and bereavement outcomes.

Death rituals and quality of life of bereaved relatives during the COVID-19 pandemic: Results of the observational CO-LIVE study

Grief is a normal reaction after the death of a loved one. Death rituals are an integral part of the mourning processes. Not being able to carry out death rituals can affect relatives' quality of life. The aim was to evaluate death rituals during COVID-19 and their association with relatives' quality of life. In a Swedish nation-wide study relatives to persons who died during the COVID-19-pandemic received questionnaires about their quality of life and how they could perform death rituals. Association between quality of life and death rituals was analyzed with linear regression. Of the 324 relatives, a minority indicated that their loved one's funeral (17%) met their wishes. Not being able to carry out the funeral as desired was significantly associated with a lower quality of life (p = 0.006). The experiences during the pandemic revealed that it is important for people to perform death rituals according to their wishes.

Death From COVID-19, Muslim Death Rituals and Disenfranchised Grief - A Patient-Centered Care Perspective

In Islam, religious directives regarding death are derived from the Quran and Islamic tradition, but there is a variety of death rituals and practices, lived by Muslims across contexts and geographies. This narrative study explored the dynamics of death and bereavement resulting from COVID-19 death among religious Muslims in Israel. Narrative interviews were conducted with 32 religious Muslims ages 73-85. Findings suggest several absent death rituals in COVID-19 deaths (i.e., the physical and spiritual purification of the body, the shrouding of the body, the funeral, and the will). Theoretically, this study linked death from COVID-19 with patient-centered care, highlighting disenfranchised grief due to the clash of health authority guidelines with religious death practices. Methodologically, this narrative study voices the perspectives of elder religious Muslims in Israel. Practically, this study suggests ways to implement the cultural perspective in COVID-19 deaths and enable a healthy bereavement process.

Impact of the COVID-19 Pandemic on Funerals: Experiences of Participants in the 2020 Dying2Learn Massive Open Online Course

A Massive-Open-Online-Course (MOOC) on death and dying (Dying2Learn) was offered in 2020, designed to build conversations about death as a natural part of life. In week 1, the content focused on how today's society engages with death through the language we use, humour, public mourning and funerals. This study investigated 2020 MOOC participants' responses to an online activity reflecting on funerals and memorials during the time of COVID-19. From this activity, n = 204 responses were analysed qualitatively. Themes included the positives and negatives of virtual funeral attendance (e.g. opportunity to have a way to participate when travel barriers existed, versus a sense of impersonal voyeurism); and the challenges related to the inability to physically comfort the bereaved due to physical distancing requirements. Comments made as part of this MOOC activity provide a unique insight into the community's experience of funeral changes necessitated by COVID-19, with important implications for the grieving process.

Experiences of grief and mourning practices of Greek bereaved adults during the pandemic: A qualitative approach

This pilot study aims to explore the experiences of grief and mourning practices of bereaved adults during the pandemic. Eleven adults who have lost a loved one since March 2020 participated in a semi-structured interview exploring the experiences of grief and mourning. Data were analyzed through Thematic Analysis. Participants experienced contrasting psycho-emotional reactions to loss, and they highlighted the restriction of being physically present to the dying loved one as the hardest aspect of losing someone during COVID-19. Moreover, they identified challenging factors during the funeral practices: the small number of mourners during ceremonies, abstinence from hugging and touching each other as a form of consolation, and wearing masks, which further made the ceremony impersonal. Finally, the alteration of the paying respects process has contributed to the mourners' experienced stress and sorrow. Findings are discussed per the current literature and recommendations based on cultural diversities are proposed.

Exploring the Use of Virtual Funerals during the COVID-19 Pandemic: A Scoping Review

The COVID-19 pandemic and physical distancing limitations have had a profound impact on funeral practices and associated grieving processes. The purpose of the present scoping review is to summarize the existing literature on the emerging use of virtual funerals. Five medical databases, five social science databases, and five grey literature databases were searched, identifying 1,351 titles and abstracts, of which 62 met inclusion criteria. Four themes, each with various subthemes emerged: (a) Impact of virtual funerals on coping with death; (b) Impact of the COVID-19 pandemic on the funeral industry; (c) Benefits and disadvantages of virtual funerals; and (d) Future implications for health and social work practitioners. Virtual funerals are an evolving resource for individuals, families, and communities to mourn in response to the interruptions to traditional grieving practices due to the COVID-19 pandemic.

Post-death burial and funeral practices in rural Alberta

BACKGROUND

Burial and funeral practices are important customary mortuary rituals, especially in rural areas as people are likely to have different values and interests than people who live in larger cities. However, little is known about rural post-death practices in Canada.

AIMS

This review gathered information on funeral and burial practices in rural Alberta, a western Canadian province with a diverse rural population.

METHODS

A literature review of community print sources, including obituaries and funeral home websites, was conducted for select representative rural communities.

FINDINGS

This review found that cremations outnumber burials, and mortuary ceremonies more commonly occur in non-religious settings. Furthermore, personalised post-death rituals were identified as highly significant to rural people as they allow the dead to remain connected to their rural land, family and community.

CONCLUSION

It is important to understand rural mortuary rituals to help prepare dying rural people and their families.

Disembodied ritual: An explorative study on the meanings of physical absence during funerals by bereaved in times of COVID-19

Death is accompanied by rituals in every culture. It seems universal that we symbolically approach this life transition. This study focuses on experiences of bereaved who could not physically attend a funeral during COVID-19. Ten Dutch bereaved were interviewed. Disembodiment in terms of (1) not participating in ritual time and place, (2) experiencing live-stream funerals as lonely, and (3) feeling a disruption of one's grief, were revealed as main themes by thematic analysis. Without physical participation the respondents felt (partially) disconnected from the ritual and isolated from the community. The physical absence impacted ritual transformation and meaning making after a loss.

Last Honors and Life Experiences of Bereaved Families in the Context of COVID-19 in Kashmir: A Qualitative Inquiry About Exclusion, Family Trauma, and Other Issues

This study examined the changing character of the last honours of those who died of COVID-19 in Kashmir and the life experiences of the families of the deceased. A semi-structured interview schedule was used to collect information from 21 participants. Using qualitative data analysis approaches, five key themes were identified vis-à-vis the impact of COVID-19 on burial rituals and customs; effects on bereaved families, shades of grief, bereavement care, community response, and coping with loss. Based on examining the pandemic-induced changes related to customs and rituals around death, the study found that the bereaved family members were in danger of marginalization, economic burdens, psychological traumas, and overall reduced quality of life. This study would be a credible addition to the existing literature on death practices as there is a shortage of research on funeral rituals during the post-pandemic period in Kashmir.

Living in a Limbo: A Sociological Study of Missing Funerals, Death Rituals, and Complicated Grief in COVID-19

In the early months of the COVID-19 pandemic in India, due to strict lockdown, the family members of the victims of COVID-19 had to witness the dying and death of their relatives in solitude, improper funerals, and the absence of death rituals. After in-depth interviews with twelve relatives of seven deceased patients conducted more than a year after experiencing those deaths of loved ones, it was found that most of them had been struggling with long-term complicated grief without a sense of resolution. As funerals and death rituals, following the work of Van Gennep in his ‘Rites of Passage’, ensure the transition of grievers from a preliminal state by preparing for the imminent loss to a postliminal renovated stable state by reabsorbing them into the collective social and cultural conditions, the absence of that compels the mourners to get stuck in a liminal state, or limbo.

Using Family Narrative Reports to Identify Practices for Improving End-of-Life Care Quality

CONTEXT

Patient experiences should be considered by healthcare systems when implementing care practices to improve quality of end-of-life care. Families and caregivers of recent in-patient decedents may be best positioned to recommend practices for quality improvement.

OBJECTIVES

To identify actionable practices that bereaved families highlight as contributing to high quality end-of-life care.

METHODS

We conducted qualitative content analysis of narrative responses to the Bereaved Family Surveys Veterans Health Administration inpatient decedents. Out of 5964 completed surveys in 2017, 4604 (77%) contained at least one word in response to the open-ended questions. For feasibility, 1500/4604 responses were randomly selected for analysis. An additional 300 randomly selected responses were analyzed to confirm saturation.

RESULTS

Over 23% percent (355/1500) of the initially analyzed narrative responses contained actionable practices. By synthesizing narrative responses to the BFS in a national healthcare system, we identified 98 actionable practices reported by the bereaved families that have potential for implementation in QI efforts. Specifically, we identified 67 end-of-life practices and 31 practices in patient-centered care domains of physical environment, food, staffing, coordination, technology and transportation. The 67 cluster into domains including respectful care and communication, emotional and spiritual support, death benefits, symptom management. Sorting these practices by target levels for organizational change illuminated opportunities for implementation.

CONCLUSION

Narrative responses from bereaved family members can yield approaches for systematic quality improvement. These approaches can serve as a menu in diverse contexts looking for approaches to improve patient quality of death in in-patient settings.

Evaluations of Funerals and Health Trajectories in the Second Year After Bereavement-The Ongoing Japan National Survey

Our nationwide postal survey analyzing 190 responses from Japanese bereaved who had responded a year earlier found that funeral dissatisfaction rose during the second year after the funeral. Controverting previous research advocating participation in funeral planning, elderly bereaved spouses forced to decide about and/or pay for the funeral showed elevated grief as much as 2 years later. While not reaching levels diagnosed as prolonged, traumatic, or complicated grief, nevertheless one out of three of our bereaved sample showed continuing daily symptoms of grief from 14 to 24 months after their bereavement, with continued or increasing use of tranquillizers or antidepressants. The medical and pharmaceutical costs incurred by mourners more than a year after bereavement warrant further research into what factors improve or exacerbate the health of grieving bereaved, not limited to a single year after the bereavement.

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.

Findings the graves: SLED Family Reunification Program: SLED Family Reunification Program

In 2015, the Sierra Leone Ministry of Health and Sanitation (MoHS) and the Centers for Disease Control and Prevention (CDC) agreed to consolidate data recorded by MoHS and international partners during the Ebola epidemic and create the Sierra Leone Ebola Database (SLED). The primary objectives were helping families to identify the location of graves of their loved ones who died from any cause at the time of the Ebola epidemic and creating a data source for epidemiological research. The Family Reunification Program fulfils the first SLED objective. The purpose of this paper is to describe the Family Reunification Program (Program) development, functioning and results. The MoHS, CDC, SLED Team, and Concern Worldwide developed, tested, and implemented methodology and tools to conduct the Program. Family liaisons were trained in protection of the personally identifiable information. The SLED Family Reunification Program allows families in Sierra Leone, who did not know the final resting place of their loved ones, to be reunited with their graves and to bring them relief and closure. Continuing family requests in search of the burial place of loved ones five years after the end of the epidemic shows that the emotional burden of losing a family member and not knowing the place of burial does not diminish with time. As of February 2021, the Program continues and is described to allow its replication for other emergency events including COVID-19 and new Ebola outbreaks.

Understanding Grief During the First-Wave of COVID-19 in the United Kingdom-A Hypothetical Approach to Challenges and Support

Purpose: This article develops immediate understandings of loss and grief at both an individual and collective level following the first-wave of COVID-19 in the UK. This allows for insights into the likely challenges and support for loss and grief in facing unprecedented disruption and uncertainty. Ultimately, it explores avenues for the priorities to inform better bereavement support. Methods: By examining trusted media data and carefully selected academic literature, we analyse both individual and societal responses to loss and grief in the novel context of the first-wave of COVID-19 in the UK. The discussion relocates the ideas of good and bad deaths in the context of increased social constrains and inequalities. Further, two pairs of contrasting hypotheses are proposed to examine how the UK's first-wave outbreak has shaped policy and practical structures and how these have further impacted experiences of loss and grief both at an individual and collective level. Findings: The discussion captures a mixed picture of loss and grief in the UK, which highlights the importance of timely, holistic, and continuous support both in social policy and care provision. It is found that individuals and collectives express diverse needs in response to deaths and losses as a process of meaning-making. Further, the significance of socio-cultural environments also become evident. These findings highlight community support during the outbreak and further promote a grief literate culture as imperative to support individual and collective needs when confronted with loss and grief. Conclusion: This article provides a timely and comprehensive account of possible challenges and support both for individual and collective experiences of loss and grief at a time of unprecedented social restrictions and mass deaths in the UK. These understandings provide a base from which we advocate the priorities for future research into the ongoing impacts of COVID-19 on grief and bereavement.

How do Funeral Practices Impact Bereaved Relatives' Mental Health, Grief and Bereavement? A Mixed Methods Review with Implications for COVID-19

Those who are bereaved during the current COVID-19 pandemic are subject to restrictions on funeral sizes and practices. We conducted a rapid review synthesising the quantitative and qualitative evidence regarding the effect of funeral practices on bereaved relatives’ mental health and bereavement outcomes. Searches of MEDLINE, PsycINFO, KSR Evidence, and COVID-related resources were conducted. 805 records were screened; 17 studies of variable quality were included. Current evidence regarding the effect of funeral practices on bereaved relatives’ mental health and bereavement outcomes is inconclusive. Five observational studies found benefits from funeral participation while six did not. However, qualitative research provides additional insight: the benefit of after-death rituals including funerals depends on the ability of the bereaved to shape those rituals and say goodbye in a way which is meaningful for them. Findings highlight the important role of funeral officiants during the pandemic. Research is needed to better understand the experiences and sequalae of grief and bereavement during COVID-19.

Cremation and Grief: Are Ways of Commemorating the Dead Related to Adjustment Over Time?

Funeral services are known to serve multiple functions for bereaved persons. There is also a common, intuitively reasonable assumption of positive associations between engaging in funeral activities and adjustment to bereavement. We examined whether restricting ceremonial cremation arrangements to a minimum has a negative association with grief over time. Bereaved persons in the United Kingdom completed questionnaires 2 to 5 months postloss and again a year later (N = 233 with complete data; dropout = 11.4%). Neither type nor elaborateness of the cremation service, nor satisfaction with arrangements (typically high), emerged as significantly related to grief; no major subgroup differences (e.g., according to income level) were found. Results suggested that it does not matter to grief whether a more minimalistic or elaborate funeral ceremony was observed. We concluded that the funeral industry represented in this investigation is offering bereaved people the range of choices regarding cremation arrangements to meet their needs. Limits to generalizability are discussed.

Facilitating grief: An exploration of the function of funerals and rituals in relation to grief reactions

The loss of a loved one through death is usually followed by a funeral and engagement in various grief rituals. We examined the association between the evaluation of the funeral, the use of grief rituals and grief reactions. Bereaved individuals from the Netherlands completed questionnaires, six months and three years post-loss (n = 552/289). Although the funeral and rituals were considered helpful, no significant association between evaluation of the funeral and usage of grief rituals and grief reactions was found. More insight in the engagement in rituals will ultimately serve bereaved individuals to cope with loss.

Funeral and interment practices of rural residents: A mixed methods study

There are few studies on interment preferences and practices for people in remote and rural regions of developed countries. This mixed methods study in rural Australia collated data on funeral and interment practices with an ethnographic exploration of the post-death preferences of terminally-ill rural residents. In the region, between February 2015 and May 2016, 44% of decedents were cremated. Burial preferences reflected family traditions, generational connections to historic cemeteries, and the wish to instantiate belonging to people and place. Cremation provided the opportunity for ashes to be scattered at personally-significant places. Funeral planning was important for patients and family caregivers, and funerals are valued rural community rituals.

Managing the consumption of death and digital media: The funeral director as market intermediary

A growing number of companies are offering digital products and services for use in funerals. Drawing on interdisciplinary research in Australia, the United Kingdom and the United States, we explore how funeral directors operate as intermediaries for these digital products and services. We critically examine the popular framing of the funeral industry as a "conservative" business and examine how funeral directors actively mediate between their clients and the companies offering innovative products and services. This study provides an account of current developments in the funeral economy as well as a broader narrative about how funeral industry professionals have engaged with technology.

How Funerals Accomplish Family: Findings From a Mass-Observation Study

The article analyses how potentially conflicting frames of grief and family operate in a number of English funerals. The data come from the 2010 Mass-Observation directive “Going to Funerals” which asked its panel of correspondents to write about the most recent funeral they had attended. In their writings, grief is displayed through conventional understandings of family. Drawing on Randall Collins, we show how the funeral stratifies mourners into family or nonfamily, a stratification accomplished—by family and nonfamily—through both outward display and inner feeling. The funerals described were more about a very traditional notion of family than about grief; family trumped grief, or at least provided the frame through which grief could be written about; and perceptions of “family” prompted emotions which in turn defined family. The funerals were portrayed as a distinct arena privileging family over the fluid and varied personal attachments highlighted in both the new sociology of personal life and in the concept of disenfranchised grief.

Is there a role for the funeral service provider in bereavement support within the context of compassionate communities?

This is the first study to explore bereaved individuals' experiences of funeral service providers using these services' databases. A total of 839 Australians participated in a postal survey, 6-24 months into their bereavement. Funeral providers were reported to be the third most prevalent form of bereavement support after friends and family. Analysis found six themes related to perceived helpful or unhelpful support: instrumental support, professionalism, informational support, financial tension, communication, and emotional support. Funeral providers could improve their support by adopting a proactive approach to bereavement needs and offering personalized and ongoing support. We develop these suggestions by exploring their potential contributions to building community capacity around death, dying and bereavement.

Family and funerals: Taking a relational perspective

This article explores a number of relational features of a contemporary funeral: content, participation, and commercial choice. In so doing, it uses Finch and Mason's concept of reflexive relationalism to show that the contemporary funeral is an event when familial relationships can be (re)affirmed and rejected. This "doing" of family has methodological implications for the future study of funerals and, it is argued here, this necessarily requires the inclusion of class culture.

Funerals and families: locating death as a relational issue

Situated at the intersection of the Sociology of Death and Sociology of the Family, this paper argues that the organization and funding of funerals is an overlooked and available lens through which to examine cultural and political norms of familial obligation. Drawing on interviews with claimants to the Department for Work and Pensions' Social Fund Funeral Payment, the paper shows how both responsibility for the organization and payment of a funeral is assumed within families, and how at times this can be overridden by the state. In highlighting the tension between reflexive choice and political norms of family espoused in this policy context, it supports Gilding's () assertion that understanding family practice through reflexivity alone neglects the institutions and conventions within which 'doing' family takes place. In so doing, the paper further makes a case for families and relational negotiations and tensions to be more explicitly included within sociological understanding(s) of death more generally.

Funerals against death

While anthropological studies in non-Western societies show how funerals protect the community from the threat of death, sociological studies of British funerals have so far focused on meanings for the private family. The article reports on results from a Mass Observation directive – the first British study to focus specifically on the entire funeral congregation – and shows how attendees experience the contemporary life-centred funeral as a symbolic conquest of death. While the eulogy’s accuracy is important, even more so – at least for some – is its authenticity, namely that the speaker has personal knowledge of the deceased. Whereas Davies analyses the power of professionally delivered ritual words against death, our data reveals how admired is the courage exercised by non-professionals in speaking against death, however faltering their words. Further, the very presence of a congregation whose members have known the deceased in diverse ways embodies a configurational eulogy, which we term relationships against death. We thus argue that funerals symbolically conquer death not only through words delivered by ritual specialists, but also through those who knew the deceased congregating and speaking.