Ornstein’s team (2105, 2019) found more depressive
symptoms, entailing higher use of pharmaceuticals
among the bereaved, like similar studies showing
higher medical care costs among the bereaved
(Rolden et al, 2014), more recently confirmed by Lei
et al. (2022). So bereavement is not just personal
private sadness; it affects national productivity and
public health systems – yet economic analyses and
countermeasures remain rare.
Funerals can reduce bereavement costs
Kraeer (1981) found 34% of bereaved who held little
or no funeral faced grief complications, compared to
only 12% who held full funeral services. Wilson (2009)
found that inviting many friends and neighbors to
home funerals raised community awareness of the
needs and situations of the bereaved, and greatly
benefited those experiencing disenfranchised grief.
Funerals provide the community support that protects
mourners from suffering complicated bereavement
(Braz & Franco, 2017). Claims that “small funerals do
not affect bereaved health” focus on satisfied healthy
respondents, but we need to examine effects of
funerals on the more troubled sick and dissatisfied
grievers.
The All-Japan Bereavement
and Funeral Survey
The All-Japan Funeral Directors Co-Operation®
distributed questionnaires to recently bereaved
families who returned them anonymously to Kyoto
University using post-paid envelopes. We received not
only 1400 numerical responses for statistical analysis,
but also more than 300 handwritten comments.
We shall explain our full findings in our Krakow
presentation.
Statistics find rising medical
and pharmaceutical costs
Our survey documented continuing grievers’ ongoing
reliance on medical and welfare support. Their grief
was not merely emotional, but involved sleep-inducing
drugs and antidepressants with potential dependency
and rebound. More than 11% of Japanese bereaved
reported increased use of medical, pharmacological,
and/or financial services: most prominently for
bereaved in their ‘50’s, and for unemployed widows.
The Japanese most likely to suffer ongoing grief
were elders living alone, emotionally close to the
deceased. Their monthly medical expenses rose by
about 6000 yen per month over the second year after
bereavement. Originally high but declining household
income also correlated with higher post-bereavement
medical and pharmaceutical use, as did funeral
dissatisfaction.
Responses find Funeral Dissatisfaction predicts
problematic grief. While a satisfying funeral cannot
guarantee the health of the bereaved, funeral
dissatisfaction strongly predicted heavy grief correlating
with medical and psychological problems. Bereaved
who desire but cannot receive sufficient psycho-social
support through funeral gatherings are at higher
risk for subsequent psycho-physical problems. (One
respondent wrote that he would have suicided without
the emotional support of the funeral director!)
Then we examined anonymized survey responses
describing what aspects of funerals caused greatest
anxiety to bereaved Japanese, affecting medical/
welfare costs for the entire society. The greatest
funeral disappointment appeared in (1) attendance
(having invited too few people), (2) poor connection to
friends and relations, (3) psychological effects of the
cremation, (4) inadequate itemization or explanation
of funeral costs, and (5) botched rituals. When lacking,
insufficient, or ill-handled, these leave long-standing
bad memories and dissatisfaction that aggravate
mourners’ psychological and physical ailments,
costing society as a whole.
The All-Japan survey suggests that funeral directors’
sensitivity to such issues can mitigate funeral
dissatisfaction, and so contribute to the national
economy, health and social welfare.
Carl Becker,
PhD., D.Psych. Kyoto University School
of Medicine, Japan
THANOS MAGAZINE | No. 107 – AUTUMN 2024
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