Abstract
The aim of this study was to provide a better understanding of current memorialization practices and their influence on grief due to bereavement and to explore ways of improving bereavement outcomes. The qualitative research design incorporated two phases, a scoping literature review, followed by in-depth interviews with eight service providers from the funeral, cemetery, and crematorium industries across Australia. The trend toward informal memorialization practices blurs the roles of community members and formal industry service providers. A public health approach to bereavement support that encompasses both groups is recommended as the most appropriate response to the evolving landscape. This approach focuses on building partnerships between industry service providers and other community organizations involved in end-of-life issues. We propose that reframing the role of formal industry service providers as educators and facilitators partnered within compassionate communities will support improved outcomes for the bereaved.
Introduction
Over the past 40 years, the lack of public attention to bereavement has given way to numerous published accounts of individual loss, the formation of bereavement support groups, and the provision and accreditation of specialized grief counseling (Walter, 1999). These well-documented initiatives have been accompanied by significant changes to the way funerals are conducted, where funeral services are held, and in who conducts and participates in those services (Beard & Burger, 2017). Further, there have been significant changes to the disposal of remains, with cemeteries used less and other public or private spaces used more (van der Laan & Moerman, 2017). Memorial practices have thus changed as memorials are found not only in cemeteries but also marking the places where ashes may have been scattered or mourners prefer to remember their dead (Clark & Franzmann, 2006; Hockey, Kellaher, & Prendergast, 2007). Increasingly, memorials are created in virtual, as well as, or instead of, physical space (Gibson, 2011).
Changes to ritual practice and memorialization have received less attention than have implications of bereavement for mental health and emotional support. Nor have the connections between memorialization and social and therapeutic developments been adequately explored. We report here on a project commissioned by the Australasian Cemeteries and Crematoria Association (ACCA) that, having observed the changes in their sector, became interested both in implications for the services they provide and the effect upon the people they serve.
One specific concern ACCA expressed was whether this reduction in public expression of grief through memorialization is having an adverse impact on mourners’ capacity to respond to loss, and thus cumulatively upon societal well-being. ACCA asked our research team to focus on memorialization and its effect upon grief and bereavement, recognizing that changes to memorialization may be the best indicator of changes taking place in their sector overall.
In addition to exploring this specific concern, studying memorialization and grief allows reflection on the changing role of funeral service providers, cemeteries, and crematoria beyond their function in the legal disposal of human remains. Gaining insight into the social, psychological, and philosophical roles of cemeteries and crematoria should enable the industry to adapt and meaningfully meet the future needs of the bereaved. It is worth noting that work recently conducted by our research team in Australia shows that the majority of bereaved participants who engaged with a funeral provider would have appreciated further support to understand the postfuneral bereavement care resources available within their community (Aoun et al., 2015). This prompted us to investigate further the ongoing role of funeral service providers in memorialization and bereavement support (Aoun, Lowe, Christian, & Rumbold, 2018).
Despite current shifts from traditional forms of memorialization toward increasingly personalized and private forms (Schafer, 2016), the human need to memorialize seems unchanged, and traditional providers are expected to contribute to meeting this need (Hunter, 2008). Developing new forms or practices that do so in a meaningful way is the current challenge before the industry.
Objectives
The aim of this study is to better understand the influence of memorialization on bereavement so that cemeteries, crematoria, and the funeral industry can provide improved services and achieve better outcomes when discussing memorialization with bereaved families. There are four objectives: Establish the importance of traditions, rituals, ceremonies, and cemeteries to the grieving process; Explore the possible connections between the grieving process and the presence or absence of a physical memorial, either within or outside a formal cemetery setting; Ascertain whether memorialization assists with adjusting to grief due to bereavement; and Explore the possibility that increased access to grief counseling may have contributed to the decline in public memorialization.
Methodology
The qualitative research design incorporated two phases, a scoping literature review, followed by in-depth interviews with eight service providers from the funeral, cemetery, and crematorium industries across Australia. Ethics approval was granted by La Trobe University Research Ethics Committee (HEC18131; Lowe, Rumbold, & Aoun, 2019).
Scoping Literature Review
A scoping literature review is particularly useful where an area of research is complex and has not previously been reviewed comprehensively, as is the case with memorialization (Arksey & O’Malley, 2005; Mays, Roberts, & Popay, 2001; Wilson, Lavis, & Guta, 2012).
Search strategy
The scoping review undertook a thorough search of academic literature, industry reports, and mainstream media, focusing on studies linking grief and bereavement with memorialization practices. Databases used in searching for academic publications included CINAHL Plus, MEDLINE, EMBASE, Scopus, PsycINFO, ScienceDirect, Web of Science, Sociological Abstracts, Anthropology Online, and Anthropology Plus.
Search terms
Search terms included grief, bereavement, loss, funerals, cemeteries, crematoria, anticipatory grief, prolonged grief, memorialization, memorials, ceremonies, memorial plaques, headstones, and mourning. Because of the scarcity of studies linking grief and bereavement with memorialization practices, hand-searches were conducted using various combinations of search terms: for example, “memorialization” and “grief” or “memorialization” and “bereavement” or “memorial” and “cemetery.”
Inclusion criteria
We searched for studies published in English, from the year 2000 onward, to ensure that evidence was timely and relevant. Four searches were conducted, two focusing on academic research, yielding 51 relevant articles and two on industry and mainstream media resources, yielding 43 relevant articles. These 94 references were analyzed thematically, paying particular attention to memorialization trends. The search process, while rigorous, was also iterative, allowing for the inclusion of unexpected sources of relevant information (Wilson et al., 2012). Seminal articles were traced using the reference lists from more recently published works to ensure threads pertaining to memorialization remained intact. Thus, articles published prior to 2000 were included where pertinent. The fifth and final search identified 116 additional sources, a total of 210 references for inclusion.
Interviews With Service Providers
Sampling strategy
Invitations to participate in this research were extended exclusively to industry members of the ACCA, constituting a purposive sampling strategy. The invitation was extended by ACCA via e-mail. Eight industry members expressed their interest, and their details were passed on to the research team, who contacted members via phone and e-mail to provide further information about the study and confirm consent.
Data collection and analysis
Eight semistructured in-depth telephone interviews were conducted in August–September 2018, with interviews ranging in length between 35 and 80 minutes, average duration of 60 minutes. Interviews were audio-recorded with the written or verbal consent of the participants. The interview protocol was based on the research objectives and preliminary findings from the literature review. Interview recordings were transcribed and coded by the research team for thematic analysis. Themes were then compared and contrasted with those that previously emerged in the scoping literature review.
Participant profile
The eight interview participants were drawn from metropolitan and regional areas of four Australian states: New South Wales, Queensland, Western Australia, and Victoria. The majority of participants (six of eight) represented the perspectives of the cemeteries and crematoria industries, while the remainder (two of eight) represented those of the funeral industry. The commercial context in which interview participants operated should be noted, with the minority (two of eight) from a privately owned business and the majority (six of eight) operating under the jurisdiction of local government or trusts.
Findings
The findings are presented as responses to the four research objectives, then in terms of themes emerging in the interviews.
Importance of Traditions, Rituals, Ceremonies, and Cemeteries to the Grieving Process
The rituals around death are transition rituals. They move the deceased person from one space to another—both literally and metaphorically—and effect a change in the social identity of bereaved people that is intended to hold them while their sense of self changes to incorporate their loss (Davies, 1997).
Rituals are embedded in traditions—social, religious, family, and community discourses (Glassock, 2001; Hall, 2001; Lensing, 2001). The intersecting discourses mean that rituals can be effective at several levels: It is not necessary to be religious to gain benefit if connected at a family or community level, for example (Dickinson, 2012; Garces-Foley & Holcomb, 2006; Holloway, Adamson, Argyrou, Draper, & Mariau, 2013; Venbrux, Peelen, & Altena, 2009). However if, again for example, antipathy for religion overrides other connections, or no connections exist in the first place, public ritual will not be effective in inducting bereaved people into their roles as mourners (Gamino, Easterling, Stirman, & Sewell, 2000; Schachter & Finneran, 2013; Vale-Taylor, 2009). A further barrier may be the current trend that encourages the family to be performers at a funeral more than participants in a ritual that engages all the mourners: The funeral can become more an event than an effective ritual (Anderson, 2010). Mourners report feeling anxious about conforming to social expectations and concerned about being scrutinized and judged if their grief is not “normal” or expressed in the “right way” (Breen & O’Connor, 2011; Woodthorpe, 2010, 2011). One implication for the industry is that formal funerals and cemeteries may be avoided or replaced with less daunting alternatives such as a private service or ash disposal outside of the cemetery (Hockey et al., 2007; Kellaher, Hockey, & Prendergast, 2010; van der Laan & Moerman, 2017).
Thus, an effective ritual will move participants from one state to another, and flexibility is needed to meet their differing needs. But it is important not to equate flexibility with merely providing multiple options for elements of the funeral service; innovative details can distract from the overall coherence required by ritual (Wolfelt, 2013).
Public rituals need therefore to engage as many participants as possible at as many levels of connection as are available. A deeply personalized ritual may be quite unhelpful for many others who attend that funeral just as an abstract or unintelligible ritual with which people cannot connect will similarly be unhelpful. Rituals construct space in which transformation can happen (Castle & Phillips, 2003; Corless et al., 2014). If a “ritual” is contrived or managed, it is unlikely to be effective (Glassock, 2001; Ramshaw, 2010).
In this regard, cemetery visits can be particularly helpful as they place personal grief in a social perspective (Francis, Kellaher, & Neophytou, 2000; Maddrell, 2013; Walter, Hourizi, Moncur, & Pitsillides, 2012). Cemeteries are not only repositories of family memories and memorials; they reflect the social history of a suburb or town where they are located (Sabra, Andersen, & Rodil, 2015; Veale, 2004). Continuity with this history needs to be respected while contemporary memorials are added and further traditions from recent migrant communities and other cultural traditions are incorporated.
The Grieving Process and the Presence or Absence of a Physical Memorial
Memorialization as a process is much less studied and documented than that of grief (Holloway, Bailey, & Hukelova, 2017). Grief is not about letting go so much as relocating that person in our social world (Walter, 1996, 1999). The connection between grief and memorialization comes because of the way action in the outer world can catalyze inner change (Fulghum, 1995; Gennep, 1960). For some, the physical memorial in a cemetery is an essential part of locating the person who has died, reuniting them with family and honoring their wishes. Public memorialization facilitates mourning and, in due course, a return to new social roles (Wolfelt, 2016; Worden, 2008). For others, outer world action is focused more about stewardship of objects that have belonged to the person who has died, so that sharing, storing, and dispensing with these possessions mirrors an inner renegotiation of relationship with that person (Curasi, Price, & Arnould, 2004; Price, Arnould, & Folkman Curasi, 2000; Turley & O’Donohoe, 2012; Volkan, 1972). People are increasingly moving toward the merging of physical and digital spaces (Gibson, 2011), with this shift influencing the way cemeteries as “sacred” spaces are conceptualized (Clark & Franzmann, 2006; Gibbs, Meese, Arnold, Nansen, & Carter, 2015). There are clear indications that people are creating their own sacred spaces integrated with their lives, be it a memorial in a favorite park, or their home, or a trip—in effect a pilgrimage—to a holiday spot or public place they once shared with the deceased (Gibson, 2007, 2011; Hockey et al., 2007). Fixed physical memorials may be less attractive due to the increased number of families separated by geographic distance, and this encourages replacing physical interaction with digital connection (Hallam & Hockey, 2001; Mitchell, Stephenson, Cadell, & Macdonald, 2012; Veale, 2004). Memorialization and grief adjustment are thus increasingly managed by individuals and networks of family and friends (Graham, Arnold, Kohn, & Gibbs, 2015). Processes or tasks related to an individual’s mourning and grief do not necessarily require professional intervention or access to formal designated spaces; adjustment in bereavement can take place in the everyday world (Bradbury, 2001; Richardson, 2014; Vale-Taylor, 2009). This is a common shift acknowledged across the industry, by consumers and mainstream media.
The Evidence Whether Memorialization Assists With Adjusting to Grief Due to Bereavement
For those with strong cultural or religious involvement, traditional death-related rituals and memorialization can provide an immediate sense of comfort and familiarity (Hunter, 2008; Wolfelt, 2013). For others lacking this involvement, traditional practices may be perceived as preventing innovation, limiting the introduction of new and potentially more beneficial products and services that could be offered to the bereaved (Nansen, Kohn, Arnold, Van Ryn, & Gibbs, 2017). Evidence suggests a generational shift toward questioning the role and relevance of traditional death practices, whether cultural or religious in nature (Roberts, 2004). Contemporary memorialization provides opportunity for the bereaved to express their grief in diverse ways, adapting memorialization practices while adjusting to significant loss (Bradbury, 2001). Memorialization supports people searching for meaning following loss, offering individuals an opportunity to form their own distinct responses and reimagine their lives without the deceased, while also integrating their memory (Castle & Phillips, 2003; Kellaher et al., 2010). Through memorialization, the past, present and future can merge to form a new understanding of an ongoing relationship with the deceased (Valentine, 2008; Woodthorpe, 2011).
Several key factors influence bereaved individuals’ decision-making about memorials and memorialization practices, including gender, age, culture, religion, relationship to the deceased, and the cause of death (Lowe et al., 2019). Memorialization practices do not lend themselves to a “one size fits all” approach, although there are patterns evident in the literature, such as the use of digital memorialization and peer support groups where types of loss, such as infant loss (Grout & Romanoff, 2000), suicide (Bell, Bailey, & Kennedy, 2015), homicide (Bottomley, Burke, & Neimeyer, 2017), and motor vehicle accidents (Breen, 2006) are considered socially isolating (Mitchell et al., 2012). Where death is unexpected, sudden or violent in nature, memorialization seems to play a more important role in assisting the bereaved to process their loss and the associated feelings of grief (Burke & Neimeyer, 2012; Haney, Leimer, & Lowery, 1997). It is suggested that restoring a sense of control supports adjustment to grief (Norton & Gino, 2014; Ramshaw, 2010). Taking action to commemorate the person can introduce order—control—into what seems a chaotic situation and assist the bereaved in finding some personal meaning in the event (Cacciatore & Flint, 2012; Glassock, 2001; Hall, 2001; Neimeyer, 2001).
Access to Grief Counseling and Effect on Public Memorialization
Some studies suggest that the public rituals that used to give shape to the process of mourning, allowing grief in effect to be supervised by family, friends, and neighbors, have for some been replaced by counseling, where mourning is supervised in private by a therapist (Ramshaw, 2010; Schachter & Finneran, 2013; Vale-Taylor, 2009). However, according to our research team’s work in Australia, less than 30% of bereaved people seek counseling from professional or nonprofessional sources, and many of these for only a brief period, while a much larger proportion, some 80%, affirm the importance of the funeral process (Aoun, Lowe, et al., 2018). Those who seek counseling do so well after the funeral; whether counseling changes their intentions about subsequent forms of public memorialization is not known. On balance, it seems that grief counseling may supplement public memorialization for some but is not an alternative to it.
Grief counsellors make extensive use of what they call “ritual.” Some may indeed be public rituals, designed in the counseling room but played out in the external world, involving family and friends. These rituals complement other public rituals in which mourners may have been engaged, either because the initial funeral rituals were not effective in assisting the transition to the social role of mourner or because a complementary ritual is needed to make a transition returning the mourner to other social roles. Other “rituals” confined to the counseling room are more action-method strategies, ritual-like activities intended to change a person’s inner state, not his or her social role (Ramshaw, 2010).
On balance, the shift toward private memorialization more likely reflects an overall social trend where people want not only choice, but more active collaboration, in the services they use (IBIS World, 2018; van der Laan & Moerman, 2017). Perhaps better or more effective public memorialization may reduce the need for grief counseling: But the drift, or shift, to private memorialization that complements public forms is far more pervasive than this. This trend will not be reversed, and it is counterproductive for service providers to compete to occupy the private space: The point of private ritual is that it is private, controlled by the individuals who enact it, not delivered as someone else’s product. However, if service providers understand better how public and private forms of memorialization complement each other, they will be able to be more intentional about contributing to public forms and supporting private forms. Although there are various forms of public and private practices that constitute memorialization (Lowe et al., 2019), examples and core characteristics are provided in Table 1.
Public and Private Memorialization Practices.
The Experience of Service Providers
Industry accounts reported here focused on how memorialization influences adjustment to grief. Analysis uncovered the themes: Readiness, Resistance, Momentum, Finality, Making Space for Grief, and Sense of Community.
Readiness
Service providers agreed that, unless people were ready to engage in memorialization, it would not influence their adjustment to grief in an effective way and that this state of “readiness” was different for each individual, emotionally and financially I think everybody is different and everybody grieves differently. I find that some families need to take them [cremains] home, they need to have them there, they need to work through that part of their grief and then there’ll be a point in time when they’re just ready. (P4) Some people don’t want to do it because they feel that if they get involved [in making decisions about a memorial] they’ll break down and cry, they don’t want to be seen in tears. I think people don’t want to have negative experiences. People are trying to avoid feeling sad but it’s only when they go through that process, that they actually feel better in the end. (P6)
Resistance
Participants consistently expressed concern for the family and friends of those who explicitly decide that they do not want to be formally memorialized. Service providers reported that when memorialization was resisted in this way it was accompanied by less desirable grief adjustment and an exacerbation of others’ experiences of grief. The loved one says “I don’t want anything” thinking they’re protecting their loved ones from having to go through a difficult process … not understanding that the process is maybe something they need to go through to help them heal. (P4) They’re saying I don’t want to spend any money, cremate me, put me in a cardboard box and spend the money at the pub on a big party … without understanding that people are going to be grieving … you want to actually put some framework around that to support them through that, so sure they can spend the money at the pub but it’s not really going to help them. (P6)
Momentum
The experience of many service providers instilled the idea that the bereaved would move through the grieving process at their own pace, underlining the role of service providers as facilitators. We find a lot of families come back to us, it might be in 12 months, 2 years, 3 years’ time to actually go through that process of creating a memorial. I think it’s something that they realise that they need to do in order to help them to move on. (P4) For some people, that box is still there and they can’t go back to it, so I feel they’re still going through that grieving process. (P3) If they haven’t decided what they want to do, they kind of put mum in the cupboard and think about it later. I think there’s a whole heap of mums and aunties still sitting in the cupboard. (P8)
Finality
Service providers suggested that effective grief adjustment depended on the consumers’ willingness to engage with the process of memorialization and act on their intentions. It’s not so much the memorial itself, it’s going through the process … it seems to help a lot with them to be able to process their grief. And I find families that don’t go through that seem to be at a bit more of a loose end. (P4) Memorialisation is like the final step, they want to draw it out as long as they can, and that happens quite regularly. I’ve got a plaque here a guy ordered, he’s probably had it for two and a half years now, but he won’t put it in the cemetery because he just can’t face that finality. (P7)
Making space for grief
Participants agreed that times are changing, consumers’ preferences are changing, and so those providing places, products, and services to the community must also change. This approach acknowledged the innate need to grieve the loss of a loved one as fundamental to human experience within a changing sociocultural context. We need to create more spaces where people can express themselves in different ways … at the moment, all our spaces have this is how you memorialise in this space … there’s no room for people to have any other form of expression, like in art or any other form of memorialisation other than a plaque. (P5) We’ve got Father’s Day and we’re doing a sausage sizzle because you used to have barbie with Dad. We’re having some classic cars here, ghost tours, historical tours, flower sellers, we’re just doing things differently. We’re not telling people how they are to grieve, but we’re trying to give them something to grieve with. (P1)
Sense of community
Participants described the cemetery as an integral part of the wider community in which it is situated, particularly for those whose loved ones are interred there. They described activities that take place within the cemetery grounds as fostering a sense of community. Previously, if you weren’t buried here you couldn’t put a memorial in our cemetery, now cemeteries are becoming a place of community, so in order for us to facilitate that, we’re opening up different options. (P1) They meet people here, they visit graves, they talk about their loved one that’s in there, it’s quite a big part of their life … there’s a rotunda with tables and chairs, they’ll all meet and have something to eat and they’ll drink their grappa while they’re there as a toast to their loved one, and have a priest there to bless the grave. (P4)
Discussion
It is clear from these findings that the evidence available is rather mixed, or sparse, or both. A significant proportion of the published articles report what might be called niche studies, studies of small groups of particular interest to the researcher. There are almost no studies that attempt to capture a population, or society-wide, perspective. It is difficult to escape the sense that some researchers are drawing wide-ranging conclusions from small, rather selective, samples. What we have tried to do is identify solid evidence where it exists, review contrasting findings and differing interpretations that are being debated, and describe some outlying studies that are relevant to the questions but remain difficult to patch into the picture overall.
Traditions, rituals, and ceremonies continue to be important, but they are used more flexibly, often by drawing upon elements of several traditions. This flexibility extends to the disposal of remains, and cemetery use is declining as ashes are placed in a variety of ways. These trends require greater flexibility in both services offered and service provider responses.
Grieving and memorialization are processes that run in parallel and ideally will intersect such that memorialization will express and facilitate grieving. These intersections are most obvious around physical memorials, but they may also be made in a variety of informal ways; establishing or preserving family customs; sorting, giving away, and retaining possessions; making memorial gifts; and so forth.
There is inconclusive evidence from the literature that memorialization assists with adjusting to grief. This evidence is somewhat skewed because there are no population-wide studies of normal grief and few studies that show memorialization as an integral part of adjustment. Other methodological challenges include studies with small sample sizes, self-selected participants, different bereavement periods used, and various proxy outcome measures such as coping, sense of control, search for meaning, and social connectedness. However, it is clear from accounts of therapy with people where grief has been a problem that ritual expression and forms of memorialization are important in adjusting to grief. As with previous findings, these trends require greater flexibility in both services offered and service provider responses.
There are no studies and therefore no evidence that access to grief counseling has caused a decline in public memorialization, although expanded forms of memorialization and the growth of grief counseling as a profession both express wider social changes that blur the boundary between public and private aspects of life.
Both the literature review and interviews with service providers show a shift from public to private memorialization; but public elements continue to be valued. There is still an important place for formal service providers, but they are having to share the space they formerly dominated with informal “actors” as well. With each generation, the importance of consumer choice seemingly increases, and the long-term effects of this trend on the industry are as yet unclear. Similarly, the technological advancements influencing consumer behavior more broadly on a societal level increase the importance placed on digital forms of memorialization (Brubaker, Hayes, & Dourish, 2013; Gibbs et al., 2015; Graham et al., 2015). The shift toward online memorialization further integrates the deceased into the everyday lives of the bereaved, blurring boundaries previously divided between professional and personal tasks of mourning (Gibbs et al., 2015; Graham et al., 2015). While families and friends are increasingly involved in some aspects of death rituals, such as the use of music, photos, and videos played during ceremonies, other aspects may still require direction (Gibbs et al., 2015; Leaver & Highfield, 2018). As with memorialization, the role to be fulfilled by the service provider will largely be determined by the bereaved individuals’ level of experience with loss, the nature of the loss, and their personal preferences for professional guidance.
The changes outlined earlier are often characterized as the community “reclaiming” death, dying, and bereavement. Increasing and more diverse involvement of community members has led to tension between cemeteries, crematoria, and funeral providers, who used to manage this space. Formerly funeral providers directed clients for cremation or burial, leading to interment and subsequent memorialization in a cemetery. Today funeral providers, responding to clients, open up options that may direct them away from cemeteries, and physical memorials, in particular. It seems to us, from our analysis of the literature, that this tension and competition needs to be redirected toward collaboration with the clients—the community. Just as new patterns for end-of-life care that take into account community contributions are emerging, so are there opportunities for service providers to explore community-based memorialization and bereavement support (Lowe et al., 2019).
There are similarities here with the contest over professional and communal contributions to psychological support in bereavement. The recent proposals of persistent complex bereavement disorder (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) and prolonged grief disorder (International Classification of Diseases 11th Revision) both mark out limited (and slightly incommensurate) territory in which professional intervention should be mandatory (Bonanno & Malgaroli, 2019). But the new diagnoses, particularly Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition’s removal of the bereavement exclusion for major depression (Maj, 2012), opens up a renewed contest about what is normal sadness and what might be considered a treatable mental disorder (Bandini, 2015). With both mental health practitioners and funeral providers, it seems many community members are developing their own ways of limiting the reach of professional interventions.
Professional and communal approaches to care need not however be seen as alternatives. Recent work our research team has undertaken points to the ways in which a “Public Health Model for Bereavement Support” aligned with a “Compassionate Communities” approach to building community capacity around death, dying, and bereavement can develop constructive partnerships between the professional and communal domains (Aoun, Lowe, et al., 2018).
Compassionate Communities
Memorialization is a powerful contributor to community life (Petersson & Wingren, 2011). The cultural life of most towns and cities is based upon memorials, gifts given in memory of a parent, a spouse, a child, or resources devoted to philanthropy. Some are extravagant—a hospital wing, an endowed scholarship—while others are more modest—a plaque on a favorite park bench (Rumbold & Aoun, 2014). “Good grief” is best facilitated when professional services identify, confirm, and support the assets people have for caring for themselves and others (Rumbold & Aoun, 2014), for the most frequently used sources of bereavement support are informal networks of family and friends, followed by funeral service providers (Aoun, Lowe, et al., 2018). In responding to community needs, funeral service providers have a key role to play in building community capacity around death, dying, and bereavement. A compassionate communities approach develops care networks around the dying person and their family, integrating the contributions of funeral providers into this, and in due course the bereaved persons’ social network (Aoun, Breen, White, Rumbold, & Kellehear, 2018; Kellehear, 2005; Wegleitner, Heimerl, & Kellehear, 2015).
Public Health Model of Bereavement Support
The public health model of bereavement support offers a foundation for determining the types of bereavement services and supports offered, depending on an individual’s needs and risk factors. These can be divided into three groups (Aoun et al., 2015). Typically, the low-risk group (about 60%) has the support they need already in place in their informal social networks. The moderate-risk group (about 30%) need some additional support from the wider community, including general support from various professionals, while the high-risk group (about 10%) typically need support from mental health professionals (Aoun et al., 2015).
In using the model to include memorialization needs based on bereavement risk, the following trends are identified from the synthesized findings of this study (Figure 1). Bereaved people with high memorialization needs may require a private memorial in a public space, highly personalized memorial rituals, close proximity to the remains, and rituals enacted daily. If these rituals become compulsive, blocking their return to everyday living, therapeutic intervention may be needed. Those with moderate memorialization needs may benefit from a public memorial in a private space, personalized memorial rituals, access to remains, and rituals that decline in frequency over time. Those with low memorialization needs may prefer a public memorial in a public space and standardized rituals that are enacted on occasion.
Memorialization needs based on bereavement risk.
This model may guide service providers in understanding the potential benefits of matching specific memorialization practices to clients’ bereavement risks and support needs. They must however be perceived by the bereaved as relevant to their needs and align with their personal motivations for engaging in specific memorialization practices (Lowe et al., 2019).
Strengths and Limitations
An inadequacy of literature reviews is that the practical wisdom of service providers usually goes unreported, as it is seldom documented in a form that appears in electronic searches. A strength of this study is that reviewing the literature and also seeking the views of service providers has allowed us to identify some broad trends in the social organization of death, dying, and grief reflected in memorialization. We have also considered ways in which these trends are shaping, and being shaped by, the “death industry” itself. One limitation is that the views of bereaved consumers are here indirectly represented by service providers; another that only a small group of service providers participated. The evidence that came from their accounts however was compatible with the findings from the literature review.
Conclusion
A public health approach to bereavement support is recommended as the most appropriate industry response to a changing social environment, focusing on building partnerships with other community organizations involved in end-of-life issues. Identifying a role for the funeral and memorialization industry within such community-based approaches may help it respond more adequately to the cultural and market changes currently affecting the industry and the changing role of service providers. Reframing the role of formal industry service providers as educators and facilitators, within the ethos of compassionate communities, may support improved outcomes for the bereaved. A population-based study, involving consumers, on the effect of memorialization in assisting with grief and bereavement is an obvious next step for future research.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors acknowledge the financial support of the Australasian Cemeteries and Crematoria Association.
