The Relationship Of Cause Of Death To Attitudes Toward Funerals And Bereavement Adjustment examined how multiple factors might combine to affect the bereaved. Whether someone died suddenly, or after an illness, whether they were close or distant, and other circumstances of death would seem likely to influence how survivors adjust to the loss. Funeral activities have also been suggested as factors affecting participants’ later adjustment. The researchers used multivariate analysis to explain how various factors combine to affect mourning.¹

Subjects: 438 adults who had experienced the loss of a family member or friend within two years (90% had occurred within one year). Average age of subjects: 35.

Main findings

When the person’s death was expected, survivors tended to have better bereavement adjustment.

When the death was expected, and the mourner was emotionally close to the deceased, they saw the funeral as more meaningful and they participated more in post-funeral activities.

For older bereaved persons, the type of death did not have as big an impact on how well they adjusted, or how much they participated in the funeral rituals.

People whose loved ones died from violent, sudden, or stigmatized causes had the worst grief and bereavement adjustment overall, and received the lowest levels of social support. These mourners do get more involved in the early stages of the funeral process, which may be beneficial for them. But the study does not show better adjustment for such bereaved persons as a result of funeral participation.

Regarding type of death:

• People who showed the best grief and bereavement adjustment were those whose loved one died from either a “serious nonterminal” sickness such as flu or diabetes, or in their sleep, or from old age. Deaths in this category are usually of older people, which in general is less challenging conceptually.

  These people also had the least involvement in pre-funeral activities.

• People who had the worst adjustment were those who lost someone to murder or suicide, or an accident. People who die for these reasons are usually younger, which is more of a shock.

  These people had the most involvement in pre-funeral activities.

• Type of death made no difference in post-funeral participation.

The study did not find any causal relationship between funeral ritual participation and bereavement adjustment. The authors suggest likely correlations based on the data:

… as a function of cause of death, for some bereaved persons, the funeral ritual may perform an invaluable service in helping individuals move toward acceptance of death, feel more at peace with their feelings toward the deceased person by allowing them to begin to work through their feelings, and possibly even in preparing for future losses by sensitizing them to the reality and inevitability of loss.

For others, however, its utility is dubious.

Study detail

Subjects provided information about themselves and about the person who died, the reason for death, relationship with the person, and various other characteristics of the circumstances of the loss.

They completed a number of different questionnaires designed to elicit information and gauge health and psychological states.

Regarding funerals and ritual participation, they answered questions on their attitudes toward funerals, the funeral industry, viewing the body, and other related topics.

They reported their participation in the following ritual-related areas:

• Pre-funeral, such as selecting the grave, choosing the type of funeral service, and placing public notices of the death.
• Funeral rituals, including delivering the eulogy and performing music.
• Post-funeral activities, such as acknowledging food and donations, and visiting the grave site.

Additional tests asked about general health, and different aspects of their psychological status, and others gauged aspects of their grief and their overall bereavement experience, and how these had changed over time.

Note: The blanket term “adjustment” is used in studies of grief and bereavement to indicate a general state of normalcy, psychological health, and happiness, as measured by various questions about how the person is doing, including thoughts and feelings, at present or in the past. It is a category that contains substantial vagueness, because who is to say what constitutes good adjustment?

But without value judgments or analyzing the terminology too closely, we can see what the researchers are trying to get at: how normal is the person feeling, and how well are they getting on with life, or how much are they suffering and having a rough time of it.

Hierarchy of bereavement and grief “adjustment”, and funeral participation, based on closeness to the deceased, and type of death

For those losing a close family member:

Funeral participation: did not vary based on type of death.
Post-funeral participation: did not vary based on type of death.

When loved one died of serious nonterminal illness, such as flu or diabetes, or from old age, or in their sleep:
Best adjustment for the bereaved.
Pre-funeral participation was lowest.

When loved one died from a terminal illness, or heart attack or stroke:
Next-best level of adjustment for bereaved.

When the loved one died from murder or suicide, or in an accident:
Worst adjustment for the bereaved.
Pre-funeral participation was highest.

For those losing less close family member or friend:

Bereavement and grief adjustment: did not vary based on type of death.
Post-funeral participation: did not vary based on type of death.

When the person died from murder or suicide, or accident:
Pre-funeral participation of survivors was lowest.

When the person died of serious nonterminal illness, or in their sleep, or of old age:
Pre-funeral participation was highest.

When the person died from murder or suicide, or from serious nonterminal illness:
Funeral participation was lowest.

When the person died in their sleep, or from old age:
Funeral participation was highest.

Additional observations

Certain causes of death lead to different levels of social support as well.

Murder or suicide, or accidental deaths, bring the bereaved the lowest levels of emotional support from others.

Dying in sleep, or of old age, terminal illness, and serious nonterminal illness, all brought high levels of support.

Heart attack and stroke deaths brought survivors the highest levels of support.

The subjects of the study were volunteers which, the authors note, could mean the results are not applicable to mourners who would not have been inclined to participate in such a study. The participants may have been, for example, adjusted to their loss in a certain way, or seeking a specific avenue for exploring their grief, that would make their experience different from that of other bereaved people.

At the time of this project, in the 1990s, the authors noted that hardly any data existed regarding how funeral activities affect bereavement—and, frankly, little more has been collected since then. That is the main reason I consider it worthwhile to report on these studies from the past 50 years.