Aspects of Funerals Affecting Public Health of Grieving Families in Japan Funerals Affect Health of Grieving Families
Article Sidebar
Downloads
Submit your own article
Register as an author to reserve your spot in the next issue of the Medical Research Archives.
Author RegistrationJoin the Society
The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.
Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.
MembershipMain Article Content
http://orcid.org/0000-0002-4519-8837
Megumi Kondo-Arita
http://orcid.org/0009-0002-1860-7727
Abstract
The realization that bereavement grief consumes medical and welfare resources has increased public interest in preventing or reducing prolonged/persistent grief. After reviewing the merits and limitations of pharmacological and psychological approaches to grief, this research focuses on aspects of funeral rituals that exacerbated or ameliorated grief in Japan. A team of experts from the All-Japan Funeral Co-operation® categorized and discussed hundreds of anonymous open-ended responses to a nationwide survey of mourners, conducted within a year of their bereavement. The team extracted eight major categories demanding attention and improvement:
(1) Cooperating with priests and religious institutions;
(2) Detailed explanation of funeral services and costs;
(3) Coordinating with medical workers and institutions;
(4) Careful conduct of the funeral itself;
(5) Crematorium trauma and catering service;
(6) Insufficient invitation;
(7) Follow-up with the bereaved;
(8) Pre-planning of funeral rituals.
This article discusses the details of and advice for each category. In addition, the comments emphasized that funeral planners should consider and consult with the bereaved about the wishes of the deceased, and the perspectives of friends and relatives uninvited to the funeral. Overall, this study documents the importance of funeral directors’ cooperation with religious and medical services, their attention to the feelings and concerns of the bereaved, and the advisability of funeral pre-planning and follow-through, for the reduction of prolonged or persistent grief.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. https://strategicchro360.com/how-much-is-grief-costing-your-company/ accessed Dec. 15, 2025
3. Stephen, A.I., Macduff, C., Petrie, D.J. et al. (2015) The economic cost of bereavement in Scotland, Death Studies. 2015; 39 (3): 151-157. doi: 10.1080/07481187.2014.920435
4. Kinchin, I., & Doran, C. M. The economic cost of suicide and non-fatal suicide behavior in the Australian workforce and the potential impact of a workplace suicide prevention strategy. Int. J. Environ. Res. Public Health. 2017; 14: 347. doi:10. 3390/ijerph14040347
5. van den Berg, G.J., Lundborg, P., & Vikstrom, J. The Economics of Grief. IZA Discussion Paper 7010, November 2012, Bonn, Germany. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2183543
6. van der Klink M. A., Heijboer L., Hofhuis J. G. et al. Survey into bereavement of family members of patients who died in the intensive care unit. Intensive and Critical Care Nursing. 2010; 26(4): 215-225. doi: 10.1016/j.iccn.2010.05.004
7. Holden, L., Scuffham, P., Hilton, M., et al. Health-related productivity losses increase when the health condition is co-morbid with psychological distress: Findings from a large cross-sectional sample of working Australians. BMC Public Health. 2011; 11: 417. https://doi.org/10.1186/1471-2458-11-417.
8. Fox, M., Cacciatore, J., & Lacasse, J. Child death in the United States: Productivity and the economic burden of parental grief. Death Studies. 2014; 38: 597-602. https://doi.org/10.1080/07481187.2013.820230.
9. Gilbert-Ouimet, M., Sultan-Taïeb, H., Aubé, K., et al. (2024). Costs of presenteeism and absenteeism associated with psychological distress among male and female older workers. Journal of Occupational and Environmental Medicine, 2024; 66: e467-e475. https://doi.org/10.1097/jom.0000000000003182.
10. Evans-Lacko, S., Evans-Lacko, S., & Knapp, M. Global patterns of workplace productivity for people with depression: Absenteeism and presenteeism costs across eight diverse countries. Social Psychiatry and Psychiatric Epidemiology. 2016; 51. https://doi.org/10.1007/s00127-016-1278-4.
11. Wilson, D., Rodríguez-Prat, A., & Low, G. (2020). The potential impact of bereavement grief on workers, work, careers, and the workplace. Social Work in Health Care. 2020; 59: 335-350. https://doi.org/10.1080/00981389.2020.1769247.
12. Zisook, S., Iglewicz, A., Avanzino, J., et al. Bereavement: Course, consequences, and care. Curr Psychiatry Rep. 2014;16(10): 482. doi: 10.1007 /s11920-014-0482-8.
13. Becker, C. B., Taniyama, Y., Kondo-Arita, M. et al. Unexplored costs of bereavement grief in Japan: Patterns of increased use of medical, pharmaceutical, and financial services. Omega: Journal of Death and Dying, 2021; 83(1): 142-156. https://doi-org.kyoto-u.idm.oclc.org/10.1177/0030222821992193
14. Prigerson, H. G., Bierhals, A. J., Kasl, S.V, et al. Traumatic grief as a risk factor for mental and physical morbidity. Am. Jl Psychiatry. 1997; 154: 616-623. DOI: 10.1176/ajp.154.5.616
15. Stroebe, M., Schut, H., & Stroebe, W. Health outcomes of bereavement. Lancet. 2007; 370:1960 -1973. doi:10.1016/S0140-6736(07)61816-9
16. Genevro, J. & Miller, T., Emotional and economic costs of bereavement in health care settings. Psychologica Belgica. 2010; 50: 69-88. doi: 10.5334/pb-50-1-2-69
17. Lenferink, L.I.M., Eisma, M.C., Smid, G.E. et al. Valid measurement of DSM-5 persistent complex bereavement disorder and DSM-5-TR and ICD-11 prolonged grief disorder: The Traumatic Grief Inventory-Self Report Plus (TGI-SR+), Comprehensive Psychiatry. 2022; 112: 152281. https://doi.org/10.1016/j.comppsych.2021.152281.
18. Bui, E., Nadal-Vicens, M., & M. Simon, N. Pharmacological approaches to the treatment of complicated grief: Rationale and a brief review of the literature. Dialogues in Clinical Neuroscience. 2012; 14(2): 149–157. https://doi.org/10.31887/DCNS.2012.14.2/ebui
19. Shear, M.K., Reynolds C.F., Simon N.M., et al. Optimizing treatment of complicated grief: A randomized clinical trial. JAMA Psychiatry. 2016; 73(7): 685-694. doi:10.1001/jamapsychiatry.2016.0892
20. Beesley, V.L., Kennedy. T.J., Maccallum, F., et al. Psilocybin-Assisted supportive psychotherapy in the treatment of prolonged Grief (PARTING) trial: Protocol for an open-label pilot trial for cancer-related bereavement. BMJ Open 2025; 15: e095 992. doi:10.1136/bmjopen-2024-095992
21. Jordan, J.R., & Neimeyer, R.A. Does grief counseling work? Death Studies. 2003; 27(9): 765-86. doi:10.1080/713842360.
22. Shear, M.K., Wang, Y., Skritskaya, N., et al. Treatment of complicated grief in elderly persons: A randomized clinical trial. JAMA Psychiatry. 2014; 71(11):1287-1295. doi:10.1001/jamapsychiatry.2014.1242
23. Breen, L.J., Greene, D., Rees, C. S. et al. A co-designed systematic review and meta-analysis of the efficacy of grief interventions for anxiety and depression in young people, Journal of Affective Disorders. 2023; 335: 289-297. https://doi.org/10.1016/j.jad.2023.05.032.
24. Comans, T., Visser, V., & Scuffham, P. Cost effectiveness of a community-based crisis intervention program for people bereaved by suicide. Crisis, 2013; 34: 390-397. Doi: 10.1027/0227-5910/a000210
25. Hyland, L., & Morse, J. M. Orchestrating comfort: The role of funeral directors. Death Studies. 1995; 19(5): 453–474. https://doi.org/10.1080/07481189508253393
26. Lowe, J., Rumbold, B., & Aoun, S. M. Memorialization practices are changing: An industry perspective on improving service outcomes for the bereaved. Omega: Journal of Death and Dying. 2019; 84(1): 69-90. doi: 10.1177/0030222819873769.
27. Becker, C.B., Taniyama, Y., Sasaki, N., et al. Mourners’ dissatisfaction with funerals may influence their subsequent medical/welfare expenses: A nationwide survey in Japan. Int. J. Environ. Res. Public Health. 2022; 19(1): 486. https://doi.org/10.3390/ijerph19010486
28. Becker, C.B., Taniyama, Y., Kondo-Arita, M., et al. Costly causes of funeral dissatisfaction and satisfaction: responses to an All-Japan survey. Psychology International. 2024; 6(3): 722-733. https://doi.org/10.3390/psycholint6030045
29. Elo, S., & Kyngas, H. The qualitative content analysis process. J Adv Nurs. 2008; 62(1): 107-15. doi: 10.1111/j.1365-2648.2007.04569.x
30. Rugg, J. & Jones, S. Funeral Experts by Experience: What matters to them. (2019). Available at: https://eprints.whiterose.ac.uk/id/eprint/162914/
31. Graneheim, U.H., Lindgren, B-M., & Lundman, B. Methodological challenges in qualitative content analysis, Nurse Education Today. 2017; 56: 29-34. https://doi.org/10.1016/j.nedt.2017.06.002.
32. Mayring, Philipp. Qualitative Content Analysis. Theoretical Foundation, Basic Procedures and Software Solution. Monograph. Klagenfurt, Austria, 2014. https://www.ssoar.info/ssoar/handle/document/39517
33. Saliba, George. 'Homo Religiosus' in Mircea Eliade. 2023; Leiden, The Netherlands: Brill. https://doi.org/10.1163/9789004669369
34. Taniyama, Y., Becker, C., Takahashi, H., et al. “Listening to Sutra-chanting reduces bereavement stress in Japan.” Journal of Health Care Chaplaincy. 2021; 27 (2): 105-17. doi:10.1080/08854726.2019.1653637.
35. Redinbaugh, E., Sullivan, A., Lock, S., et al. Doctors’ emotional reactions to recent death of a patient: Cross-sectional study of hospital doctors. British Medical Journal. 2003; 327: 1-6. doi: 10.1136/bmj.327.7408.185
36. Schwarz, C.S., Münch, N., Müller-Salo, J., et al. The dignity of the human corpse in forensic medicine. Int J Legal Med. 2021; 135 (5): 2073-2079. 10.1007/s00414-021-02534-x
37. Mathijssen, B. The human corpse as aesthetic-therapeutic. Mortality. 2023; 28(1): 37-53. https://doi.org/10.1080/13576275.2021.1876009
38. Doka, K. J. Expectation of death, participation in funeral arrangements, and grief adjustment. Omega: Journal of Death and Dying. 1984; 15(2): 119-129.
39. Gamino, L. A., Easterling, L. W., Stirman, L. S., et al. Grief adjustment as influenced by funeral participation and occurrence of adverse funeral events. Omega: Journal of Death and Dying. 2000; 41(2): 79-92.