CareSearch Blog: Palliative Perspectives
A ‘normal’ way to grieve?
A guest blog post by Dr Georgia Rowley, Research Associate, ELDAC (End of Life Directions for Aged Care)
When I was seven, I experienced my first insights into death and the grieving process. It was our ‘pappou’ (grandpa). ‘Pappou’ died suddenly, in his 60’s, from a heart attack. I will always remember the seemingly unrelenting darkness that enveloped the household. ‘Yiayia’ (grandma) clad herself in black. She banished her colourful clothes from the home. For days, weeks, months, and years, the house and our family mourned the loss. The fog of bereavement held a tight grip for what felt like decades.
Initially, there were endless streams of visitors, a viewing conducted in the familial home, an open casket funeral. A multitude of religious mourning rituals were enacted on specified dates post-death (e.g. 40 days). Cemetery visits were ritualistic, and occurred daily during these early years. Music, TV, parties – myriad things which held connotations of enjoyment and pleasure - were shunned. Celebratory familial events like Easter and Christmas were clouded by mourning and lamentation. Unable to fully grasp the enormity of these events as a child, I did not until years later realise that this was perhaps not the way my non-Greek counterparts experienced death. Should bereavement follow a ‘normal’ course? What is appropriate after death? Did others feel compelled to ‘perform’ visible mourning rituals and engage in public displays of grief? Are all deaths bound by such heaviness and heartbreak? I pondered the impact of mourning on well-being, given the impact of cross-cultural differences. Fourteen years later, the culmination of death, bereavement, and grieving from a Greek cultural perspective spurred my Psychology Honours topic, and a few years later, my PhD thesis.
Bereavement signals the period of grief and loss immediately following losing someone significant, whereas mourning reflects cultural practices, denoting the actions and manner of grief expression. Bereavement and grief are inherently individual; no two individuals react in the same way to a loss. Myriad factors determine bereavement outcomes, including age, gender, nationality, religion, culture, socio-economic status, social support and isolation, familial factors, childhood and later-life experiences, and relationship and strength of attachment. Culture and religion can dictate what is societally acceptable in mourning, but they are not always prescriptive.
Greek-Australians are typically afforded countless ritualistic ways in which they publically mourn the loss of loved ones, in line with culture and Orthodox religion. Church funerals and associated mourning rituals are highly regimented. There are prescriptive ways to publically enact or perform mourning, like wearing black, visiting the cemetery, lighting a ‘kandili’ (religious candle) and ‘livani’ (religious incense). The most important memorials are observed at 40 days, six months and one year following the loss. Among older Greeks, continuing bonds to the deceased are wholly maintained, which has implications for ensuing identity and coping strategies. Continued relationships are often life-long, normative and socially sanctioned. These relationships often have deep religious and cultural underpinnings, and may be retained in numerous ways. Possessing a meaningful grief framework may assist bereaved individuals to understand, incorporate, adjust to and accept the finality of death. These relationships serve to integrate the deceased into the survivor's life.
Grief and bereavement in Greek culture is gendered. Women more so than men are traditionally expected to perform more of the grieving work and associated customs and practices. Strict roles and expectations provide a grieving template of sorts for older Greeks, who may feel obliged to follow such predetermined, implicit and explicit acts of mourning and rituals. Anecdotal evidence suggests Greeks grieve more publically or lament the loss more openly than Anglo-Australians. Physical and emotive reactions to the loss, like crying and wailing, are commonplace. These normative expectations are particularly pertinent where individuals have sustained traditional familial and cultural values despite living overseas. The landscape of grief in Australia is changing. I often wonder how successive migrant generations will experience death after decades of residing in a ‘foreign land’. However, from a personal standpoint, there are factors associated with grieving that I perceive to be inappropriate based on my upbringing and cultural understandings, such as wearing bright colours to funerals or playing loud music.
For my Honours project, I compared the experiences of older widowed Greek migrant women to older British females. This study found cultural differences in variables such as depression, loneliness, and self-rated health, and perceptions of familial support and not surprisingly, in the performance of mourning rituals. My PhD was a more in-depth, qualitative exploration of the experience of widowhood among older first-generation Greek men and women living in rural and urban South Australia. I focused on the impact of social determinants of health, such as gender, education, residential location, familial support, and perceptions of societal inclusion or exclusion. With the successive deaths of multiple grandparents, I have felt inherently tied to this space on a personal and academic level. Over and above the influence of culture, we must appreciate that individual differences within groups are crucial and require acknowledgement. Individuals of similar socio-cultural and contextual backgrounds may still experience bereavement and loss differently. Having recently started as a Research Associate as part of the End of Life Directions for Aged Care (ELDAC) project at Flinders University, I am keen to gain further insights into conceptualisations of a ‘good death’ and palliative care among different groups.
Dr Georgia Rowley, Research Associate, ELDAC (End of Life Directions for Aged Care)
For some more information and resources that may be helpful visit CareSearch 'Bereavement, Grief and Loss' section of the website.