The findings emanated from the open-ended answers to the question “If you participated in the bereavement group, what role has it had in your processing of grief?” They show that the bereavement groups gave significant others opportunities to share their inner feelings. Another finding involved the impact of the role of the palliative home-care team on bereavement.
In regard to self-image, significant others described their experiences of participating in bereavement groups as a positive form of support. The bereavement group contributed to a feeling of being seen by others and provided increased understanding of their own identities. The group was found to be valuable in a challenging situation. Mr. A, whose age was between 61 and 70 years, commented: I [now] better understand that those who do not have someone in their own household to share their grief with have much more difficulty. I can more easily accept that I was present at the very moment of death.
Other significant others expressed receiving no or minimal support in regard to cognitive and emotional aspects. They seemed unable to move on from their grief: I still have a hard time and I cry a lot, but I guess that’s the way I am (Mrs. B, age 61–70 years). Over time, the follow-up answers illustrated that the groups gave the participants a feeling of commonality but that grief persisted.
Mrs. C, age 61–70, wrote: However, grief goes up and down and it needs to do so. A big thank you to everyone who attended the meetings and for the support we received.
Significant others described their experiences of participating in bereavement groups as a forum for strengthening their self-determination. The bereavement group supported them in regaining a sense of harmony within themselves by being co-actors in the group. Participation was described this way:
It meant a lot to set words on what happened. Painful memories came up to the surface again, but it was also nice to talk about them [the deceased]. By narrating, we made him "alive" again (Mrs. E, age 41–50).
Significant others also compared themselves to others in the group. These comparisons were mostly positive, but some did not want to share their grief in this setting. Mr. F, age 61–70, wrote: I do not want to discuss my grief with unknown people; I process it by myself and with my relatives. Thus, he participated only twice. Other significant others commented that they also needed other kinds of support, for example, individual contact with a psychologist. Over time, comments about the benefits of participation in the bereavement groups were both positive and negative.
Bereavement groups confirmed social needs and that significant others could depend on each other. They gained insights about other persons’ journeys through the grieving process and those who were in the same stage of grieving as they were. Mr. G, age 51–60, wrote: [I] found out that we are several in the same situation as me. You are not alone. Significant others also sensed positive support from the counsellors. The continuity and composition of the groups were important, and participants offered advice about the arrangement including: Good arrangement. Possibly smaller groups – maximum of five significant others. Missed "my" nurse from the palliative-care team – the feeling of belonging that was built up during the illness (Mrs. H, age 51–60). Over time, the significant others wrote about the positive feelings of sharing experiences, but in addition, a need for further support was declared. They asked for support from either some kind of psychologist or from the palliative home-care team. Mrs. I, age 51–60, illustrated this: I do not know how only the bereavement group has influenced my grief. However, together with appointments with my psychologist, it has been very good for me. I do not close up anything. I hope that these bereavement groups will continue and expand to be additional. We are many who need support and help. You have all done fantastic work!
Only one significant other mentioned a physical symptom in the post-participation questionnaires five weeks after the bereavement groups.
Mrs. D, age 71–80, wrote: Now I feel calmer and can sleep without sleeping pills, thereby, expressing positive benefits from participating in the bereavement group. Over time, significant others related that the groups had been premature in relation to their declining physical and/or mental health. Starting with adequate medication was helpful; Mrs. J, age 71–80, wrote: None [effect of the bereavement group]; I think it came a little too close to the death. I got depression in the early summer. I now medicate with Citalopram 20 mg and feel healthy and strong again.
Synthesis and summation
The group provided support for the significant others’ retrospective existential needs and created meaning in the present. Mrs. K, age 61–70, wrote: It [the bereavement-group] had a great impact, where each one could tell and cry about the trauma that everyone had experienced. We became like a big family, who felt the same grieve after the loss of our loved one died. I felt confidence from the leaders who were there.
The reflections that arose in the bereavement groups in regard to being in a phase of existential loneliness were experienced as support, but the feeling of grief was still present in everyday life. It was of great value to me, but the grief is still just as big (Mrs. L, age 61–70).
Over time, the answers showed that some of the significant others did not get on with their lives but rather continued to feel grief. Mr. F, age 61–70 years, wrote in the follow-up: Not much [benefit from the bereavement-group] more than that, I was told about other peoples’ grief. However, every grief and experience is unique to that person.
In regard to the need for support, the answers revealed that the death of their loved one was always with them, but that the bereavement group offered great support. The bereavement group’s structure of five meetings over time was essential for passing through the different phases of grieving up to the death, at the time of death, and the period following the death and the funeral. The bereavement groups fulfil a great function. I began healing and gained insight on how others experienced their grief (Mrs. M, age 61–70).
Participation in bereavement groups gave significant others strategies to help them realize that life goes on and grief reaches closure, although it is always present. The grief must take “its time” (Mrs. N, age 71–80).
Significant others expressed that the counsellors helped the participants express their inner feelings about grief in the present. They also offered counsellors advice about the composition of the groups; they suggested that widows and widowers should have been in one group and younger bereaved persons should have had their own group. An additional number of meetings was also suggested to ease the bereavement process.
The role of the palliative-care team
There appeared to be two different experiences of support in bereavement – support from the bereavement group and support from the palliative home-care team. The support from the palliative home-care team was a finding outside of the 6S’s.
The bereavement groups were considered very valuable for providing a context for grief. However, the answers also indicated the high level of value of the earlier close contact with the palliative home-care team. The team had provided a sense of meaning to the significant others related to difficult situations in life and appeared to serve as a kind of lifeline for grief in both the post-participation questionnaires and in the follow-up. Thank you for being there. [...] What would I have done if the palliative-care team had not been there; I cannot think of that. You do an incredible job. You are the relatives' lifeline and comfort. Thank you for being there (Mrs. K, age 61–70).