Social support is crucial for individuals grieving a loss, although research on how bereaved persons experience social support is limited. A new study, published in PLOS One, explores bereaved individuals’ experiences and satisfaction with social support. The researchers’ findings indicate that animal, as opposed to human supports, can be the most satisfactory form of support.
They also offer suggestions on how to best support grieving individuals both during the COVID-19 pandemic and post-pandemic. The researchers, led by Joanne Cacciatore, Associate Professor in the School of Social Work at Arizona State University, write:
“Social support seems to help some bereaved people, particularly those with traumatic grief, that is, the violent or sudden death of a close loved one or the death of a child, cope with psychological distress, while its absence may exacerbate poor physical and psychological outcomes. Yet, a breakdown in social relationships after a loss is not uncommon, and loneliness- particularly salient during the COVID-19 pandemic- may exaggerate that effect for grievers, increasing the risk for poor outcomes.”
The benefits of social support on human health and wellbeing are well-documented. For example, social support has been shown to positively affect psychological and physiological stress reactions, as seen through an improved immune system, endocrine, and cardiovascular health. On the other hand, lack of social support and loneliness has been shown to negatively affect physical, emotional, and mental well-being, including increased risk of premature death from many causes.
Loneliness and insufficient social support are common in grieving individuals, which raises concerns about their health and wellbeing. In addition, loneliness has been exacerbated by the COVID-19 pandemic, which in turn has contributed to increases in mental health concerns like depression and suicidality.
Conversely, adequate social support, whether in-person or online, can contribute to a better quality of life in bereaved persons. Additionally, both the quantity and quality of support received have been shown to affect grieving individuals’ wellbeing. Social support for bereaved individuals has been demonstrated to be particularly effective for persons who have experienced “traumatic grief,” or the violent or sudden death of a loved one or the death of a child. However, research has also shown that social relationships are prone to fall apart after a loss.
The researchers identify four categories of social support: informational, instrumental, appraisal, and emotional:
“Informational support may include logistical help on available services after death as well as advice, data, and information offered during a difficult or stressful time. Instrumental support is actionable aid that helps with specific tasks or provides necessary physical support such as food, shelter, transportation, and financial aid. Appraisal support is a more passive means of self-evaluation often enacted, for example, in peer-to-peer contact. It provides a means to assess one’s self in a particular circumstance through like-others utilizing affirmation, feedback, and social equality.”
In the current study, the researchers provided qualitative surveys to a total of 372 adults who had experienced traumatic grief. The interviews consisted of questions about the participants’ perceptions of social support both directly following the loss and long-term.
The participants were mostly white (91.1%), married or partnered (69%) females (91.4%) with college or graduate degrees (58.1%) who had experienced the loss of a child (75.1%). In addition, the majority of participants had experienced the loss more than five years ago (43.3%), and the cause of death was most frequently an illness or disease (25.8%).
When asked to rate their overall perceptions of support from others since the death of their loved one, 35.7% of participants rated their experience of support as excellent or good, 26.5% reported receiving adequate support, and 37.9% rated their support as poor or very poor.
Mortuary staff were ranked as being the most effective in providing human-to-human support (65%). Conversely, law enforcement and physicians, and hospital social workers ranked the lowest, being the least effective in providing bereavement support at 37% and 35%, respectively.
Interestingly, 89% of the 248 participants who had pets or interactions with other animals reported being extremely or mostly satisfied with the support received. In fact, animals were ranked the highest among all forms of social support, which included categories like friends, family, community members, faith leaders, therapists or counselors, support groups, and faith leaders.
These findings are consistent with research that identifies care farming as a useful intervention for individuals experiencing traumatic grief and research that indicates that pets are effective supports for individuals struggling with mental health problems and mental distress.
In their open-ended responses to survey questions, the participants noted emotional support and “acts of emotional caring,” such as receiving a phone call or text message, as the most effective form of support.
Some of the participants described their experiences of emotional support and acts of emotional caring as:
“Telling me that my grief is valid, that my feelings are real. Basically just allowing me to be.”
“Just letting me mention his name without awkward silence or changing the subject.”
In their descriptions of actions that felt unsupportive, participants noted failures to provide emotional support or engage in emotional acts of caring as being most problematic. Examples of unsupportive acts include feeling abandoned by loved ones, feeling as if their grief was being rushed, and not feeling listened to.
When asked how others could better support them, participants identified increased emotional support and emotional acts of caring, emphasizing the importance of listening and being present and remembering their loved ones with them without feeling a need to try to fix or resolve their grief.
Although emotional support and acts of emotional caring were mentioned by participants most frequently across the survey questions, both instrumental and appraisal support were also discussed as being helpful. Informational support was infrequently mentioned by participants, with aligns with previous research findings that this form of support is generally not helpful for grieving individuals.
The researchers summarize their findings regarding specific acts of instrumental and appraisal support identified by participants as being particularly effective:
“Instrumental support was effective when expressed through helping with meals, childcare, housekeeping, and written notes and gifts. One important aspect of instrumental support deserving of attention may be the classic mistake of saying, “. . .call if you need anything,” without any follow-up. Participants appreciated others actively reaching out to them to offer practical aid. Appraisal support meant connecting with like others through grief support groups, in-person and online, and on social media. Time spent with others, both online and in-person, who share a common tragedy of loss was reported as supportive in these data.”
The researchers note their finding that animals are highly effective in providing support as being especially important, as animals are not typically mentioned when considering bereavement support. Recognizing the role that animals can play in providing support during grieving is crucial, particularly when isolation through social distancing or quarantine is required.
The findings also carry implications for healthcare providers and law enforcement, who were ranked the highest in dissatisfaction with social support. As these individuals most often are confronted with persons in crisis, further research must examine why the perception of support from these professionals is so low.
Further, Cacciatore and her colleagues highlight how emotional support was identified as key in the grieving process. Yet, supports were demonstrated to struggle with providing adequate support in this area. Therefore, they call for education for individuals supporting bereaved individuals to assist them with being more responsive to the grievers’ emotional needs.
Limitations of the study include a lack of diversity in participants and the study’s focus on traumatic grief, whose findings may not translate to grieving individuals in the general population.
The researchers conclude by emphasizing how their findings on the importance of animal support can be used to assist grievers and should be investigated in future research:
“Animals may be an especially important source of emotional support during conditions involving social isolation, such as the COVID-19 pandemic when contact with other people is limited, or during experiential conditions such as the loneliness so common in bereavement. Further research could investigate the ways in which animals are perceived as beneficial in grief more thoroughly, but the adoption of pets could be one avenue which to promote well-being and reduce loneliness during the pandemic, especially for those who are not able to access strong social support networks. When it comes to good grief support, perhaps we may have much to learn from our fellow non-human animals.”
Cacciatore, J., Thieleman, K., Fretts, R., & Barnes Jackson, L. (2021). What is good grief support? Exploring the actors and actions in social support after traumatic grief. PLOS One, 16(5), 1-17. https://doi.org/10.1371/journal.pone.0252324 (Link)