This qualitative study used a symbolic interactionist approach to identify, define and explore the experiences of formal bereavement care among 38 Baby Boomers (ages 46-64 at the time of interview) who have suffered spousal loss This research investigated conceptions of shared culture, language, and meaning among survivors who have taken part in formalized grief care. An emphasis on the experienced reality of bereavement care coupled with the self as an agent of reflective action, are the focus for discussion. As well, there is an exploration of negotiation strategies to address a disrupted narrative and the subsequent reconstruction of individual and social selves following the death of a spouse. Interviews with these individuals investigated meanings surrounding terminal illness; death, bereavement, and support, along with how these meanings are constructed, institutionalized, legitimated and actualized. The research explored why some mourners attrition out of formal grief care earlier than others and explained how these support services aid us in the understanding of bereavement. Findings revealed one overarching key theme among these participant experiences after losing a spouse, namely, compromised individual and social selves as evident in an on-going effort to re-construct the past, present and future self. Four other themes emerged and include: 1) the importance of a support group as a safe haven to do `grief work' and re-construct one's wounded self and life narrative; 2) the value of a shared experience of spousal loss with other widowed group members; 3) the significance of a community where one's loss is explored; and lastly, 4) unmet needs surrounding both pre-loss and post-loss concerns. There was also a noticeable gap with regard to appropriate and effective grief care. This gap was evident between what the current literature recommends and what these five agencies offered in the groups. It was also noted through the participant stories which revealed an ineffective structure of support group care for the widowed, namely, inattention to readjustment stress related to tasks associated with practical needs. This finding, along with other emergent themes, offer insight into vital areas in need of attention by practitioners, the medical community, and the death and grief care industry who provide end of life and bereavement care. This research exposed particular needs for this group of Boomer spouses, such as a desire for improved pre-loss needs (e.g., coordination of care when there is an illness), and post-loss needs (e.g., advice for practical matters, such as financial concerns for themselves). A new model of grief work is put forth (Figure 5.1, Hilliker) that observes the temporal aspects of a disrupted narrative as the bereaved spouses look at who they are now, while re-constructing the past and contemplating the future. They examine the present struggles as well as a future without their spouse as they recreate the now fragmented and compromised self to adopt a new role as a widowed person. Recommendations are given for implementing a more holistic and hope based structure for support groups and include addressing both emotional and readjustment stress by moving away from an emphasis on a `grief process' in the groups and through extending support group sessions which include topics of interest to the members as opposed to a pre-set agenda. Further research is warranted to determine the most critical concerns of mid-life widowed people in order to provide recommendations for those who offer programs for this type of care, in particular in the support group format.
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