Functioning, growth and continuing bonds with the deceased among bereaved grandparents in Israel

Old age is characterized by various biological, personal and social processes, many of which entail coping with physical, occupational and interpersonal losses. These are defined as natural losses and one can prepare for them. Alongside such losses, elderly people may face unnatural and traumatic losses which defy the laws of nature and for which one cannot prepare. For many grandparents a grandchild represents a sense of continuity and meaning, and thus the loss of a grandchild is experienced as a unique painful, unnatural loss that rattles their lives. 

The State of Israel has known many wars and military operations that have left families bereaved and in pain. The definition of bereaved families usually includes fathers, mothers and siblings. Despite the overwhelming sense of loss, grandparents are not formally included in the definition of a bereaved family. Their personal pain - pain over the grandchild whose life came to a sudden end and pain for their child (the bereaved parent), is referred to in the literature as "triple pain", unique to the experience of grandparents. According to the normative life cycle adult children should support their parents at this stage of life but, under these circumstances, the adult children are dwelling in their own sorrow and pain, and are not usually available to assist the grandparents who remain alone in their mourning.  

Rubin’s two‐track model of bereavement (1981) poses the theoretical framework for the current study examining the mourning process and reaction to loss in two parallel tracks. The first track focuses on the individual’s level of functioning and his/her ability to move forward despite the traumatic event and accompanying stress. The second track, based on the psychodynamic approach, focuses on the assessment of the bond with the deceased, on both emotional and cognitive levels, and the development of this bond over time.

The current study aims to shed light on the experience of losing a grandchild as part of the overall aging process, and to understand the ways in which grandparents cope with this loss. For that, in addition to bereaved grandparents, grandparents of adult grandchildren were included as a comparison group. We assume that there are many similarities among all grandparents and that these may frame some of the unique perspectives of losing a grandchild. 

According to our hypotheses, compared to grandparents of adult grandchildren, bereaved grandparents will show higher levels of attachment anxiety and avoidance, lower functioning, social support, well-being, family communication and personal growth. In addition, there will be a positive association between lower levels of functioning with higher levels of attachment anxiety and avoidance and lower levels of social support, and well-being. A question was asked regarding the association between functioning and family communication. Personal growth was hypothesized to be negatively correlated with higher levels of attachment anxiety and avoidance, and positively correlated with well-being, social support and family communication. Another question was asked regarding the association between attachment anxiety and avoidance, well-being, family communication and social support and the bond with the deceased among bereaved grandparents.

In addition, the unique and combined contribution of attachment anxiety and avoidance, well-being, social support and family communication to functioning, personal growth and the bond with the deceased.

This quantitative correlational study examines the contribution of internal resources - such as attachment orientation and subjective wellbeing, and external resources - such as perceived social support and family communication, to functioning and personal growth among bereaved grandparents as compared to grandparents of adult grandchildren. Additionally, the study examined the contribution of these internal and external resources to the continuing bond of the bereaved grandparents with the deceased.

The sample was composed of 106 grandparents; 50 lost a grandchild during military service and 56 had adult grandchildren. Participants completed a series of questionnaires relating to functioning and growth: the Hogan Grief Reaction Checklist (Hogan, Greenfield, & Schmidt, 2001), attachment (Brennan, Clark, & Shaver, 1998), subjective wellbeing (Diener, Emmons, Larsen, & Griffin, 1985), percieved social support (Zimet, Dahlem, Zimet, & Farley, 1988), family communication (Olson, Gorall, & Tiesel, 2006; Olson, 2011). The bereaved grandparents also completed the Continuing Bonds Scale (Field, Gal-Oz, & Bonanno, 2003).

The findings of the study suggest that there are many similarities between bereaved grandparents and grandparents of adult grandchildren. Personal characteristics such as attachment, subjective wellbeing and family communication appear to form a stable base that does not change in light of unique circumstances or life events. Contrary to this, social support resources take on a different meaning when faced with the loss of a grandchild. Lower levels of support from family and friends were reported among bereaved grandparents as compared to grandparents of adult grandchildren. Additionally, bereaved grandparents reported lower functioning and lower personal growth. The findings indicate that while high resources (health, education, subjective wellbeing, familial support) predict functioning, low resources (life crises, low education, no spousal relationships and low familial support) are associated with higher personal growth. This is in line with findings from previous studies that reported an inverse association between internal resources and growth. It is plausible that when the internal world is rattled by an existential crisis, individuals become active in searching for alternative resources, especially those who are lacking such resources. This is contrary to those with high resources who may not be quite as rattled and hence are able to maintain balance and stability despite the difficult crisis. Interestingly, while family communication was not associated with lower functioning among grandparents of adult grandchildren, the sad and painful family communication in bereaved families was associated with greater lower functioning among bereaved grandparents. Moreover, while attachment anxiety is usually negatively associated with growth among grandparents, it contributes positively to growth among bereaved grandparents. It appears that the over-activity which characterizes those with high levels of anxiety shapes their relationships with their surroundings but also serves as a catalyst for growth. It is possible that in situations of traumatic bereavement, such as the loss of a grandchild, anxious individuals have difficult disturbing thoughts, contemplate the meaning of life and the meaning of loss. These individuals must search for internal and external resources and undergo meaningful processes that may, in turn, lead to growth alongside lower levels of functioning.

Additional findings suggest that support from family and support from friends are perceived differently by grandparents overall. While familial support is considered stable and taken for granted, it is an important resource that contributes to the functioning of elderly people. Contrary to this, age and generational gaps may lead to grandparents feeling that there is not always common ground or sense of belonging to their families. Thus, they do not perceive family members as partners for change in thoughts and schemas, and experience lower levels of personal growth. Unlike familial support, relationships with friends are based on choice. One can find a sense of belonging and empathy among peers who also experience old age and life crises and, hence, support from friends contributes to growth.    

Among bereaved grandparents, external resources of a support network and family communication were not associated with continued bonds with the deceased. Personal characteristics and those related to the loss (geographic distance from the grandchild’s family, time since the loss) predicted continued bonds with the deceased. Surprisingly, low personal resources, such as income and education, were associated with greater bonds with the deceased, probably because these imply that grandparents have lower coping resources and limited options for leisure activities. Hence there is more preoccupation with the deceased grandchild. Finally, among bereaved grandparents there is an association between the two tracks suggested by Rubin. It appears that continued bonds with the deceased cause physical and emotional alertness which, on one hand, negatively affect functioning and, on the other hand, create opportunities for personal growth. 

The findings of the current study suggest that bereaved grandparents form a vulnerable population characterized by lower levels of functioning and lower levels of personal growth. Their families are not always able to provide an answer to their needs and, thus, it is important to build designated intervention strategies. Professionals should reach out to bereaved grandparents and focus on their personality characteristics, e.g. subjective wellbeing and attachment anxiety, as well as their family and social support from friends. Taken together, this will enable to identify the unique needs of grandparents and create tailored interventions strategies that will assist bereaved grandparents in coping with their challenges and promote their personal growth.