・Introduction

The number of deaths in Japan will peak at approximately 1.65 million people in 2040. The increase in the number of deaths implies an increase in the number of people who lose loved ones. Finding ways to support these people is an urgent issue.

Are you aware of the term, "compassionate city"?

The term was proposed by sociologist Dr. Alan Kelleher and refers to a local community where people support each other through aging, illness, death, and bereavement. Recently, the importance of such community building has been receiving attention in Japan.

In Japan, support for people who experience bereavement is becoming more widespread through medical and welfare professionals, religious people, funeral homes, and other groups. However, limited research has been conducted on people living in the community, that is, people who are close to the lives of those who have lost loved ones (family/relatives, friends, neighbors).

・Focus on remote islands

This study focuses on remote islands that are part of the Islands of Tokyo.

Although remote islands have insufficient medical and nursing resources, the rate of at-home end-of-life care is extremely high, and many people experience bereavement in the area where they have grown up and with which they are familiar. Moreover, reports have indicated that islanders have a strong sense of mutual assistance daily, and that rituals and perspectives on life and death based on local beliefs are deeply rooted. Thus, islanders who have lost loved ones are provided active support not only in terms of social aspects, but also in terms of the island's culture and values.

Therefore, we clarify the nature of support provided to people who experience bereavement on remote islands.

・What support is provided to people who experience bereavement on remote islands?

Interviews with island residents revealed the overall picture of support provided on remote islands (Fig. 1).

Figure 1. Overall picture of support for people who experience bereavement on remote islands

　　　　　　　　　　　　　　　　　　　

1. Activities that serve as a basis of bereavement support (yellow section)

On remote islands, residents are close to each other owing to the small size of the land and population, creating an environment where they can see each other and thoroughly understand each other's circumstances. This environment creates an awareness of valuing friends, ability of island residents to act in solidarity, and relationships where family, friends, and neighbors can help each other daily, allowing surrounding people to be in a position to promptly provide support when something occurs.

2. Activities that promote support (pink section)

Strong feelings toward the dead, such as treating the death of a fellow island resident as if it were their own, as well as respecting and honoring the soul of the deceased when situations aforementioned occur. Additionally, the common understanding that unique funerals held on the island would be difficult without support promotes awareness of support

3. Actual circumstances of support (green section)

Strong feelings among island residents toward death and the common understanding of the difficulties in having funerals lead to an attitude of actively supporting island residents who experience bereavement. Therefore, people and articles naturally gather around those who experience bereavement, and they receive various types of support. Specific types of support include demonstrating consideration and reaching out to them regarding grief, providing funeral manuals, creating and decorating altars, preparing meals for funeral attendees, and visiting homes/offering lifestyle support after bereavement.

A distinctive feature of this type of support is that when island residents receive support, it leads to an awareness of supporting other island residents in similar situations, in the same manner as they were supported. Thus, it implies that the process of a positive attitude toward support → gathering people and articles → receiving support creates a virtuous cycle. This appears to be an important factor that has led to continued support for people who experience bereavement on remote islands.

・Summary

Intimate and active support, which is unique to remote islands, is provided because of the closeness among island residents. This type of support is not provided specially at the time of death, but is an extension of the mutual assistance that people provide in their daily lives. Furthermore, the island residents feel close to the deaths of fellow island residents. Therefore, they treat it as their own affair and share the common understanding that funerals associated with bereavement are difficult. This indicates deep empathy and understanding for those who experience bereavement.

Although it is not possible to change the topography and population of other regions to resemble that of remote islands, the empathy and understanding revealed in this study are important aspects that transcend land and culture. It is important to take an interest and attempt to understand those close to us who experience bereavement. The accumulation of such interest and understanding among local residents will eventually lead to a tremendous force that supports bereavement in the entire community (all areas of life, such as neighborhoods, schools, workplaces, and so on).

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