But dealing with the loss and grief is highly problematic in Japanese culture, Karen felt. Although prostate cancer is a very slowly advancing disease his family did not know that he had symptoms because he did not want to burden them. The objective was to keep him from thinking about death, according to Karen's observation. Even now, as Patrick's grandmother reaches her 92nd birthday and is in a physical decline, the family will not talk about advanced directives and the possibililty of her death. If friends come to pay a visit soon after a death it is expected that they will be entertained and the subject of how she is faring is quickly dismissed.
Food is used in almost all cases to symbolize caring.
Karen spoke about the proper amount of grief that should be shown by close family members at the funeral services - discrete weeping with a smile breaking through is good, sobbing is never acceptable and she actually remembers attending a funeral where the sobbing widow was secretely ridiculed by the guests. We then discussed her own perceptions of traditional Japanese handling of the grief process. She feels that traditionally Japanese do not deal with the grieving process and that this is the cause of a number of problems. There is, she feels, a high incidence of suicide after the loss of a spouse and the tradition of willing oneself to die is also prevalent. Widows and widowers often report the dead spouse calling them to join them, she relates.