Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-10-28T13:27:23.883Z Has data issue: false hasContentIssue false

‘Keeping silent to keep the peace’: changes in grandmother's access to their grandchildren following the loss of the son/father

Published online by Cambridge University Press:  09 July 2021

Irit Regev*
Affiliation:
School of Social Work, Sapir Academic College, Hof Ashkelon, Israel
Yael Hochman
Affiliation:
School of Social Work, Sapir Academic College, Hof Ashkelon, Israel
Einav Segev
Affiliation:
School of Social Work, Sapir Academic College, Hof Ashkelon, Israel
*
*Corresponding author. Email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Relations between grandmothers and their grandchildren following the loss of the son/father have not been studied to date. The present article focuses on this experience, as reflected in the stories of grandmothers (bereaved mothers) and spouses (widows) after the loss, and explores the perception of grandparenthood following the loss of the son/husband. Twenty semi-structured interviews were conducted with ten grandmothers (bereaved mothers) and spouses (widows) who were recruited as a convenience sample. Data were subjected to thematic analysis. The findings revealed three key patterns of the grandmother–grandchild relations, as perceived by the two groups of women. The patterns indicate complex relations between widows and bereaved mothers, which have implications for the access of the grandmothers to their grandchildren and for their perception of grandparenthood. The study sheds light on the patterns of relations in families that have lost the son/husband/father. The change in power balance between family members and the asymmetry in the family structure created by the absence of the son/husband affect grandparenthood relations. The study emphasises the role of the widows, as the middle generation, in shaping or mediating relationships following the loss. The findings stress the importance of clinical intervention with both the bereaved mothers and the widows.

Type
Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Introduction

The dramatic increase in life expectancy has affected family relations, which are becoming multigenerational. It has been recognised that, as part of these relations, the role of grandparents is meaningful to the family and serves as a source of intergenerational solidarity. Most studies of grandparenting have described grandparent–grandchild relations as significant for both generations and as being part of developmental roles across the lifecycle (Hank et al., Reference Hank, Cavrini, Di Gessa and Tomassini2018). Gerontological research disagrees with the contribution of this function to the psychological wellbeing of grandparents. Research evidence shows that the fact that grandparenting plays a central role in the lives of people does not necessarily improve their psychological wellbeing (Muller and Litwin, Reference Muller and Litwin2011). Other researchers have suggested that good grandparent–grandchild relations contribute to the grandparents’ personal wellbeing (Mahne and Huxhold, Reference Mahne and Huxhold2014; Thomas et al., Reference Thomas, Liu and Umberson2017), claiming that the intergenerational relations are a main source of support, social integration and intergenerational solidarity.

Intergenerational solidarity theory (Bengtson and Schrader, Reference Bengtson, Schrader, Mangen and Peterson1982) provides a conceptual framework for understanding the relations between generations. The theory proposes six dimensions of family solidarity: association, affect, consensus, functional, normative, and family structure. Further analyses by Bengtson and Roberts (Reference Bengtson and Roberts1991) suggest that the six dimensions reflect two underlying dimensions: (a) structural-behavioural (comprising association, function and structure), and (b) affective-cognitive (affect, consensus and normative).

Family solidarity is reflected in the behaviour of family members over the course of changing circumstances of life, stresses and losses experienced by the family. The death of a family member is a significant loss to the entire family and affects all generations. The loss reshapes family structure, puts family solidarity to the test and demands the reorganisation of the roles of the various generations in the family, including grandparents. The loss affects family members wherever they happen to be in the lifecycle, and each generation copes with the various roles and tasks that require reorganisation, producing different personal responses (Walsh and McGoldrick, Reference Walsh and McGoldrick2013).

Losing a son who had his own family creates an intergenerational asymmetry and upsets the balance in the family. The absence of the deceased results in the loss of his roles as spouse and father. The loss of a significant figure undermines the boundaries of the family and upsets the balance of roles in it, requiring family members to adapt to new roles and to old ones that assume a new form (Bowen, Reference Bowen1978; Bowlby-West, Reference Bowlby-West1983). In multigenerational families, loss of the parent in the middle generation challenges the grandparents, who are required or expected to take on some of the parent's functions. Multigenerational relations become more significant precisely in crisis situations because of the need for practical and emotional support, which is significant and often essential for the grieving spouse, the grandchildren and the grandparents (Mahne and Huxhold, Reference Mahne and Huxhold2014). The death of a family member is followed by changes in the family routine, uncertainty about the new family roles, and a sense of stress and isolation (Holmes et al., Reference Holmes, Rauch and Cozza2013; Kaplow et al., Reference Kaplow, Layne, Saltzman, Cozza and Pynoos2013; Das et al., Reference Das, de Valk and Merz2017).

The literature deals extensively with grandparenthood and in-laws relations, but less is known about the effect of loss on the role of grandparents as a result of change in family relations and of the absence of the son/husband/father (Gewirtz and Youssef, Reference Gewirtz, Youssef, Gewirtz and Youssef2016). The implications of the relationship between bereaved mothers (mothers-in-law) and widows (daughters-in-law) on the relationship between bereaved mothers and their grandchildren in the wake of the loss has not been studied to date; in particular, there have been no studies about changes in the access of bereaved mothers to their grandchildren after the loss of the son/husband. Thus, the purpose of the present study is to examine the perception of the relationship between grandmothers (bereaved mothers, mothers-in-law) with their grandchildren (orphans), by widows (daughters-in-law) and grandmothers, after the loss of their husband/son.

The effect of losing a son and husband on multigenerational relations

A great portion of the research dealing with questions related to the family coping with loss falls under the conceptual framework of stress management research. Two key theories addressing this issue are the Family Stress Model (FSM) and the critical role transition theory.

The FSM deals with the threat that stress poses to family members’ mental wellbeing. The tension and loss associated with stressful events such as divorce, illness or death affect relations within the family and impair its ability to cope with these situations. According to this theory, a stressful event experienced by one family member affects all the other members, upsets the family balance, and affects the members’ functioning in the family and how they continue to fulfil previous roles and take on new ones. This is a period of disequilibrium characterised by confusion, helplessness and a sense of disorientation. The results may be reflected in a change in the family structure and in the interaction patterns between family members (Patterson, Reference Patterson2002). The significance of the stressful event (death of the son, husband, father) serves as a framework for understanding grandparent–grandchild relations in a situation of loss (Mahne and Huxhold, Reference Mahne and Huxhold2014; Allen and Henderson, Reference Allen and Henderson2017).

Role transition theory deals with family relations following dramatic life events, such as divorce or death. The theory emphasises the manner in which families respond to the loss in the early stages of its occurrence, and on the way in which the initial response shapes family relations later. Shortly after the event, members of the family are looking for ways to deal with the situation and are pondering a new division of roles, adopting new behaviours. This is a critical time, in which emotional and instrumental support provided by the extended family is of importance, shaping the relations between the generations in the present and the future (Doyle et al., Reference Doyle, O'Dywer and Timonen2010). Grandparents play an important role at such times and can be a stabilising force for parents. The emerging need for help increases the grandparents’ sense of commitment and involvement in supporting the multigenerational family (Mahne and Huxhold, Reference Mahne and Huxhold2014). When grandparent–parent relations are described as positive, family adaptation to the state of change is better. Furthermore, positive relations between the grandparents’ and the parents’ generations were found to have a positive effect on the quality of the relations with the grandchildren (Doyle et al., Reference Doyle, O'Dywer and Timonen2010).

By contrast, there is research evidence that a stress event, such as divorce or death, may trigger conflicts in multigenerational relations, and at times it has led to a breakdown in grandparent–grandchild relations. In the case of grandparents, damage to the relations with the grandchildren following the stressful event has caused harm to their sense of wellbeing and has led to manifestations of distress, anxiety and confusion (Becker and Steinbach, Reference Becker and Steinbach2012; Sims and Rofail, Reference Sims and Rofail2013).

Grandparent–grandchild relations occur in a multigenerational context. Parents play a central role as mediators in the relations between grandparents and grandchildren. Some studies have found that the quality of the relations between parents and their children and between parents-in-law and daughters-in-law has a crucial effect on the type, extent and quality of relations of grandparents with their grandchildren, both in childhood and in adulthood (Doyle et al., Reference Doyle, O'Dywer and Timonen2010; Westphal et al., Reference Westphal, Poortman and Van der Lippe2015).

Grandparent–grandchild relations in light of the relations with the generation of the parents: the parent as mediator

One of the main theories to address the relations between grandparents and grandchildren is the parent-as-mediator theory, which emphasises the role of parents (the middle generation or G2) as mediators of the relations between grandparents and grandchildren. According to this theory, parents are facilitators who promote opportunities to connect grandparents with their grandchildren, but can also limit these opportunities (Doyle et al., Reference Doyle, O'Dywer and Timonen2010; Westphal et al., Reference Westphal, Poortman and Van der Lippe2015). When parents encourage interaction between grandparents and grandchildren, the relations take on a supportive, positive and rewarding character, the frequency of interaction increases, and the range of activities becomes wider and richer (Xu et al., Reference Xu, Chi and Wu2018).

The bridging function of the middle generation is exercised as a function of their perception of the desired or preferred role for the grandparents. According to the research literature, the desired model of grandparenting and the desired style of relations between grandparents and grandchildren are shaped by the women in the family, and the matrilineal lineage takes precedence over the patrilineal one. This preference is based on women being the facilitators and advancers of intergenerational relations, because they are traditionally closer to their family of origin than men are (Fingerman, Reference Fingerman2004; Doyle et al., Reference Doyle, O'Dywer and Timonen2010; Westphal et al., Reference Westphal, Poortman and Van der Lippe2015). This tendency strengthens the relations between grandchildren and the mother's parents, as opposed to the father's parents. Note that from the grandparents’ point of view as well, the emotional connection with their own children is stronger than that with their sons- and daughters-in-law. This family dynamic influences the type, extent and nature of the relations with grandchildren (Fingerman and Hay, Reference Fingerman, Hay, Pillemet and Luscher2004). At the same time, if the relations between the mother-in-law and the daughter-in-law are close and positive, the relations between the grandmother and her grandchildren will be similar to the relationship between the grandchildren and their grandmother on the mother's side (Monserud, Reference Monserud2010).

There are only a few studies of widowers raising their children after the loss of their partner, and limited research on parental gender differences following the death of a spouse (Yopp and Rosenstein, Reference Yopp and Rosenstein2013; Yopp et al., Reference Yopp, Park, Edwards, Deal and Rosenstein2015). Even fewer studies have focused on relations with the in-laws (grandparents) after the loss. Researchers claim that following divorce, the access to grandchildren of paternal grandfathers and their side of the family is limited (Harper and Ruicheva, Reference Harper and Ruicheva2010). One explanation is that in the past, when their wives were alive, men were dependent on their wives in shared parental responsibilities, and after the loss hesitate to ask for help and perceive receiving help from others as a sign of weakness (Yopp et al., Reference Yopp, Park, Edwards, Deal and Rosenstein2015).

Research shows that the history of the relations between grandparents and the middle generation has implications for grandparent–grandchild relations. The nature and quality of these dyadic relations affect the readiness of parents to receive assistance from the grandparents, which influences and shapes the quality and frequency of interactions between the grandparents and grandchildren, so that when the dyadic relations between the grandparents and parents are good, the grandparents are more involved in their grandchildren's lives (Becker and Steinbach, Reference Becker and Steinbach2012). Note that studies on the relations between mothers-in-law and daughters-in-law also confirm that past relations between the two greatly affect their relations after the death of the son/husband (Barnett et al., Reference Barnett, Scaramella, Neppl, Ontai and Conger2010; Segev et al., Reference Segev, Regev, Hochman, Zafrany, Sherfi and Elkayam2021).

Following the death of the husband, widows (daughters-in-law) serve as the bridge between the generations. The relations between bereaved mothers and widows are described in the research literature as complex and ambivalent, involving stress and conflict alongside support, love and acceptance (Allendorf, Reference Allendorf2017; Segev et al., Reference Segev, Regev, Hochman, Zafrany, Sherfi and Elkayam2021).

The implications of this relationship for grandparent–grandchild relations have been investigated to date within the framework of studies of family relations following divorce or illness. The studies explored the role of the parent, of the middle generation, as mediator between the grandparents and grandchildren. The bridging function takes on a unique form when one of the spouses is absent from the family structure or when there is a substantive change in the relations in the family. For example, it has been found that a dramatic change in family structure following a divorce or the death of one of the parents affects the relations between the grandparents’ and the parents’ generations, G1 and G2 (Westphal et al., Reference Westphal, Poortman and Van der Lippe2015; Jappens and Van Bavel, Reference Jappens and Van Bavel2016, Jappens, Reference Jappens2018). It has also been found that following divorce, the relations between the parents and their family of origin (their parents) become stronger, whereas the ties with the family of the former partner are weakened. The parent who is the primary care-giver of the child or who has custody of the child exercises greater control over access to the child and becomes the ‘gatekeeper’ of the contact between grandparents and grandchildren (Westphal et al., Reference Westphal, Poortman and Van der Lippe2015). For example, it has been found that grandparent–grandchild relations were more severely impaired with the father's parents, because the mother was often responsible for raising the children (Jappens and Van Bavel, Reference Jappens and Van Bavel2016; Jappens, Reference Jappens2018).

Involuntary harm to the relations between grandparents and grandchildren, due to an event such as divorce or death, is experienced as a significant loss of relationship, affecting the grandparents’ mental and emotional state. Studies have shown that the loss of relations with grandchildren has resulted in mourning reactions in grandparents (Drew and Silverstein, Reference Drew and Silverstein2007). Grandparents expressed a desire and yearning to renew the relations. The grandchild's absence from the grandparent's life was experienced as harmful to the grandparenting function, with the grandchildren not physically but psychologically present in the grandparents’ mind. This is an ambiguous loss (Boss, Reference Boss2010), which brings together conflicting feelings, the hope of reuniting with the grandchild and renewing the relations, alongside a sense of mourning. These feelings increase stress and mental pain, and create confusion. The ambiguous loss also raises identity questions (am I still a grandparent?) at a time when grandparents are mourning their sons, resulting in a continuum of two simultaneous losses (Drew and Silverstein, Reference Drew and Silverstein2007).

In sum, the professional literature sheds light on the situations of family coping with loss: the changes in family relations, in general, and on the relations between mothers-in-law and daughters-in-law, in particular, and on the role of the parent's generation as mediators between the grandparents’ and grandchildren's generations. Yet, the effect of these changes on the relationships between grandparents and grandchildren, and especially on the access of grandmothers to their grandchildren after the loss of their son, have not been investigated to date. The aim of the present study is to explore the perception of bereaved mothers (grandmothers) and of widows (daughters-in-law) of the relationships between the bereaved mothers and their grandchildren after the loss of the son/husband/father and of the effect these relations have on the access of grandmothers to their grandchildren.

Methods

The present study is а part of a larger one that examines the relationship between daughters-in-law and mothers-in-law following the loss of the husband/son from the points of view of widows (daughters-in-law) and bereaved mothers (mothers-in-law) (Segev et al., Reference Segev, Regev, Hochman, Zafrany, Sherfi and Elkayam2021). The study of the dynamics of these relationships was based on a qualitative methodology deriving from the phenomenological tradition (Starks and Trinidad, Reference Starks and Trinidad2007). We aimed to examine how the participating women perceived grandparenthood following the loss of their husband/son.

The research questions were:

  1. (1) What is the bereaved mothers’ perception of the relationship with the grandchildren orphaned of their father? How do widows feel regarding the relationship of bereaved mothers with their son's children?

  2. (2) How did the loss affect the bereaved mothers’ access to their grandchildren and what kind of relations can be identified in the triangle consisting of the bereaved mother (grandmother), the grandchildren and the widow?

Study population

The study sample included ten bereaved mothers and ten widows from different families, whose sons/husbands died in various circumstances when they were serving in the Israeli military forces – the army, the police or the security forces. Of the deceased sons/husbands, seven were killed in road accidents, six on active duty, one in a natural disaster, four died of disease, one in combat and one in a terrorist act. The sample population was assembled with the help of social workers in the Family and Commemoration Department of the Ministry of Defense. The participants were interviewed in 2018.

At the time of death of the husbands/sons, the widows’ ages ranged between 25 and 43 years, with an average of 33 years, and they were mothers of children in elementary school or younger. The bereaved mothers’ ages ranged between 48 and 72 years, with an average of 59 years. At the time of the interviews, the widows’ ages ranged between 32 and 56 years, with an average of 45.4 years; the bereaved mothers’ ages ranged between 56 and 87 years, with an average of 68.4 years.

Data collection

We conducted semi-structured, in-depth interviews to investigate the subjective experience of the bereaved mothers and of the widows with respect to grandparenting relations with the children of the deceased. We also sought to trace the dynamics of the relations between the widow and her husband's family over time. We designed an interview guide, beginning with a broad question about family relationships, with emphasis on relations between the daughter-in-law and the mother-in-law, followed by questions on the relations of the bereaved mothers with their grandchildren after the passing of the children's father, for example: ‘Tell me about the relationship between you and your grandchildren since the loss’ and ‘How did the evolving relationship between you and your daughter-in-law affect your relationship with the children?’

Three experienced social workers (with 12–30 years of practical experience with bereaved families, as part of their clinical work) conducted the interviews. None of these social workers worked directly with the participants within the framework of their job. They were trained by the authors in conducting in-depth qualitative interviews. The interviews took place in the homes of the respondents; on average, they lasted from an hour to an hour and a half. Audio recordings of the interviews were transcribed verbatim.

Data analysis

Thematic analysis of interview data was carried out in several stages (Braun and Clarke, Reference Braun and Clarke2006). First, the authors read all the interviews in sequence to become familiar with the data. Each author recorded first impressions of the interviews and extracted the main topics from the recordings (Braun and Clarke, Reference Braun and Clarke2006). Next, every interview was analysed separately by the authors. We carried out an inductive process of open coding of the data, to derive the units of meaning from each interview. We proceeded by identifying recurring patterns of significance in the various interviews and combining them into categories. In the third stage, we examined the categories and grouped them into themes, first sorted separately by interview, then for all the interviews together. In the course of the analysis, the authors compared and discussed their findings.

Trustworthiness of the study

The three authors analysed the transcripts separately. As a group, we discussed the coding to identify the differences in perception and bridge the gaps, until agreement was reached. In the last stages of the research process, we conducted peer debriefing to re-examine our assumptions and interpretation of the findings (Creswell and Miller, Reference Creswell and Miller2000).

Ethical considerations

The study was approved by the Ethics Committee of the School of Social Work at Sapir Academic College. The interviewees received a detailed explanation about the purpose of the research, and were briefed regarding the protection of the confidentiality of their personal information. Each respondent signed an informed consent form. All identifying details were obscured to preserve the privacy and confidentiality of the participants. Information obtained in the course of the interviews was not made available to the social workers in charge of the participants’ cases.

Findings

The purpose of this study was to examine the meaning and nature of the relations between the bereaved mothers (grandmothers) and their grandchildren from the perspective of the bereaved mothers and of the widows, in light of the relationship between the two women after the loss of the son/husband, and to examine whether it affected the access to their grandchildren. Participants stated that the grandmother–grandchild relation was central to the dynamic of the relations between the bereaved mother and the widow after the loss of the son/husband. Grandmother–grandchild relations were related to the systemic change that took place in the family following the loss, and which brought together various elements of power relations, feelings and motivations of the women. The interviews revealed three key patterns of the grandmother–grandchild relations, as perceived by the women, in light of the relations between bereaved mothers and widows following the loss. For each of the patterns, we present the dynamics of the relations between the three parties – grandmothers (mothers-in-law), mothers (daughters-in-law) and grandchildren – from the perspectives of the bereaved mothers and of the widows.

First pattern: ‘three monkeys’ communication style (not seeing, not hearing, not talking)

The central feature of this pattern is that in order to maintain family cohesion and contact with grandchildren, communication between bereaved mothers and widows is limited, cautious and hesitant. This pattern was present mainly in the bereaved mothers’ accounts, which depict hesitancy in direct communication and a penchant towards silencing disagreements and discrepancies to maintain their important relations with the grandchildren. This caution was also reflected in the accounts of some of the widows, as illustrated below.

The bereaved mothers described the great effort they invested in maintaining contact with grandchildren, and the fact that maintaining the relations depended on their understanding that they should exercise caution in their relations with their daughters-in-law, show restraint, stifle feelings of anger, and absorb criticism and insults. Here is how Lea (60), a bereaved mother, described the situation: ‘I feel like I'm racing against time to maintain the relations with her and the children. I invested a lot in this connection, I didn't follow her lead, I didn't judge even when I was angry.’ Rachel (62), another bereaved mother, elaborated as follows:

I set everything aside for my granddaughters, so that at least we stay on good terms with these girls … I can keep silent to keep the peace between us.

It is evident that the intense yearning of the bereaved mothers for contact with the grandchildren is inextricably linked to silence, restraint, anger regulation and the ability to overlook offences in their relations with their daughters-in-law.

The widows also described the importance of restraint for maintaining relations between their mothers-in-law and children. For example, Sharon (37), one of the widows, described her need for patience and restraint in her relations with her mother-in-law, even when she was angry:

What options do I have right now? Break relations? I try not to break it off. I need more patience. Pretty soon they [the grandchildren] will do it by themselves. Whoever [of the grandchildren] wants will go, and whoever doesn't won't.

Lora (42), another widow, described her restraint and understanding of the grandmother's emotional state, when her mother-in-law tried to interfere in the grandchildren's education. This is what she told her mother-in-law:

I choose not to answer, I choose not to answer you right now. I think you're in a bit of an emotional state. I think it surprises me what you say and we'll discuss it on another occasion.

This pattern of silence and restraint can be found both in the widows and in the bereaved mothers, but it was more pronounced for bereaved mothers, where it was present in the statements of seven bereaved mothers, as opposed to only three widows.

The ‘three monkeys’ pattern of communication attests to the price and sacrifices that bereaved mothers and widows are willing to pay, and to the importance of bereaved mothers’ connection with their grandchildren, both for them and for the widows, so that they consciously adopt a unique communication pattern to maintain this relationship by any possible means.

Second pattern: dynamics of conflict, breakdown in relations and power struggles – opening the Pandora's box

This relationship pattern revealed the encounter between the various forces, emotions and motivations of the bereaved mothers and widows. The process of family change following the loss created a dynamic of overt and covert power struggles between the bereaved mothers and the widows regarding the grandchildren. It was evident that the different perceptions and positions of the two women in the lifecycle, together with the history of family relations, in general, and of the two women, in particular, gave rise to a dynamic of account settling and struggles that shaped family relations after the loss. In this dynamic, the voice of the widows was more prominent than that of the bereaved mothers, although the latter also reported on the power struggles, but to a lesser extent.

The widows’ remarks revealed that the power struggles and conflicts were both covert and overt, and that some of the widows had even gone to court over the relationship of the grandmother with the grandchildren. Eva (41, widow) described:

There is no connection today. It takes two to tango. The other side needs to want it too. The kids are already big. They're not small kids to tell them what to do.

Yael (34, widow) described: ‘Someone else would have cut off relations altogether, and yet I let them see the kids…’ The bereaved mothers described conflicting events in which they felt victims of the situation, as noted by Rebecca (68): ‘She started going around saying that we took the orphans’ money.’ Lily (55, bereaved mother) described:

There's no contact … She said that we are bad people who take the children's money … She told me: ‘If you come to the child's graduation party in the kindergarten, I'll call the police.’ When I came, she shouted it to the kids. I kissed the children and said: ‘When you're big, come.’

The power struggles and conflicts were reflected in struggles over money, inheritance, grants from the Ministry of Defense and the right to see the children:

There was a fear regarding the inheritance among my husband's brothers. They heard that the grandfather included my sons as well in his will … The judge told me: ‘Don't let the children lose their grandmother.’ (Anat, 38, widow)

The differences in content and style between bereaved mothers and widows suggest a shift in the power structure in post-loss family relations, and are explained in some of the interviews as a result of the change in family composition: the absence of the husband/son who was a significant figure in maintaining contact between generations. His absence places great responsibility on the widows, who are required to cope with the complex matter of child rearing. They feel that the children are their sole responsibility, and therefore the decisions concerning them are at their discretion. Eva (29), one of the widows, explained: ‘They [the grandparents] always wanted to see her [the granddaughter] and I said: “she grows up she'll make her own decisions.”’ Sharon (37), another widow, said:

I brought a lawyer and told my father-in-law: ‘Do you want to see your grandchildren? Do you want them to visit you?’ I need a house. They can't take my house away. So he signed everything.

The change in the balance of family power is reflected in the relations between the bereaved mothers and their grandchildren, as it is evident in the reports of both groups: the weakening of the bereaved mothers in the balance of power and the increased feeling of power of the widows which affect their access to their grandchildren. In some of the interviews, the widows’ statements regarding the relations with the mothers-in-law ranged from belligerence, manifest as a sense of power, including punishment of their mothers-in-law for behaviours perceived as abusive or discriminatory, to the realisation that the grandmothers’ function is important for their children. But even the widows who expressed understanding and a desire to maintain close relations with their mothers-in-law expressed their ability to shape relations and control the communication between the children and their grandmothers.

In some cases, the tension between the bereaved mothers and widows was rooted, according to their statements, in unresolved conflicts from the past, which at times opened the Pandora's box. In cases where there were past conflicts in the family relations or conflicts following the loss, a multigenerational triangle was formed that included the bereaved mother, the widow and the grandchildren. Some of the widows and bereaved mothers described situations in which there were tensions at the beginning of the relationship.

Anat (38, widow) described a conflictual past relationship in which she felt that her mother-in-law was domineering. Anat went on to describe the relations after her husband's death, when her mother-in-law continued in the same vein and tried to manage Anat's life and relations with her daughter. The struggle for control seems to have begun even before the marriage, but was manifest over the years and has affected the multigenerational family ties:

When we met, I saw that they were very primitive … Sometimes they interfered with me, and I didn't like it. Especially my mother-in-law was very bossy. After David [the husband] passed away … she'd call me three times, four times, ‘What's going on?’ What's wrong with once a day? Once a week? Twice a week. Sorry, I can't talk to you every day! I really started to set them right. When I was with them when he was alive, I was more pleasant. Now I became assertive. I said I won't let them walk all over me. No way. To make a long story short, they always wanted to see the granddaughter, see the granddaughter, see the granddaughter.

The bereaved mothers also reminisced about the beginning of the relationship with their daughters-in-law, and at times made the connection between the history of this relationship and the relations with the grandchildren after the loss. Miriam (70) described the thread linking the past and the present: ‘She didn't want the girl to be brought to us. Relations with her were not good already before.’ When relations in the past were perceived as positive, it was manifest and affected relations also in the present. Both parties made the connection between past relations and the present, and some of them thought that past relations were the reason for conflicts and a cause to limit the access of grandmothers to the grandchildren.

In conclusion, this pattern emphasises the critical role of the widow in the grandmother's access to the grandchildren and suggests that a relationship characterised by conflicts and tensions between the bereaved mother and the widow blocks the bereaved mother's access to the grandchildren. These conflicts are related both to the history of the relationship between the two women and to the issues that arise following the loss.

Third pattern: dynamics of split loyalty

Some bereaved mothers and widows noted the sensitive position of children who were torn between loyalty to their mothers and to their grandmothers. They indicated that the grandchildren were a tool in the power struggle between the women. Some of the interviews suggest that the children were used as a tool in the conflict through incitement and defamation. It is possible to glean from the interviews that this situation has implications for the interaction between grandparents and grandchildren, and the emotional state of the grandchildren. Often, the bereaved mothers showed awareness of the position of the children, and some of them renounced the relations to protect the grandchildren, despite the heavy price they felt that they were paying.

For example, one of the bereaved mothers, Rebecca (68), described how the widow deliberately prevented her relationship with the grandchildren: ‘I understood that she doesn't let the children come near, talk…’ Miriam (70), another bereaved mother, said:

I haven't seen the girl for a whole month. She said, I can't give her to you. She said to the kindergarten teacher, don't let her see the children.

Some situations were even more extreme, with the grandchild expressing intense anger towards the grandparent. For example, Annette (49), one of the bereaved mothers, related that her grandson told her: ‘You are my enemies.’

Some bereaved mothers were aware of the heavy price the grandchildren paid for the conflicts of loyalty they experienced. For example, Annette related: ‘Grandparents have rights, but if the mother doesn't agree, I won't exercise them by force … and will not cause harm to the girl.’ Awareness of the conflict of loyalty, which exacts a price of severed relations, was at times accompanied by pain for not being able to see the grandchildren. Lea (60, bereaved mother) said: ‘The girl is in the middle. I'm in pain because of the loss, and because I cannot see the girl.’

Bereaved mothers pointed out the complex situation in which the grandchildren found themselves, being forced to choose sides. Siding with their mother meant going against the grandmother, and indirectly against the memory of the father, who is no longer alive. This is illustrated in the following excerpt, in which Rachel (62, bereaved mother) told her five-year-old grandson not to say that he loved her, adding that this was the reason the grandchildren were afraid of coming to see her:

Once when there were disputes, I took him for a walk around the house and told him, Yanivchik, if they ask whether you love me, don't say [that you love me]. He looked at me, and he's five years old. That's why they're scared of coming.

The widows also described the dynamics that cause their children to identify with them. In some interviews, the widows provided a rational explanation for the refusal of their children to be in contact with the grandmother, laying the blame on the behaviour of the grandmothers, who were depicted as cold, lacking love or sensitivity. Anat (38, widow) said: ‘When they were little they didn't want to go to see the grandparents at all, they felt that something was not right, they are not treated with love…’ She explained the grandchildren's reluctance to associate with the grandparents by the inappropriate behaviour of the grandparents, which resulted in broken relations or anger. The widows’ statements indicated understanding and even support for the children distancing themselves from their grandmothers. For example, Sharon (37, widow) said: ‘Their [the grandparents’] comments were always biting. Today the children are very angry with them. They're not willing to see them.’

Split loyalty was present in the accounts of both groups of women, but in the case of the bereaved mothers (grandmothers) it was accompanied by expressions of pain and a feeling of missing out, and hints at the understanding of the split loyalty conflict in which the grandchildren find themselves. In the statements of the widows, the main motif was that of understanding the physical and emotional distance created between their children and grandmothers.

In this relationship pattern, the price paid by the children/grandchildren as a result of the dynamics of the relationship between their widowed mothers and their bereaved grandparents is evident. It is clear that the use of the children by both parties as a tool of balance in the struggle that serves the interests of each party, is a destructive pattern that harms the children/grandchildren.

In sum, the findings suggest that the central themes of the two groups of women attest to the key function of the multigenerational relationship in bereaved families. Both bereaved mothers and widows addressed extensively the central place of the relationship with the grandchildren as shaping the dynamic of the relations between the bereaved mothers and the widows. The three main patterns that were described above reveal the complexity in managing the relationships after the loss in the face of conflicting interests and different motivations of the two parties, which shaped the relationships between the three generations. Both groups of women depict the complexity and ambivalence of multigenerational relations. The perception of relations ranged from the desire to preserve and strengthen them to anger and disappointment in them. The state of relations with the grandchildren was reflected in the communication between the women and in expressions attesting to the change in the balance of power in the family following the loss.

Discussion

The aim of the present article was to examine the patterns of relationships in the multigenerational family with regard to the relations between bereaved mothers, widows–children/grandchildren following the loss of a son/husband/father. The focus of the investigation was the relations between bereaved mothers and their grandchildren, as they emerge from the perspective of two groups of women: the bereaved mothers and the widows. The study drew on approaches and understandings that have been confirmed over many years in the gerontological research regarding the centrality of the grandparent's role for older people and its contribution to their personal sense of wellbeing (Hank et al., Reference Hank, Cavrini, Di Gessa and Tomassini2018; Hayslip and Fruhauf, Reference Hayslip and Fruhauf2019). The findings of the present study lend support to the research trend that places great importance on the meaning of the grandparent's role in life-changing situations, including situations of loss.

The literature review revealed scarce and partial studies concerning the relations between bereaved mothers and grandchildren following the loss of the son/father. The few studies that dealt with the consequences of loss for multigenerational relations have not addressed the relationships between bereaved mothers and widows, and their implications for the relations between bereaved mothers and grandchildren. The innovation of the present study was to address these questions. We believe that although the study examined the relationships in bereaved families of military personnel, the findings may reflect dynamic processes in bereaved families in the general population as well.

The findings of the study indicate the importance of the relations between bereaved mothers and grandchildren, and reveal the complex and ambivalent nature of these relations after the loss of the son/father, as well as the pivotal role of the widows in shaping these relations. The findings show that both bereaved mothers and widows attach importance to these relations, which reinforces what is already known from the gerontological literature about the centrality of relations with the grandmothers in multigenerational family life (Mahne and Huxhold, Reference Mahne and Huxhold2014; Gewirtz and Youssef, Reference Gewirtz, Youssef, Gewirtz and Youssef2016; Hank et al., Reference Hank, Cavrini, Di Gessa and Tomassini2018).

The research findings shed light on the multi-faceted dynamics of the relationship between bereaved mothers and their grandchildren, and the patterns of relations formed in the grieving multigenerational family after the loss. The asymmetry in the multigenerational family structure resulting from the death of the son/husband appears to upset the existing balance and to produce a change in family relations, with consequences for the relations between bereaved mothers, widows and children/grandchildren.

Intergenerational solidarity theory (Bengtson and Roberts, Reference Bengtson and Roberts1991) suggests that the death of the spouse/son harms family solidarity. Based on the women's stories, the patterns presented in the article demonstrate harm or change in all six dimensions of family solidarity: association, affect, consensus, functional, normative and family structure (Bengtson and Schrader, Reference Bengtson, Schrader, Mangen and Peterson1982).

In the families surveyed, the opportunities for family interaction between the bereaved mothers and their grandchildren decreased, and the sense of belonging and the connection between the bereaved mothers and the widows, the degree of agreement on various issues, especially regarding raising the grandchildren, and the relationship style were harmed. All of these affected the system of connections between the three generations. Bengtson and Roberts's theory (1991) serves as the framework that explains the degree of solidarity or conflict within the family.

The critical role transition theory (Doyle et al., Reference Doyle, O'Dywer and Timonen2010; Mahne and Huxhold, Reference Mahne and Huxhold2014) regards the role of grandparents in times of crisis as significant and critical because of the need of the family for parental help during this period. These arguments were not supported by the present study. Based on what both bereaved mothers and the widows stated, these relations did not play an influential or stabilising role, and it is possible that the grandparents’ bereavement makes this function more difficult. Nevertheless, the interviews with the bereaved mothers revealed a desire to maintain relations with their grandchildren, but no new and meaningful role was described, attesting to the fact that the bereaved mothers’ function as grandmothers was not as central as expected. Patterns of silence and avoidance, as well as of conflicts in multigenerational families following the loss, are two sides of the same coin, and they suggest the presence of dynamic processes in the multigenerational family. On one hand, there is a pattern manifest in silence and restraint on the part of the bereaved mothers (grandmothers), suggesting a strong desire for connection with the grandchildren, possibly as a way of maintaining contact with the son who is no longer alive. On the other hand, patterns of conflict, disagreement and even break-up were also present in the responses of both parties. The bereaved mothers perceived the grandchildren as an extension of the son and as a way of preserving his memory. These expressions appear to indicate dynamic processes, together with a fear of conflict and anxiety over abandonment of the grandparents by their grandchildren. This theme is present in the interviews with most bereaved mothers, and it includes the need to turn a blind eye, not to speak up, to give in, to absorb criticism in order not to lose contact with grandchildren, to appease and to maintain the family ties.

Alongside this pattern, conflicts were revealed in the relations between the bereaved mothers and widows that affected relations with the grandchildren. The mutual criticism of the two groups of women is an expression of the ambivalence of their relationship. Vulnerability is evident in the statements of both bereaved mothers and widows. The mutual criticism was often in the open, and it was manifest in limiting the contact between grandmothers and grandchildren, and in threats to sever the ties. According to the theory of the parent as a mediator (Doyle et al., Reference Doyle, O'Dywer and Timonen2010; Westphal et al., Reference Westphal, Poortman and Van der Lippe2015), the bridging function between grandparents and their grandchildren is usually fulfilled by the mother. Studies concerning the theory of the parent as a mediator have found that the middle generation can encourage interaction between grandchildren and grandparents but also limit it. This theory points out that the women (in our case, the widows) have greater influence on the relations, and notes that in the case of divorce, for example, relations become stronger with the wife's family than with the husband's, because the women generally have custody of the children (Fingerman, Reference Fingerman2004; Monserud, Reference Monserud2010; Jappens and Van Bavel, Reference Jappens and Van Bavel2016). The findings of the present study reinforce these claims and shed light on the central role of the widow in the intergenerational relations after the loss of the son/husband. The influence of the widows also appears to be reinforced by the asymmetric relations when the son/husband is absent. It is important to clarify that the children in this study were at the age of elementary or nursery school – not old enough to have an independent relationship with the grandparents, which strengthened the vital role of the widows as gatekeepers. The widows indeed became the gatekeepers, and as such were able to open the gate completely, partially or close it altogether.

The three patterns of relationship described in our findings demonstrate the growing power of the widows, especially the two patterns characterised by the silence and restraint of the bereaved mothers, and the conflictual pattern. With regard to the latter pattern, the study also examined the implications of past relations between bereaved mothers and widows for the relations between grandmothers and grandchildren. The patterns of the past were mentioned in the stories of both groups of women in a way that reflects both positive and negative aspects of past relationships. These findings strengthen the conclusions of earlier studies investigating the relations between mothers-in-law and daughters-in-law, and showing that past relations between the two greatly affect their relations after the death of the son/husband (Barnett et al., Reference Barnett, Scaramella, Neppl, Ontai and Conger2010; Segev et al., Reference Segev, Regev, Hochman, Zafrany, Sherfi and Elkayam2021). In some cases of bereaved mothers and widows, a Pandora's box of negative memories and claims was opened, leading to distancing and separation between grandmothers and grandchildren. Yet in some other cases, a toolbox of resources with positive memories was opened, contributing to ongoing relations between bereaved mothers, widows and children/grandchildren following the loss. The literature contains similar findings on the ambivalence that characterises relations between mothers-in-law and daughters-in-law and on the influence of past relations (Kim and Kim, Reference Kim and Kim2015; Shih and Pyke, Reference Shih and Pyke2016).

The last pattern presented identified a dynamic of split loyalty of the grandchildren in response to the relationship between bereaved mothers and widows. The findings show that grandchildren are often used as tools in the power struggles between the two women and are exposed to mutual slander. This dynamic of split loyalty and the consequences for intergenerational relations is related to the term ‘relational ethics’, coined by Boszormenyi-Nagy (Reference Boszormenyi-Nagy1987). Mutual respect, fairness and loyalty play a central role in family relations. When members of the family feel that these qualities are injured, tension and even breakdown in the relations can occur. The difficulties the women experienced in communicating directly with each other seem to have placed the grandchild into the relationship triangle between them. The projection process described here is consistent with the family projection processes described by Bowen (Reference Bowen1978). The bereaved mothers and the widows painted a complex multi-dimensional picture of the vulnerable emotional state of the children, and they were aware of the emotional cost that children may pay because of the conflict of loyalties of which they are part. These findings are consistent with the body of research showing that conflicts between the grandparents’ and the parents’ generations are a stress factor that affects the mental health of the grandchildren's generation (Cummings and Schatz, Reference Cummings and Schatz2012). The bereaved mothers’ and the widows’ stories depicted the use of the grandchildren as a tool in intergenerational conflict, mentioning at the same time an understanding of the harm caused to the children, and at times even renouncing the relationship altogether, so as not to harm the children. The children's exposure to the opposing interests and involvement in the dynamic of split loyalty may have both short- and long-term consequences, not only for the relations of the grandmothers with the grandchildren, but also for the children's mental health.

Summary

The study reinforces what we already know from the literature about the importance of grandmother–grandchild relations in old age, and the central place these relations occupy in the life of the multigenerational family. The study sheds light on the special place of these relations in families that have lost the son/husband, and the consequences of disrupting the family balance and of the asymmetry created by the absence of the son/husband in the relations between bereaved mothers (grandmothers) and their grandchildren. The present study adds a new dimension to this issue, which has been scarcely investigated to date, by shedding light on the implications of the fabric of relations between bereaved mothers and widows on the patterns of relations between bereaved mothers (grandmothers) and their grandchildren. The change in the family relationships affects also the types of relations created in the family, emphasising the role of the widows as the middle generation in shaping relationships in situations of loss. The findings highlight the importance of clinical interventions that focus on relations between bereaved mothers and widows after the passing of their son and husband.

Limitations and recommendations for further research

The present study sheds light on relations in the multigenerational family from the retrospective point of view of bereaved mothers and widows and on the relations between grandparents and their grandchildren after the death of the son/father. The grandchildren's perspective on the relationship is brought here through the eyes of the two groups of women. Future research is needed to examine the perspective and the story of the grandchildren at the heart of this research. Another limitation of the study is that it does not include dyads of bereaved mothers and widows from the same family. Future research on the subject should focus on dyads within the same family and shed light on the relationship within a particular family unit following the loss.

Acknowledgements

We wish to thank Ms Yafa Zafrany, Ms Yafa Sherfi and Ms Ayelet Elkayam, from the Southern District of the Department of Families and Commemoration of the Israeli Ministry of Defense, for conducting the interviews with the participants.

Financial support

This work was supported by the Department of Families and Commemoration of the Israeli Ministry of Defense.

Ethical standards

The study was approved by the Ethics Committee of the School of Social Work at Sapir Academic College.

References

Allen, KR and Henderson, AC (2017) Family Theories: Foundations and Applications. Malden, MA: Wiley.Google Scholar
Allendorf, K (2017) Like her own: ideals and experiences of the mother-in-law/daughter-in-law relationship. Journal of Family Issues 38, 21022127.CrossRefGoogle Scholar
Barnett, MA, Scaramella, LV, Neppl, TK, Ontai, L and Conger, RD (2010) Intergenerational relationship quality, gender, and grandparent involvement. Family Relations 59, 2844.CrossRefGoogle ScholarPubMed
Becker, OA and Steinbach, A (2012) Relations between grandparents and grandchildren in the context of the family system. Comparative Population Studies 37, 544566.Google Scholar
Bengtson, VL and Roberts, RE (1991) Intergenerational solidarity in aging families: an example of formal theory construction. Journal of Marriage and the Family 53, 856870.CrossRefGoogle Scholar
Bengtson, VL and Schrader, S (1982) Parent–child relations. In Mangen, D and Peterson, WA (eds), Research Instruments in Social Gerontology, Vol. 2. Minneapolis, MN: University of Minnesota Press, pp. 115186.Google Scholar
Boss, P (2010) The trauma and complicated grief of ambiguous loss. Pastoral Psychology 59, 137145.CrossRefGoogle Scholar
Boszormenyi-Nagy, I (1987) Foundations of Contextual Therapy: Collected Papers of Ivan Boszormenyi-Nagy, M.D. New York, NY: Routledge.Google Scholar
Bowen, M (1978) Family reaction to death. In Family Therapy in Clinical Practice. New York, NY: Aronson, pp. 335348.Google Scholar
Bowlby-West, L (1983) The impact of death on the family system. Journal of Family Therapy 5, 279294.CrossRefGoogle Scholar
Braun, B and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.CrossRefGoogle Scholar
Creswell, JW and Miller, DL (2000) Determining validity in qualitative inquiry. Theory into Practice 39, 124130.CrossRefGoogle Scholar
Cummings, EM and Schatz, JN (2012) Family conflict, emotional security, and child development: translating research findings into a prevention program for community families. Clinical Child and Family Psychology Review 15, 1427.CrossRefGoogle ScholarPubMed
Das, M, de Valk, H and Merz, EM (2017) Mothers’ mobility after separation: do grandmothers matter? Population, Space and Place 23, 114.CrossRefGoogle ScholarPubMed
Doyle, M, O'Dywer, C and Timonen, V (2010) ‘How can you just cut off a whole side of the family and say move on?’ The reshaping of paternal grandparent–grandchild relationships following divorce or separation in the middle generation. Family Relations 59, 587598.CrossRefGoogle Scholar
Drew, LM and Silverstein, M (2007) Grandparents’ psychological well-being after loss of contact with their grandchildren. Journal of Family Psychology 21, 372379.CrossRefGoogle ScholarPubMed
Fingerman, K (2004) The role of offspring and in-laws in grandparents’ ties to their grandchildren. Journal of Family Issues 25, 10261049.CrossRefGoogle Scholar
Fingerman, KL and Hay, E (2004) Intergenerational ambivalence in the context of the larger social network. In Pillemet, K and Luscher, K (eds), Intergenerational Ambivalences: New Perspectives on Parent–Child Relations in Later Life. Oxford: Elsevier, pp. 133152.Google Scholar
Gewirtz, AH and Youssef, AM (2016) Parenting and children's resilience in military families: a twenty-first century perspective. In Gewirtz, AH and Youssef, AM (eds) Parenting and Children's Resilience in Military Families. Cham, Switzerland: Spring International Publishing, pp. 19.CrossRefGoogle Scholar
Hank, K, Cavrini, G, Di Gessa, G and Tomassini, C (2018) What do we know about grandparents? Insights from current quantitative data and identification of future data needs. European Journal of Ageing 15, 225235.CrossRefGoogle ScholarPubMed
Harper, SD and Ruicheva, I (2010) Grandmothers as replacement parents and partners: the role of grandmotherhood in single parent families. Journal of Intergenerational Relationships 8, 219233.CrossRefGoogle Scholar
Hayslip, BJ and Fruhauf, CA (eds) (2019) Grandparenting: Influences on the Dynamics of Family Relationships. New York, NY: Springer.CrossRefGoogle Scholar
Holmes, AK, Rauch, PK and Cozza, SJ (2013) When a parent is injured or killed in combat. The Future of Children 23, 143162.CrossRefGoogle ScholarPubMed
Jappens, M (2018) Children's relationships with grandparents in married and in shared and sole physical custody families. Journal of Divorce & Remarriage 59, 359371.CrossRefGoogle Scholar
Jappens, M and Van Bavel, J (2016) Parental divorce, residence arrangements, and contact between grandchildren and grandparents. Journal of Marriage and Family 78, 451467.CrossRefGoogle Scholar
Kaplow, JB, Layne, CM, Saltzman, WR, Cozza, SJ and Pynoos, RS (2013) Using multidimensional grief theory to explore the effects of deployment, reintegration, and death on military youth and families. Clinical Child and Family Psychology Review 16, 322340.CrossRefGoogle ScholarPubMed
Kim, MJ and Kim, YJ (2015) Experience of relationship between mother-in-law and daughter-in-law among Korea rural married immigrant women: with a focus on daughter-in-laws from China, Vietnam and the Philippines. Indian Journal of Science and Technology 8, 307314.CrossRefGoogle Scholar
Mahne, K and Huxhold, O (2014) Grandparenthood and subjective well-being: moderating effects of educational level. Journals of Gerontology: Psychological Sciences and Social Sciences 70B, 782792.Google Scholar
Monserud, MA (2010) Continuity and change in grandchildren's closeness to grandparents: consequences of changing intergenerational ties. Marriage & Family Review 46, 366388.CrossRefGoogle ScholarPubMed
Muller, Z and Litwin, H (2011) Grandparenting and psychological well-being: how important is grandparent role centrality? European Journal of Ageing 8, 109118.CrossRefGoogle ScholarPubMed
Patterson, JM (2002) Integrating family resilience and family stress theory. Journal of Marriage and Family 64, 349360.CrossRefGoogle Scholar
Segev, E, Regev, I, Hochman, Y, Zafrany, Y, Sherfi, Y and Elkayam, A (2021) Widow-bereaved mother relations following the loss of husband/son: a double perspective. Family Relations 70, 4358.CrossRefGoogle Scholar
Shih, KY and Pyke, K (2016) Seeing mothers-in-law through the lens of the mothering ideology: an interview analysis of Taiwanese American and Mexican American daughters-in-law. Journal of Family Issues 37, 19681993.CrossRefGoogle Scholar
Sims, M and Rofail, M (2013) The experiences of grandparents who have limited or no contact with their grandchildren. Journal of Aging Studies 27, 377386.CrossRefGoogle ScholarPubMed
Starks, H and Trinidad, SB (2007) Choose your method: a comparison of phenomenology, discourse analysis, and grounded theory. Qualitative Health Research 17, 13721380.CrossRefGoogle Scholar
Thomas, PA, Liu, H and Umberson, D (2017) Family relationships and well-being. Innovation in Aging 1, igx025.CrossRefGoogle ScholarPubMed
Walsh, F and McGoldrick, M (2013) Bereavement: a family life cycle perspective. Family Science 4, 2027.CrossRefGoogle Scholar
Westphal, SK, Poortman, AR and Van der Lippe, T (2015) What about the grandparents? Children's postdivorce residence arrangements and contact with grandparents. Journal of Marriage and Family 77, 424440.CrossRefGoogle Scholar
Xu, L, Chi, I and Wu, S (2018) Grandparent–grandchild relationships in Chinese immigrant families in Los Angeles: roles of acculturation and the middle generation. Gerontology and Geriatric Medicine 4, 18.CrossRefGoogle ScholarPubMed
Yopp, J, Park, E, Edwards, T, Deal, A and Rosenstein, D (2015) Overlooked and underserved: widowed fathers with dependent-age children. Palliative and Supportive Care 13, 13251334.CrossRefGoogle ScholarPubMed
Yopp, JM and Rosenstein, DL (2013) A support group for fathers whose wives died from cancer. Clinical Journal of Oncology Nursing 17, 169173.CrossRefGoogle ScholarPubMed