‘A good ending but not the end’: Exploring family preparations surrounding a relative’s death and the Afterlife – A qualitative study

Background: Adequate death preparation positively influences families’ experience before death and during bereavement. However, how to prepare families in non-Western cultures has received scant attention. Aim: To explore family caregivers’ experiences in preparing for a relative’s death in specialist palliative care in Taiwan. Design: A qualitative study employing reflexive thematic analysis of data collected from semi-structured interviews was conducted. Setting/participants: Twenty-two family caregivers from seven hospitals participated. Results: The overarching theme was ‘getting everything right to have no regrets between the dead and the living’. We developed two themes to explain preparations for the time surrounding and after the death, including the deceased’ afterlife: (1) ‘having a good ending but not the end of the relationship’, which addresses preparations for the death itself, the funeral, the afterlife and maintaining connections and (2) ‘using religious beliefs and cultural norms to guide preparation’, which explores perceptions of a good death, including refrain from strong emotions before and after the death. Conclusion: Funeral arrangements, enhancing the deceased’s afterlife and maintaining connections to the deceased are crucial for families’ experiences which can be impacted by actions they take as they prepare for the death. A culturally appropriate death is beneficial for the dying relative which includes preparing to not show strong emotions during and after the death. These insights inform the importance of the cultural context in death preparation in Taiwan and provide perspectives for palliative care beyond Western culture, potentially benefiting Chinese populations, predominantly East Asian and Buddhist societies.