Meaning-Making in Home-Based End-of-Life Care: A Qualitative Study of Wives’ Experiences after the Loss of Their Husbands to Cancer

Background Caring for a spouse with cancer during the end of life at home is an emotionally demanding experience that can have lasting effects on bereaved partners. For some spouses, this caregiving period becomes a source of meaning, personal growth, and relational reconstruction after loss. However, existing research has not fully explored the creative processes that unfold over time after loss, particularly how spouses derive positive meaning from caring for a husband with cancer at home or how they rebuild relationships. This study investigated how spouses who had provided home care for a partner with cancer, and who had interpreted the end-of-life caregiving experience positively six months to two years after bereavement, subsequently understood and reinterpreted that experience two years later. Methods Using a qualitative longitudinal design, we conducted a second interview (approximately four years after bereavement) with spouses who participated in the first interview (six months to two years post-bereavement) and provided renewed consent. Data obtained through semi-structured interviews were transcribed verbatim and analyzed by conducting sequential comparative analysis. Results The analysis yielded five themes: “the enduring bond of the married couple,” “the importance of family members who spent time together until the end,” “the meaning attached to caring for the husband in the terminal phase,” “confronting life without the husband” and “reflection on one’s way of life”. Wives who had initially attributed positive meaning to their caregiving experience gradually reconfigured their relationship with their husband, shifting from viewing it as a “concluded past” to a “relationship that continues in the present.” Conclusions The meaning-making process surrounding care for a dying spouse did not remain fixed after bereavement; it evolved as a dynamic, ongoing reinterpretation. The findings indicate that positive meaning-making after loss deepens over time and is accompanied by relational growth. Through end-of-life care support, visiting nurses can understand how spouses “make meaning of their marital relationship” and provide opportunities for narrative exchanges that lead to post-bereavement re-meaning.