Background Bereavement profoundly impacts caregivers, especially adult children who lose a parent. Grief may become complicated when cultural, relational, and spiritual conflicts remain unresolved. Rituals rooted in local tradition can serve as powerful psychospiritual interventions, yet they remain underutilised in mainstream palliative bereavement care. Case Presentation We describe the case of a 32-year-old unmarried man who developed severe grief-related distress following the death of his 60-year-old mother from metastatic ovarian carcinoma. As her sole caregiver and emotionally dependent companion, he experienced intrusive images of her suffering, guilt, insomnia, anorexia, and inability to work. He also expressed a culturally rooted fear that his mother's soul remained in distress, creating profound spiritual dissonance. The Brief Grief Questionnaire (BGQ) score was 9 out of 10, indicating high risk for complicated grief. His bereavement occurred during Diwali, intensifying a sense of incompleteness in shared rituals of light and remembrance. Conventional counselling offered minimal relief, as his grief was anchored in unaddressed cultural–spiritual obligations. A culturally informed intervention, the Pāyā Śhrāddha ritual in Odisha, was recommended to provide symbolic fulfilment of filial duty and spiritual release. Following the ritual, he reported significant emotional relief, cessation of intrusive imagery, restored sleep, and functional recovery. His BGQ score improved from 9 to 3, remaining stable at 6-week follow-up. Conclusion This case highlights the therapeutic power of culturally grounded rituals in addressing grief sustained by spiritual–moral conflict. Integrating indigenous practices such as Pāyā Śhrāddha into bereavement care can promote meaning-making, resolve guilt, and support recovery where conventional counselling alone may be insufficient. Culturally responsive, ritual-aware approaches should be recognised as vital components of holistic palliative care.
Mahapatra et al. (Sat,) studied this question.