Grief is a universal phenomenon, affecting every age and culture However, the literature reveals that this concept is surrounded with ambiguity and conflicting research findings There are few studies which focus on the grief of older widows, and none which focuses on the grief of older women whose husbands received hospice care The purpose of this longitudinal study was to generate a conceptual definition and theory of grief for older adult women using grounded theory methodology Informants comprised six older widows whose husbands were enrolled in a hospice programme in a southern metropolitan setting in the United States Each informant was asked to respond to the initial question ‘What is your experience in dealing with the loss of your husband?’ Interviews were conducted in the widows' homes after the deaths of their husbands during the following three time frames of bereavement 1–4 months, 7–10 months and 13–16 months Interviews were audio-taped, transcribed, coded and analysed using the constant comparative method Oracle, a text-oriented database management computer program, was used to facilitate the creation, storage, coding, analysis and retrieval of data Cross-comparisons of the findings from the three phases of data collection were made and these findings were compared with the literature The following core concepts emerged from the data ‘being aware’, ‘experiencing distress’, ‘supporting’, ‘coping’ and ‘facing new realities’ Core concepts were combined into a conceptual definition of grief and a grounded theory of grief of older adult women whose husbands experienced hospice care was developed The results of this study expand our knowledge of the grief process of older widows whose husbands received hospice care and have implications for the development of effective bereavement intervention programmes