Temporary distancing was one strategy family caregivers employed to cope with the stress.

Alcohol use disorder (AUD) is a major global public health issue, affecting more than 28 million adults in the United States and causing 3 million deaths each year worldwide. The impact of AUD extends beyond the individual. At least five people are affected by an individual’s drinking problem, with family members typically stepping into the role of primary caregiver.

Caregivers, burdened by the severity of alcohol-related issues, frequently struggle with ineffective coping, leading to feelings of hopelessness. However, most research focuses on helping individuals with AUD and promoting abstinence, neglecting their support systems. To foster a holistic approach, it’s crucial to address this gap and better understand the needs of family caregivers.

Researchers at Florida Atlantic University’s Christine E. Lynn College of Nursing conducted a qualitative study to deeply explore the lived experiences of family caregivers and uncover the essence of their role in caring for a relative with AUD. A small sample of family members across the U.S. took part in one-on-one, audio-recorded interviews, either in person or virtually.

Researchers used Van Manen’s hermeneutic phenomenological approach, which focuses on understanding human experiences by interpreting and reflecting on how individuals make sense of their lived realities. It combines a deep, descriptive analysis of personal experiences with a focus on uncovering the meaning behind those experiences.

Results of the study, published in the Scandinavian Journal of Caring Sciences, reveal six major themes that emerged: traversing the peaks and valleys; wandering in the unknown; pointing fingers; weathering the storm; drawing a line; and looking back, looking in. These themes shed light on the diverse obstacles, coping strategies and personal demands the family caregivers face. The study underscores the need for improved support systems, resources and evidence-based interventions for family caregivers to mitigate the emotional and physical toll of caring for a relative with AUD.

Findings show family caregivers often experienced feelings of isolation, confusion and powerlessness due to the lack of clear resources, information and support. This uncertainty contributed to emotional distress, with many caregivers feeling guilt, inadequacy and self-blame, which can strain relationships and perpetuate maladaptive family dynamics. While some caregivers developed adaptive coping mechanisms such as therapy, prayer and medication, others resorted to maladaptive strategies like substance use, which offer only temporary relief.

The isolation experienced by caregivers is largely due to the scarcity of support systems, as resources are predominantly focused on individuals with AUD rather than their families.

“The family members’ experiences illustrate the many challenges that they faced, which impacted their social, emotional and psychological well-being. Yet, they never relinquished their role as caregivers,” said Clarene E. Brown-King, Ph.D., first author and an instructor in the Christine E. Lynn College of Nursing. “Their experiences embody caring, compassion and support by being committed to the care of their relatives during the challenging moments.”

Despite facing overwhelming emotional, social and psychological tolls, the family caregivers never abandoned their role, demonstrating unwavering commitment to their relatives. Their experiences illuminated both the struggles and the meaning they found in caring for someone with AUD, often leading them to reflect on their own behaviors and past choices. Many caregivers, however, lacked prior experience and knowledge of how to best support their loved ones, resorting to trial and error in their caregiving approaches.

Though deeply concerned for their relatives’ well-being, these caregivers also recognized the importance of their own mental and emotional health. Temporary distancing was one strategy they employed to cope with the stress.

“Caregivers play a vital role in supporting individuals with alcohol use disorder, but the challenges they face can take a toll on their health. Effective coping strategies and tools to set healthy boundaries are essential. Health care professionals, support organizations and policymakers must work together to create solutions that meet the unique needs of these family caregivers,” said Beth Pratt, Ph.D., co-author and an assistant professor at the Christine E. Lynn College of Nursing and a faculty fellow at the FAU Institute for Human Health and Disease Intervention (I-HEALTH).

Study co-authors are Kyndall Mammah, Ph.D., an assistant professor in the Christine E. Lynn College of Nursing and Wanda Morancy, DNP, an instructor in the Christine E. Lynn College of Nursing.

This work was supported by the Christine E. Lynn College of Nursing, Office of Nursing Research and Scholarship and the Florida Nurses Foundation Research Grant.

-FAU-