The negative impact of addiction is not limited to the patient. It also affects caregivers, who are already dealing with increased physical and emotional stress. “Alcohol and nicotine have high rates of recidivism,” says Laura Sunn, MD, psychiatrist at Cancer Treatment Centers of America® (CTCA) in Zion, Illinois, “which makes it hard on the caregiver to remain neutral. But when people are under the influence of alcohol or a substance, you need to remain neutral to have a higher chance of success in communicating with them.”
Caregivers can also feel frustrated, says Lynn Bornfriend, MD, psychiatrist at CTCA® in Philadelphia, Pennsylvania. “They may say to the patient, ‘I told you this would happen, but you just kept doing it’ or ‘Why should we treat you for cancer if you’re going to continue smoking or drinking?’”
Often caregivers view the person’s addiction problem as a reflection of poor caregiving on their part, “so patients and caregivers will fight about the caregiver being perceived as over-controlling or domineering or bullying or treating the patient like a child,” Dr. Bornfriend says, adding, “The other side is patients who become recalcitrant or oppositional. I spend a lot of time talking with families about these issues.”
Caregivers not only are at risk for burnout but may also slide into their own dependence issues—smoking or drinking more than they had previously. Recognizing the important role of caregivers and their specific needs, CTCA offers a wide range of supportive services. “We have caregiver support groups, offering group therapy and an opportunity for caregivers to support one another,” Dr. Bornfriend says. “We also have Cancer Fighters® and our Cancer Fighter Care Network, where patients can support one another and their family members. All of our departments support and treat our caregivers.”
Even the design of each CTCA hospital, which features social spaces throughout the buildings, can be powerful sources of comfort. “People get a lot of support just sitting with people in the dining room or by the fish tanks. The culture is such that people strike up conversations,” Dr. Bornfriend adds. “It’s a good coping mechanism for the people who are offering the help as well as the people receiving it.”
Family members and caregivers are also encouraged to reach out to organizations such as Al-Anon for support close to home, which can provide a much-needed lifeline for those who are struggling to meet the needs of their loved one while also safeguarding their own health and well-being.